Articles July 31, 2014

Malpractice Stability Hangs on Proven Procedures

By Stuart E. Hoffman, DC, FICA – ChiroSecure President

The headlines across the nation in recent months have featured a host of stories about medical doctors going on strike or dropping out of practice because of huge and growing malpractice premiums. From emergency room physicians in Las Vegas walking out, to MDs in Pennsylvania not renewing their licenses in protest of upwardly spiraling premiums, the cost of risk and liability continues to erode the economic stability and certainly the peace of mind of some classes of health care professionals. Fortunately, for now, the doctor of chiropractic remains the envy of the doctor-level health professional since DC malpractice rates are but a fraction of those paid by the MD. The drugless, non-invasive nature of chiropractic science and practice, along with the skill and abilities of the average doctor of chiropractic, combine to offer the public the most effective and certainly the lowest risk option available in health care today.

Even with all the massive investment in medical training, technology and pharmaceuticals, the statistics on medical errors and the incidence of drug reactions and improper application of drugs, etc., show irrefutably that seeking the care of the MD a dangerous endeavor in its own right. These are not my findings or a matter of opinion. This state of affairs is documented by findings by government, the third-party payment industry and objective medical organizations and institutions. The malpractice backwash is logical, predictable and unavoidable. The reason for so much medical malpractice and such high medical malpractice premiums is so much bad medicine. Is this the falling star to which chiropractic should hitch its wagon?

This should be a glaring signal to the chiropractic profession regarding the risks and liabilities inherent in seeking to extend chiropractic’s scope of practice into the realm of medicine. The current discussions underway in Council of Chiropractic Education (CCE) circles are, from my perspective, far to cavalier and far to naïve to let go by without comment from the malpractice perspective. Motivated by these concerns, I submitted a letter to the CCE, in response to the comment opportunity afforded by the accrediting body. I believe every DC should read my comments and consider where the best interests of chiropractic, now and in the future, are to be found. I told the CCE:

As the chief operating officer of a chiropractic risk purchasing group and insurance concern that provides malpractice coverage to thousands of doctors of chiropractic across the United States, I have a unique perspective on several of the proposed standards changes recently published for comment by the Council on Chiropractic Education (CCE). This perspective is based on a detailed knowledge of matters of liability and professional responsibility, plus a real-world experience with the jeopardy the doctor of chiropractic places him or herself in when steps are taken to exceed the established boundaries of chiropractic science and practice.

The clear expansion of liability potential inherent in two of the proposed changes in CCE standards is of special, indeed, urgent concern. I refer to a desire on the part of some within the CCE to substitute the term “primary care physician” for established chiropractic reference terms such as doctor of chiropractic. This step is clearly beyond what state laws and regulations authorize for the doctor of chiropractic and carries with it significant consequences, all dangerous and potentially economically devastating. Likewise, the initiative to “include physiotherapy in doctor of chiropractic degree requirements and in the clinical competencies.” This step is certainly to be interpreted as a signal to the underwriting industry of the need to recalculate risk/premium equations, a step that will cost every doctor of chiropractic additional malpractice premium expenses, regardless of how or where they practice.

It is clear to the objective observer that these proposals represent a political and philosophical orientation that is out of step with the realities of chiropractic practice and inconsistent with legal and regulatory norms. It would seen reasonable to expect an accrediting body to tailor all demands on institutions and students to the strict legal definitions in operation throughout the nation. These proposals seek to drive the educational process and thus the profession in an entirely new direction, not supported by any discernable legal underpinning. Such steps would be a gross disservice to the student, practitioner and educational institution, with equal prejudice. I urge that these items be withdrawn from consideration in recognition of the unnecessary, costly and disruptive impact such expansive initiatives are certain to have on the profession in active practice.

Because we are clear about who we are and what we do, and confident in the effectiveness of our science, ChiroSecure is able to offer highly competitive rates, quality service and continued stability in coverage. Within this solid context, I invite you to see what ChiroSecure can do for you. Service, anchored in proven procedures and chiropractic’s timeless principles, is ChiroSecure’s mission. 1-866-80-CHIRO, 1-866-802-4476 Ext. 11, or on the web at: