Midwives, Chiropractors & Risk
Many chiropractors who have family, wellness and subluxation centered practices work with midwives, doulas and other birthing professionals. This is great as there is a great deal of synergy and acceptance between the professions.
However, there are some things you should be aware of and some steps you need to take to protect yourself and your practice when and if you are working in this area.
If the relationship involves the sharing of office space in any way make sure you get a copy of the midwife’s malpractice policy or declarations page and keep it on file making sure you get an updated one each year. Even if you are not sharing space – get a copy of their declarations page to verify they have coverage. Do not, under any circumstance, share space with a birthing professional or refer to one who does not carry malpractice coverage. If something goes wrong and the patient is walking through one door to see the both of you guess what the perception is going to be and guess who is going to get named in the lawsuit? If you referred them to a midwife that does not share space but who does not have coverage and something goes wrong guess who is going to get dragged into the suit through a vicarious liability charge? Better to give your expectant mother a list of midwives to choose from rather than working with only one.
If you are working with a birthing center you should consult with an attorney regarding that relationship. There are many questions to address. Do you or should you have a contract with them? Are you seeing patients within their facility? If you are seeing patients in their facility are you listed on their malpractice coverage? Where are the records kept?
You can see how the water gets muddy real fast.
What about hospitals? I know chiropractors who attend births in hospitals and even adjust the mother and the baby right then and there. Do you have hospital privileges? In what universe is a health care provider allowed to provide care to a patient in a hospital when they do not have privileges in the hospital? Imagine having to answer those questions in a deposition or in front of the 12 people who could not get out of jury duty. If you are comfortable with the nurse who looks the other way – please get uncomfortable with that.
Also, keep in mind that the majority of states do not allow you to practice obstetrics and I am not aware of any malpractice insurer within the profession that offers coverage for chiropractors practicing obstetrics.
Finally, remember that whether we like it or not many states define chiropractic as being primary care so if something goes wrong during the delivery and you are in the room and you have the broader scope license it might be tough to lay all the blame on the midwife.
As always I look forward to your feedback, comments and suggestions.
Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures Malpractice Program
matthewmccoy@comcast.net
http://www.chirofutures.org
