Chiropractic is a Hands on Profession

One of the reasons chiropractic is so beneficial for people and why they give us such high marks when it comes to offering compassionate care is because we do more touching of our patients than perhaps any other health care provider. There can be no question that just the simple act of touching our patients in an effort to not only find out what is causing their problems but then also to correct the underlying cause has health related benefits in and of itself.

But, as with most things, there is another side to this and that is what happens when that touch is interpreted as something else by the patient.

Any accusation from a patient that you did something to hurt them is always difficult to handle given that the reason you got into chiropractic was to help people. Even harder to take is the accusation that you did something sexually inappropriate during your care of a patient or crossed a “boundary” and made your patient uncomfortable.

For the chiropractor inexperienced with such allegations what can happen next is extremely distressing and oftentimes overwhelming. Most times the patient will file a complaint with your State Board. Some will file a civil cause of action. Those that are highly agitated with do both. There are a lot of things that will be important at this point but one very critical thing is:

• What resources do you have available to provide a quality, credible defense for yourself?
• Does your malpractice insurance cover the defense of false patient boundary/sexual misconduct allegations?
• Is there a limited dollar amount of defense costs covered?

At ChiroFutures, we understand that ours is a “hands on” profession. We’ve also seen enough of these claims over the years to know how devastating they can be to your life and threatening your very livelihood. That’s why we provide stronger protection than many carriers in this area.

Take a close look at your malpractice insurer’s coverage in this area. Not everyone offers comprehensive coverage for false, sexual boundaries issues. So your first step in being proactive on this issue is to make sure you have the best protection.

Next, you’ll want to make sure you are in the habit of explaining what you are doing to your patients:

First, what you are going to do before you do it, next, why you are doing it, then where you will be touching them and lastly and most important get their permission to proceed before actually touching them.

While you are used to touching people regularly and getting into their personal space remember that the average person is not going around touching people all day long.

Give your patient the opportunity to get used to the idea. This is especially true if you are going to be touching them in any areas that non-intimate partners don’t usually touch them. These include but are in no way limited to: Pelvic and hip adjustments, anterior thoracic “hug” adjustments, any adjustments or palpation to the chest, clavicles, shoulders etc.

if you are going to need to get skin on skin for an adjustment in the lower back, pelvis, sacrum or coccyx make sure you tell them exactly what you are doing and why before you lift up a shirt or pull down on their pants. Doing a pubic adjustment on a female? Let’s make sure you are real clear on what you are doing here and why. When appropriate, ask for assistance from a CA or have them in the room.

Finally, beyond the touching issues related to sexual boundary complaints please make sure you do not engage in romantic relationships with your patients or even socialize alone with a patient. If you just fall so head over heels in love with one of your patients, take a look at the laws and rules in your state and act accordingly. In every state I’ve seen, you are going to need to end the doctor-patient relationship, find them another chiropractor and then stay away for a period of time – PRIOR to pursuing a relationship. Please don’t take any chances with this. I’ve seen too many nightmares – don’t be another one.

And for those of you reading this that are female chiropractors – don’t think all this does not apply to you. We see cases of male patients filing complaints just as easily as female patients.

So, in summary: check your coverage and make sure you have the best sexual boundaries coverage in the market and then adopt a risk management approach for dealing with this issue that involves open communication about what you are doing and why you are doing it.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
http://www.chirofutures.org