At the Orthospinology Conference in Atlanta the main topic of discussion was risk management in the chiropractic industry.
At the conference Dr. Scott Rosa addressed a number of topics relating to patient care. He spoke about several topics including specifically a patients reaction to an upper cervical adjustment. Dr Scott Rosa noted that after a poor cervical adjustment, he never used the same vectors again. He emphasized the importance of reevaluating, and reanalyzing the patient following the adjustment in order to determine where the treatment went wrong. He encouraged other chiropractic practitioners to do the same when treating their patients.
No matter how long you have been in the chiropractic industry it is important to take extra care when treating your patients. When a patient responds poorly, you have to go back and reevaluate that patient. This includes reviewing their medications and previous treatments.
It can be extremely detrimental to continue to administer the same treatment again after a patient complains or does not respond well.
Some ways that chiropractors can manage risk in their practice:
1. Always keep accurate records of your initial findings, patient history, and medications they may be on as well as reevaluations you have performed.
2. Always document each visit including how the patient is responding as well as your findings on that day. Indicate how your adjustment was performed including segment, contact, line of drive, type of thrust and any other details you use for your analysis and correction. Indicate any additional specifics about the procedures you performed that day.
3. If the patient indicates that the treatment was tolerated poorly or caused any adverse reaction, make sure you document that in the notes as well as what you communicated back to the patient and what you will change going forward. This would apply to the patient reporting this while they’re still in your office or maybe they called you up, or emailed you, or even told you on the next visit.
4. Inform your staff that if the patient indicates any adverse reaction for them to immediately notify you. This should be included in the patient charts.
5. If the patient indicates there was a problem with your adjustment, this may warrant a reexamination including new imaging if necessary, to make sure you’re treatment correlates with your original findings and diagnosis. You would then want to make any appropriate changes.
6. A patient indicating that they need a little bit more here or there after you’ve already adjusted them, that does not mean that you should continue to readjust them over and over and over again on the same visit. Follow your instincts and proper guidelines.
7. Never continue to perform the same treatment to a patient that is responding poorly.
8. If a patient responds poorly, regardless of how you have adjusted them, that is an indication that the patient may be considered for referral out for a second opinion whether to another chiropractor or to another health care professional.