Who can you call for help?

by Timothy J. Feuling

If you are ever sued for malpractice, or if your state board files a complaint against you, the first thing you need to do is call your professional liability insurance company to find out if you're covered. If you are, your company will probably provide or refer you to an attorney who will defend you or negotiate with the plaintiff or the board.

Sometimes, if the complaint or lawsuit was filed as a result of an error on your part, there is little you can do except cooperate with your attorney to reach the best possible settlement of your case. Often, however -- particularly in chiropractic cases -- the situation isn't that clear cut.

D.C.s are frequently accused of malpractice (and even face board complaints!) because they focus their practice solely on subluxation correction, fail to abide by "cookie cutter" guidelines that attempt to limit care to a specific number of visits, provide care to asymptomatic patients or children, or refuse to use medical jargon in their reports. The guilt or innocence of their actions depends on the interpretation of professional standards.

The job you and your lawyer have is to compile enough evidence to prove that your actions are in keeping with professional standards. You will have to counter the opposition's "evidence" with facts of your own.

Stepping in front of a judge or jury (or a board) with a stack of documents validating the propriety of your actions would be extremely persuasive and could no doubt be the determining factor in deciding in your favor.

To help you compile this information, the WCA has formed the Chiropractic Advocacy Council.

Its main function is to allow doctors to compile important documents, background information, and other material that can be used to help them.

Conveniently, at one website, you'll find material gathered from a wide variety of sources: WCA position papers and press releases, current research reports, news articles, and expert opinion statements.

There are also links to articles which have appeared in The Chiropractic Journal, the Journal of Vertebral Subluxation Research, CBS Malpractice Reports, and Health Watch articles, as well as copies of legislative resolutions and other material.

The Advocacy website provides a list of topics, so one click can take you to numerous resources on a particular issue.

Although an incredible amount of information is available at or through the website, many doctors may prefer to retain Council Chairman Matthew McCoy, D.C., to compile the information for them, and prepare a comprehensive defense package. Dr. McCoy offers a wide variety of fee-based services to assist with nearly any situation requiring research and documentation.

Using his extensive knowledge of chiropractic and network of chiropractic experts, Dr. McCoy will be able to evaluate your case and bring together the information and contacts that will be of most help.

The importance of going into court, or before a board, fully prepared cannot be understated.

In an article for Medical Economics ("Struck by a medical thunderbolt," April 13, 1998), Richard E. Walton, M.D., tells of enduring a malpractice lawsuit, disciplinary board scrutiny, and a peer review investigation.

"Each time, I truly believed that the care I'd provided was not only proper, but probably above community standards," he explained. "That belief, however, wasn't enough to vindicate me. Instead the documentation of my care, and my active participation in the investigative and legal processes, proved crucial to my successful defense."

During the hearing, he noted, "I was armed with lots of information on the case, including extensive documentation of my evaluation, and a journal article that supported the course of treatment I'd chosen. I was confident that the more the reviewers knew about the case, the more they'd understand that my care had been appropriate."

He was right -- and ultimately cleared of all accusations in each case.

No matter how good your attorney is, you'll need to help in your own defense. "Becoming intensely involved in all of the steps required for establishing your defense while avoiding any actions that can undermine your credibility are essential for improving your chance of achieving a favorable outcome," said Dr. Levin, assistant clinical professor of medicine at SUNY Health Science Center, Syracuse, N.Y in Dermatology Times ("Surviving a Malpractice Suit Requires Resistance to Temptations," June 1999).

Compiling the necessary documentation to support your position is essential to your success in court or before the board. Turning to the WCA Council on Chiropractic Advocacy, or hiring Dr. McCoy to help with this frequently time-consuming and complex task, can be the best move you can make.

(Timothy J. Feuling is president of Chiropractic Benefit Services (CBS) and vice president of the World Chiropractic Alliance. He assists doctors in maximizing their practices through the proper choice of insurance and related services. Doctors may contact him with questions, comments, and requests for insurance quotes at 2950 N. Dobson Rd. Ste. 1, Chandler, AZ 85224, by phone at 800-883-0412 or by e-mail: feuling@cbsmalpractice.com).