Articles July 31, 2014

Liability Insurance

Aggressive State Board Actions Are Redefining Your Practice’s Regulatory Exposure

By Stuart E. Hoffman, DC, FICA
In recent years, a new activism has emerged on the part of some state chiropractic boards in which actions against practitioners are being taken on the basis of questions of utilization and procedures that have never been a part of board scrutiny. Today, perhaps in response to pressure from third-party payment agencies, or some misplaced desire to re-define the norms of chiropractic practice, some boards have acted against practitioners for “over utilization,” x-ray policies and very general communications with the public. These types of board actions clearly push the envelope into new territory and have many believing that such boards have grossly exceeded their authority. Still, unchecked by the courts or the state legislatures, such boards can lay de facto claim to new authority, and this means that you will need to be on your guard even more than in the past.

Real cases highlight the list of strange and completely unforeseen situations in which DCs are finding themselves. In one state, a doctor was cited for misleading the public on the basis of the content of articles published in recognized journals posted or linked to his practice website. In another case, a DC was cited for overutilization for seeing a patient 12 times following a high-speed rear-end auto collision. Still another doctor was cited for failure to repay an insurance company for the care of a small child because no “series” of x-rays was taken, in spite of the fact that every safety and utilization guideline states that x-rays of children are to be avoided except in very specific situations, of which this was not one.

The source of this new wave of complaints is also of interest because almost none of these complaints dealing with practice norms come from consumers. Boards are taking the initiative themselves, responding to third-party payers, and sadly, other chiropractors, as the basis for their aggressive actions. The shaky ground that they are moving towards, however, has also prompted a number of lawsuits by the DCs who are on the receiving end of such complaints, and those DCs almost always win in the courts. The financial cost and distraction of such a suit is a very high price to pay, especially when in the eyes of most chiropractors and chiropractic organizations, the behavior cited as inappropriate is seen as well within the established norms of care.

Every doctor of chiropractic should be aware of this new exposure and consider the following preventive steps to protect themselves and their practices from such harassment actions:

Read the code and regulations in your jurisdiction and know exactly what the law says. Knowledge is power, and such knowledge allows you to be immediately aware of any instance in which it appears that the board in your jurisdiction is acting beyond their legitimate authority.

Join your state organization and the national organization of your choice and immediately seek their assistance, as well as that of your state legislator and state senator, and above all, contact your malpractice carrier to respond to such abuse of power.

Know who is on your chiropractic board and, either independently or through your state organization, monitor their actions and do not hesitate to mobilize your colleagues in protest through an organized appeal to those who have authority over the board, either the governor or attorney general, and ultimately the state legislature, to bring them back into line.

Be prepared to defend your right to practice within the law, and consult legal counsel and other authorities to determine your exact status immediately upon hearing of any potential complaint.

Make sure you have malpractice insurance that includes state board defense as a component of your coverage.

ChiroSecure has made state board defense an integral part of the coverage it offers its insured practitioners. Do you know what your coverage will do for you when the chiropractic board comes knocking on your door? Better yet, call ChiroSecure today and find out how you can have the best protection on the market, at highly competitive rates. The result will be excellent coverage as well as peace of mind.

Stuart E. Hoffman, DC, FICA , is the president of ChiroSecure, the only malpractice insurance program endorsed and approved by the International Chiropractors Association. Dr. Hoffman is a highly experienced doctor of chiropractic and licensed insurance broker who knows the intricate details of daily practice and who can give you the best advice based on his unique knowledge of both the insurance world and the world of chiropractic . To find out how you can get liability protection at the best rates call Dr. Hoffman at 1-866-802-4476 or visit