While rising malpractice rates are affecting so many health care practitioners in various fields, chiropractic remains a relative sea of calm, comparatively. High-risk medical specialties like neurosurgeons and obstetricians are paying as much as $200,000 to $250,000 or more in premiums but chiropractors, practicing a noninvasive specialty, generally have rates lower than $5,000, with rates for chiropractors remaining reasonably steady.
But by no means does that mean that any chiropractor should be blasé when it comes malpractice: In more recent times, cases that are filed tend to be more severe in nature, with fewer flippant cases than were seen in the early 2000’s. That’s a good news/bad news scenario if ever there was one; chiropractors today face less of a risk of feigned lawsuits than they did in the 1990s, but when suits are filed, there can be more serious consequences.
There are two main types of chiropractic malpractice-
1. Failure to diagnose conditions that require timely medical attention.
2. Damage from adjustment to parts of the body that have been weakened by disease or previous trauma.
Here are some ways that chiropractors can reduce their liability and kick malpractice into touch-
1. Document EVERYTHING!
Poor record keeping is one of the most common things that make it difficult to defend malpractice cases. Be sure to take accurate notes and keep accurate records. This includes adverse reactions. The common misconception from chiropractors is that they often think that if they put a negative result in the record, it may hurt them in a malpractice suit. If you have a legitimately defensible case, this record keeping can save you in a courtroom.
2. Make Sure Patients Fully Understand
Take the time to ensure your patient understands their diagnosis, treatment, and medication plans, and then check their understanding by asking them to explain it back to you. This shows the patient that you care, and it ensures instructions are properly followed. It’s essential to verbally communicate the risks before a procedure, not after—and to include this information in a written consent form that the patient signs. The patient must receive a proper explanation of the form’s purpose that clearly spells out the risks inherent in the procedure.
3. Stay on the Cutting Edge
Better diagnostic acumen is very important. The further we get out of school, the more likely we are to lose contact with our skills. It’s the same as driving a car; you get used to a certain way, often veering (pardon the pun) away from the way you were actually taught. Since not that much ‘new’ is happening in chiropractic compared to other specialties that have lots of new technology, chiropractors tend to pay less attention to continuing education. However, that doesn’t mean that there are no new learning tools out there for chiropractors. In areas where chiropractic has traditionally been somewhat weak, like report writing and documentation keeping, there are online coursework modules that can help improve these areas.
4. Policies and Procedures
All staff members should have easy and readily available access to specific policies and procedures. The policies and procedures can be kept in a notebook or manual or in an electronic format. You yourself or a committee should review policies and procedures on an annual basis to ensure that they reflect preferences and requirements.
5. Focus on Your Relationship With Your Patients and use Common Courtesy
Studies have repeatedly found that doctors, who have a good rapport with and show common courtesy to their patients, tend to get sued for malpractice less often, regardless of the facts of the case. That puts chiropractic at an advantage. A great way to keep a positive relationship is to keep notes on family members, pets, hobbies, or other areas of interest so you can talk with your patients and show that you’re interested in their lives. Remind your staff to be courteous as well as it’s the overall experience at your office, not just your interaction, the patient will judge.
6. Steer Well Clear of False Advertising
Something that many chiropractor shave been sued for is false advertisement to gain more patients. For example, a Pennsylvania based chiropractor was prosecuted after creating an advertisement that read ‘Experiencing intense, fearful, constricting chest pain? You should see a chiropractor!’ Though chiropractors could help someone with these symptoms, experts feel that severe chest pain could represent a heart attack requiring emergency care and that a delay in getting such care could be fatal. So be sure that you stick to solid, widely accepted methods and symptoms, to cover your back in a courtroom.
7. Choose Your Partners Carefully
When referring patients to other physicians, be sure that they are upstanding, honest and good at their profession. The last thing you want is to refer a patient and they end up having a terrible experience. Then all of a sudden you find yourself in the middle of a malpractice suit.
8. Be Prepared
Chiropractors and other health care professionals can often be seen as distant and rushed. It’s so important that you never compromise the time you give to preparing for appointments. Do your very best to review your patients’ files before walking in the door for an appointment, not while the patient is sitting in front of you. Again, this helps with patient relationships.
9. Learn From Your Mistakes
If a medical mistake or error does happen and the patient is harmed, tell the patient and apologize if appropriate. Offer a settlement for damages, and tell the patient that you and the organization have learned from the error and have instituted corrective actions to prevent it from happening again.
10. Consistency is Key
To significantly lower your risk of being sued, you should consistently deliver on the items listed above. Remember that each patient believes he or she has a personal relationship with you. Creating systems, guidelines and accountability for communication will reduce your chances of a medical liability suit, while also enhancing your reputation as a quality physician within your field and your community.