Workplace violence in healthcare settings is on the rise, putting providers at risk physically, emotionally, and legally. According to the Occupational Safety and Health Administration (OSHA), healthcare workers are five times more likely to experience workplace violence than workers in other industries. For chiropractors, this presents not only a safety concern, but a risk management priority. Implementing strong de-escalation techniques can protect staff, improve patient care, and reduce liability.

The Growing Threat of Workplace Violence in Healthcare
Healthcare environments are particularly vulnerable to aggression and violence. Contributing factors may include:

In the United States alone, approximately 8.6 million sports-related injuries are reported each year. All types of sports have a potential for injury, whether from the trauma of contact with other players or from overuse or misuse of a body part. By far, the most common injuries are sprains and strains.

As a doctor, you use your knowledge, experience, and medical judgment to determine the best course of treatment for your patient. However, adult patients with decision-making capacity have the right to choose or refuse to follow your treatment plan.

According to the U.S. Centers for Disease Control and Prevention (CDC), cardiovascular disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. Traditional treatment for cardiovascular disease often involves dietary and lifestyle changes, medication, or invasive procedures.

Artificial intelligence (AI) is generally defined as computer systems that can perform complex tasks that previously only a human could do, such as reasoning, decision-making, or problem-solving. AI is rapidly being integrated into our world, including healthcare. Proponents of the use of AI in healthcare believe it has the potential to make healthcare more efficient, less expensive, more accessible, and safer for patients. 

AI Software for Medical Documentation
One of the more common uses of AI in physician offices is software for medical record documentation. This AI software is being marketed as a tool to make documentation more accurate and less burdensome. AI medical documentation tools work by using advanced algorithms and machine learning techniques to analyze and interpret large amounts of data related to healthcare, including patient records, lab results, and clinical notes. A key component of these tools is natural language processing (NLP), which allows the AI to understand and generate human-like language.

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.

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.

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?