RISK MANAGEMENT MINUTE – Navigating the Complexities of Personal Injury Cases: A Risk Management Perspective
The medical and legal fields often intertwine, particularly in personal injury (PI) cases, where the determination of treatment scope, its necessity, and the associated costs can get complicated. Here's a prime example of a situation where the boundaries between clinical judgment and legal guidance became blurred and why its important to have a responsible company like ChiroFutures Malpractice Insurance Program to reach out to for guidance.
Case Overview:
A 48-year-old male involved in a severe car accident has been under the chiropractic care of Dr. Ann. Post-accident, he has experienced significant relief only through chiropractic care. However, the case, opened in November 2022, is approaching its one-year mark. With the patient having received services amounting to over $15,000, there's a question of how to proceed.
Chiropractic Care Decisions:
Based on Dr. Ann's professional evaluation and outcome assessments, the patient has reached 80% improvement. The remaining 20% can't be attributed to the accident, given the patient's comorbidities. Dr. Ann, considering the patient's well-being, had recommended a one-week maintenance program post the PI case. While the lawyer and the patient wish to continue the PI care, Dr. Ann believes she shouldn't overextend the PI treatment.
Risk Management & Insurance:
This situation underscores the importance of having a robust malpractice provider. The ChiroFutures Malpractice Insurance Program highlights the need for chiropractors to be aware of:
1. Clinical Autonomy: The chiropractor's clinical judgment is paramount. Their decisions should be based on the patient's well-being and their professional assessment.
2. Legal Boundaries: An attorney offering to pay a chiropractor directly for future services is unusual and problematic. Typically, any settlement or payment for future care is made to the patient, who then decides how to utilize it. Direct payments can pose ethical and legal risks.
3. The Importance of Impairment Rating Exams: Given that Dr. Ann believes the patient might require care indefinitely, it's crucial to conduct an impairment rating examination. This helps determine the extent of impairment and can provide a basis for future care recommendations and cost calculations.
4. Document Everything: Keeping detailed records of all interactions, assessments, and decisions is critical. This not only provides a clear treatment history but also protects the chiropractor from potential disputes or misunderstandings.
5. Open Dialogue with Legal Counsel: It's advisable for healthcare providers to clarify any ambiguities with the attorney, ensuring that both legal and medical perspectives align.
Conclusion:
In situations that combine medical assessments with legal implications, the line can often blur. Chiropractors, with the guidance of a solid malpractice provider, can confidently navigate these complexities, ensuring their patients receive the necessary care without overstepping legal or ethical boundaries.
Always remember, in the realm of personal injury cases, the balance between clinical judgment and legal guidelines is delicate but essential for the well-being of the patient and the protection of the healthcare provider.
