A patient suffers cardiac arrest while waiting in the exam room. An elderly visitor falls in the waiting room, is complaining of leg pain and is unable to get up. A diabetic staff member passes out from hypoglycemia. These are just a few examples of unexpected medical emergencies that could happen in a medical office.

Deciding to go from a private practice to a group practice is a significant step in a chiropractor’s career. It's a decision laden with considerations, from professional growth opportunities to financial implications, and of course, your malpractice coverage. Here are some key points to consider from a professional liability insurance standpoint if you are planning to join a group practice.

When a doctor does not refer a patient to a specialist for additional care, further diagnostics, or for treatment that only another physician can provide, they may be considered liable for negative consequences if the patient suffers as a result.

When a doctor does not provide a referral in time or at all, the patient may suffer serious complications, including:

A new patient comes to you for an initial visit. You perform a chiropractic adjustment based upon the patient’s complaints and much to your surprise, the patient develops increased pain or has an adverse reaction to treatment and must be referred to another provider for further workup and treatment. While this scenario doesn’t happen often, it can and does happen. And when it does, it can lead to a lawsuit against the chiropractor.

As a practitioner, you have most likely experienced an unexpected outcome in your care and treatment of a patient. It does not mean you are a bad doctor. It happens even with the most experienced doctor, but it can be very distressing for you and your patient. How can you protect yourself from risk and maintain a healthy doctor-patient relationship in the event of an unexpected outcome?

Start at the Beginning
First, prepare your patients for the possibility of an unexpected outcome. At the beginning when you’re developing a treatment plan with your patient, discuss the risks and benefits of your plan, including the most likely complications or side effects. Include a discussion of any risk factors that the patient may have that might affect the success of your plan. With medically complex patients, discuss the treatment challenges and the fact that they may require treatment from a team of specialists/healthcare professionals.

Chiropractic is a very “hands on” profession. As such, chiropractors are at higher risk for allegations of sexual misconduct by their patients. Therefore, it is of utmost importance that chiropractors appropriately educate their patients regarding chiropractic treatment and maintain healthy boundaries with their patients. 

The use of marijuana (cannabis) for medical purposes has been steadily increasing over the past few years and is becoming more widely accepted in the medical community. Polls show the public is largely accepting of marijuana use and research studies indicate that it has potential medical benefit.

Start with Informed Consent
As a practitioner, you use your knowledge, experience, and medical judgment to determine the best course of treatment for your patient. However, adult patients (and those having decision-making authority for others) have the right to choose to follow or refuse to follow your treatment plan. When a patient refuses a necessary treatment, what can practitioners do to protect themselves and their patients?

If you’re thinking about retirement, it’s prudent to start planning well in advance. If you are a solo practitioner, will you sell or wind down your practice? If you are in a group practice or employed, what are your obligations regarding providing notice of retirement? What are your state licensing board’s requirements regarding retirement? How will you retain your medical and business records? How will you notify your staff and patients of your plan to retire? What do your contracts with health insurers require when you retire from practice? Do you need to purchase professional liability insurance “tail coverage”? 

Review all contracts pertaining to your practice and consider seeking the advice of an attorney who specializes in business and/or healthcare law, your professional liability insurance carrier, your state board, and your state association for advice regarding these questions and the many other issues that arise in the retirement process. 

Here, we will discuss a few issues related to retirement from a risk management perspective.