Don't be Left Standing When the Music Stops

Chiropractors are often surprised when faced with a malpractice accusation if their patient had already seen a medical provider prior to care. They wonder why or how they are being sued for something the medical doctor, hospital or emergency room should have caught but didn't.

This is a very common misunderstanding about negligence, risk, triage and the responsibility of the chiropractor.

There are several reasons for this. First is the reality that the sole accrediting agency for the chiropractic profession mandates that chiropractic schools train chiropractors as primary care providers. Any plaintiff's attorney worth their salt is going to seize on this when going after a chiropractor.

Secondly is the simple fact that if you are the last one to see the patient it seems logical (especially to 12 people who couldn't get out of jury duty) that the last provider to see a patient is still responsible to triage the patient, and in the case of chiropractic, make sure it is safe to go ahead and adjust or otherwise manage the patient.

If we are talking about stroke and dissection for example, it seems logical to the chiropractor that if the medical provider saw the patient for the same headache and determined that nothing ominous was brewing then the chiropractor can move ahead with care.

While that might be true - there is no guarantee it is and there is no guarantee that the medical provider or the hospital did everything they were supposed to do to rule in or out ominous causes of the patients presenting complaints. In the case of stroke - an active dissection in progress.

Adding to this is the chiropractic profession's stance that only a chiropractor should be determining whether or not someone is a candidate for chiropractic care.

We simply cannot have it both ways.

The best risk management advice when a patient presents following a previous recent evaluation by medical personnel is to consider what was done, what was said and what the conclusions were but ultimately to understand that you are going to be tagged as the responsible party when and if something goes wrong after you administer care.

No matter the situation with a patient and whether its the first visit or the 100th - remember the concept of triage and the admonition to always consider on each and every visit whether it is safe to go ahead and adjust at that time. If you have any doubt - then wait. Get more information. Reconsider the situation. Talk to the previous health care provider. Get their records etc.

By doing this you at least provide evidence for the jury that you are a caring cautious doctor that went out their way to make sure it was safe to do your thing - even if things ended up turning out badly for the patient. And as we see on a regular basis the chiropractor who is paying attention this way very often saves the patient from medical error and ends up the hero.

As always we look forward to your feedback, comments and questions.