AROUND THE WORLD CHIROPRACTIC
Receiving a board complaint can have an effect on how you practice. In some states, it could be a mark on your professional record for your practice lifetime. Complaints are not public, but disciplinary action by the board will be, affecting your online presence and your ability to be credentialed with insurance companies or obtain insurance for your practice. A significant violation could destroy your reputation and even result in license suspension or revocation.
A growing number of complaints arise from multi-disciplinary practices. Even when the proper formation documents have been drafted and filed with the Secretary of State, you must still distinguish which services are provided by which providers. Some common complaints around this include:
• Misleading or deceptive advertising
• Misleading websites or social media posts
• Sexual misconduct
• Record keeping violations
Here’s how you can avoid a board complaint in these areas:
Advertising & Marketing—Make sure you represent yourself and your practice pursuant to the regulations of your state. Only offer permissible services and be clear about your credentials—sometimes patients will claim they thought they were being treated by an MD. Unclear language implying warranties or guarantees is very difficult to overcome with boards. Do not solicit outside of board regulations, particularly in auto and personal injury cases. Advertising violations can also include deceptive or misleading information, as well as superiority advertising. Be familiar with your board rules about advertising. Business cards and flyers are also considered advertising and all rules apply.
Websites & Social Media—Websites and other social media are often carelessly drafted so that it appears it is the chiropractor who is performing the out-of-scope services. All advertising and biographical information needs to be very clear about who is providing what services. A web designer might not be aware of your state’s advertising rules, so the doctor is responsible. Most of the complaints can be prevented by proper wording on advertising.
Patient Records—By far, one of the most common violations is failing to produce records timely upon patient request. Once you receive authorization from the patient to produce records, you have a certain number of days to comply with the request. Remember, production of records is typically regulated by board rules and HIPAA. Not producing your records can result in disciplinary action with fines from the board, but also a HIPAA investigation and sanctions.
While you may charge a fee for a copy of your records, you may not withhold the records for the nonpayment of a bill. Instruct your staff to inform you when records have been requested. Too often the staff does not respond to the request, without your knowledge, but it is your license that will be disciplined.
Sexual Misconduct—In the past few years, complaints of sexual misconduct—real or imagined—have increased significantly nationwide. A large percentage of these complaints are consensual relationships, but consent is not a defense to the rule prohibiting an intimate relationship with a patient. Many states have statutes which make intimate relationships between health care providers and patients a violation of criminal statutes.
The degree of sexual misconduct also varies significantly—from sexual assault to inappropriate touching—making communications and the informed consent process critical. It’s important to communicate with patients about examinations and treatments. The practitioner should explain, in detail, what the delivery of the treatment will entail and the rationale for it. A good rule of thumb is to over-explain what you are doing and why. If the patient is uncomfortable, offer them a patient advocate to be in the treatment room with them. Common sense still applies.
How to Avoid a Board Complaint in Any Case
• Know and understand the rules and check for updates.
• If your licensing board puts out a periodic newsletter, read it. Review the board’s website for recent disciplinary actions.
• Attend quality continuing education on ethics and risk management.
• Communicate with your patients.
• Audit your own practice’s record keeping and billing to make sure you and your staff are complying with the rules.
• Have staff meetings to discuss board rules and expectations. Remember, complaints wifi always be your responsibility.
NCMIC is committed to helping doctors through every stage of their practice. Learn more about NCMIC's top case studies, webinars and podcasts at NCMIC.com/TAC.
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