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It is worth noting these reports are only first-base reports for injuries described as 'predominantly soft-tissue' - ie nothing's broken.

I think a better approach to medco reports would have been to agree then publish a template of the expected procedure for the doctors to follow aka some guidelines rather than observe doctors are not doing x or y as part of the process.

A bigger issue for me as a bulk purchaser of the reports are the thematic responses therein - in 2017 an awful lot of reports came back with travel anxiety diagnosed (curiously enough fixable with CBT, a product that just happened to be available through that provider), 2018 has been the year of pain management despite Jenner's noble attempts at self-immolation on the witness stand.

Medco companies see the reports as loss-leaders where they can recommend unnecessary further reports from experts on their own books, which are not fixed fee.

The shell-company and the agency-by-any-other-name issues are attempts by medco to prevent entities from 'gaming the system' and are laudible, but in truth what this tells us is medco's priorities lie with controlling the income streams rather than any concerns about report quality - they themselves built their audit team after the systems went live.

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