Whether you are new to the ChiroFutures family or have been with us for awhile please make sure that you are HIPAA compliant. At ChiroFutures we took the hassle out of you having to worry about this. Our Members Only section has a complete turn key package for all your HIPAA needs.

So just go to the Members Only section, follow the instructions for HIPAA implementation and you will be all set. Let us know if any questions or concerns. 

Click Here to Go Directly to Members Only Section

There is probably nothing more confusing for chiropractors in regards to purchasing malpractice insurance than the comparison and contrast between a Claims Made and Occurrence policy. So lets take a couple of minutes and walk through them.

First up – COST. Occurrence policies are generally more expensive than claims made policies because you are charged for tail coverage (included in the premium) every year with the purchase of an annual occurrence policy. This is one reason its more expensive. With a claims made policy, tail coverage is a just one time charge when coverage is no longer needed.

ChiroFutures offers FREE tail coverage if you become permanently disabled or you have been insured with us for 3 or more years and are at least 55 years of age.

A claims made policy is more appropriate for insuring a lifetime profession like chiropractic. The reason being is that claims made policies mature with a doctor throughout their career. For example, if a DC had an occurrence policy and had an incident that occurred 10 years ago but was reported today, will that occurrence policy have the proper coverage to address the claim given how policy coverage changes over time?

If the standard limit of liability today is 1M/3M but in 10 years, increases to 2M/4M due to the rising costs of attorney fees, adverse litigation, etc… then the ability to report an incident to your current (up-to-date) claims made policy is more favorable than reporting an incident to an occurrence policy you had ten years prior.

Keep in mind that a company writing an occurrence policy could go out of business. In fact, they do go out of business and they have. Some reading this who have been in practice awhile will recall that there are several companies that wrote occurrence policies  in the chiropractic profession that are no longer in that business. Some just recently experienced this as two companies stopped writing chiropractors.
 
I should add that if a DC moves from one claims made carrier to another without any lapse, the new carrier will pick up prior acts coverage (retro-active date), so it’s not necessary to purchase a tail from the current carrier.

If a DC needs to purchase a tail (Extended Reporting Period) for whatever reason, it is a onetime charge of about 120% of the annual policy premium for a mature Claims Made policy. This tail or extended reporting period will extend for the rest of the DC’s life.

A claims made policy offers coverage for an event that occurs on or after the retroactive date but was first made against an insured during the policy period. The claims made policy is inexpensive at first and gradually increases over a period of time (4 years) to a “mature” premium.

Claims made policies offer flexibility - meaning that changes can be made to your current claims made policy and then they will apply to all your years of coverage back to your retroactive date. For example: If you increase your limits of liability at renewal on a claims made policy, the new limit of liability can be applied to all the years back to your retroactive date. On an occurrence policy, prior policies cannot be changed.

If you still decide to get an occurrence policy, make sure you retain copies of ALL of your policies throughout the years and be aware of the consequences if one of those insurance carriers goes out of business - who would you report the claim to?

As always I look forward to your feedback, questions and comments.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
www.chirofutures.org
   

Following a conversation I had while speaking on the subject recently I thought it might be worth it to review a couple of key points with regards to informed consent.

In this particular case a few in the audience were under the impression that a signed informed consent is akin to a “Get Out of Jail Free Card” if you’ll pardon the crude Monopoly reference.

In order to have the beginnings of a successful lawsuit, a plaintiff’s attorney must show two things at a minimum: 

1. The plaintiff (patient) suffered an injury from something the doctor did or didn’t do but should have.
2. The actions of the chiropractor fell below the standard of care

Doctors do things all the time to patients that might result in harm but if there was no violation of the standard of care and the doctor did what any other reasonable doctor would have done in the same or similar situation then its more a matter that something happened beyond the doctor’s control which could not have been predicted  

There is a great deal of nuance to this and every case is unique but you get the general idea.

Now, let’s throw in the informed consent. A validly executed informed consent simply tells the patient what the benefits, risks and alternatives are relative to the care being proposed.

The informed consent does NOT tell the patient: “I might do something below the standard of care and if I do you can’t come back and sue me.”

I’m not sure where this mistaken notion arises regarding informed consent but no matter the source or reason please understand the reality of the situation moving forward.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
www.chirofutures.org

ChiroFutures Risk Purchasing Group is pleased to announce the inclusion of Health Plan Billing Error Defense Coverage to its Chiropractor’s Malpractice Insurance Program.

ChiroFutures Co-Founder Dr. Matthew McCoy said “We are pleased to provide our clients with this enhanced coverage at no additional charge.   We know the special risks chiropractors face in their professional endeavors and we are able to offer insightful risk management advice and tools, as well as insurance products that meet a chiropractor’s specific needs.”

The ChiroFutures program is designed to offer broad protection and defense coverage that includes new emerging areas of liability for practitioners such as Regulatory Board Defense, Medicare/Medicaid Billing Error Defense, Information Privacy Wrongful Acts, and Peer Review Committee Defense.

For further information about the Chiropractic Professional Liability program, please contact Teresa Quale, Sonoran National Insurance Group, at teresa.quale@sonorannational.com or (480) 538-7173.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
www.chirofutures.org

For many reasons we usually associate sexual boundary issues with the male practitioner. And while it might be more likely to work out that way the truth is that female doctors need to be just as concerned about these issues as their male counterparts.

About half the chiropractic profession is made up of women and relationship issues arise no matter what the gender.

I consulted on a case several years ago where a female chiropractor had a somewhat older male patient (20 years older) who became infatuated with her. It turned out that the patient had some emotional problems that did not come out in the history. He had previously made what the doctor thought to be innocuous comments regarding being in love with her. These were made in a kidding sort of tone and the female doctor did not want to offend him so blew them off the first few times. 

Then the patient started not following care recommendations and had a couple of “outbursts” in the office followed by phone calls threatening he would never return but then would show up a month or two later wanting to return for care. These were typically accompanied by grand apologies.

If you find yourself in this type of situation please make sure you document all the events and ask staff to document what they saw as well. If the patient cannot control their behavior and/or if the situation gets out of hand then its time to dismiss the patient and find them another chiropractor. Check with your state board’s website, laws and rules to see what if any steps the state requires you to follow when dismissing a patient.

Typically you need to give them some notice in terms of time and provide the names and contact information for several other chiropractors you recommend. Get the patient’s records ready for transfer and make them available to them. This should all be done in writing as well. 

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH

CEO & Co-Founder

ChiroFutures

drmccoy@chirofutures.org

www.chirofutures.org

If you are like many chiropractors you may be involved in recommending or selling supplements and other types of products to your patients. If you do this it would be a good idea to check your office liability policy and make sure you have some type of product liability coverage in case you ever have a patient who has some type of negative outcome from ingesting something you sold them.

For example, maybe there are some allergens in the product or maybe the company you purchase the product from has some type of quality control problem and the product ends up being passed on to your patient.

If the patient ends up suing you for a product liability issue you want to make sure you are covered.  

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
www.chirofutures.org

When we started ChiroFutures we committed to supporting research and other efforts that were geared toward ensuring the sustainability of the chiropractic profession – especially lifetime, subluxation based, family wellness chiropractic.

To that end ChiroFutures Malpractice Group established an annual scholarship in collaboration with the International Chiropractic Pediatric Association (ICPA) in the amount of $2500.00 to be awarded to a chiropractic student.

It’s called the Larry Webster DC Memorial Scholarship and the first recipient was recently chosen. Her name is Marjorie Vining and she is a student at Life University in Marietta, Georgia. Please join us and the ICPA in congratulating Marjorie as we look forward to working with her on her project.

About Larry Webster DC

Larry Webster DC 1937-1997

Dr. Larry Webster was a visionary, an inventor, a technique developer and a teacher when it came to chiropractic and children. He fostered an unmatched understanding of the necessity of chiropractic care for children and his natural love and ability to connect with them was felt by anyone who watched him adjust a child.

All who knew Dr. Larry, knew of his passion for teaching. He enjoyed bringing the skills and techniques he developed to other Doctors of Chiropractic so they would be better able to care for children themselves. His individual seminars expanded to a complete Pediatric Certification Program, the first of its kind in the chiropractic profession.

In the last years of his life, Dr. Webster became involved in supporting ongoing chiropractic research for children. Dr. Larry Webster founded the International Chiropractic Pediatric Association (ICPA). Today, the ICPA has over 3,000 members internationally and its Board of Directors continues to expand its mission of Research, Training and Public Education.

About ChiroFutures

ChiroFutures is a Malpractice Risk Purchasing Group (RPG) founded by chiropractors Matthew McCoy DC, MPH and Anthony Carrino DC, FICPA who were both students of Dr. Larry Webster at Life University where he taught Pediatrics in the 1980’s.

ChiroFutures offers what no other malpractice provider offers: a partnership with its insureds. We believe that the future of this profession rests in the hands of the practicing chiropractor and we want our doctors to be able to focus on building a busy practice full of happy patients. We work to remove the fear, worry, and obstacles that get in the way of practice. We want to build a long term relationship and partnership with our insureds to help create an environment in your office where people feel truly cared for.

We are strong believers in research and the power it has to ensure the profession's future. It is for this reason that we strongly support research efforts such as those of the International Chiropractic Pediatric Association with our commitment and our combined resources.

Unlike others doing business in the profession, we are not in chiropractic... chiropractic is in us.

About the ICPA

The ICPA mission is to provide education, and training, and to support research on chiropractic care in pregnancy and throughout childhood because all children need chiropractic care.

The I.C.P.A. is the oldest and largest non-profit organization of its kind. Our Membership is composed of over two thousand chiropractic doctors and students around the world. These members share a common interest in the advancement of quality chiropractic care for children.

The International Chiropractic Pediatric Association is the profession's oldest, largest and most sought out chiropractic pediatric association. The ICPA was founded by Larry Webster, D.C. in 1986. His vision and passion in working with children had a major impact in redirecting the profession to care for more children. Upon his passing in 1997, the ICPA was given to the Board of Directors.

For his unparalleled vision and the formation of the ICPA, we are truly grateful to Dr. Larry Webster.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
www.chirofutures.org

We always like to hear from our members/insureds and we encourage ongoing communication as part of what we believe makes us different from other companies you can purchase your insurance from. For us it’s about the relationship.

Beyond the fact we just like hearing from our members we also want to stress the obligation that everyone with malpractice insurance has in terms of reporting claims or even potential claims. This obligation is spelled out in your policy.

Whenever you have something come up in your practice where someone is questioning what you do or did let us know about it – especially before you take actions that you might regret later . This serves a few purposes. It allows another perspective on the issue and the opportunity for you to get some advice on how to respond appropriately to the situation.

It also serves as a reporting mechanism so that it can be documented that you alerted us to a potential claim. This way even if you don’t hear anything more about the issue until a year later, it’s been documented that you reported a potential claim at the time you first knew about it.     

Sometimes chiropractors are hesitant to say anything, don’t think something is a big deal etc, so they don’t call. Don’t make that mistake. Give us a call. That’s exactly what we are here for.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
www.chirofutures.org

According to the Institute of Medicine iatrogenesis is responsible for at least 100,000 deaths per year.

As chiropractors we generally get very excited and feel a sense of urgency when it comes to our patients protecting their health and not becoming another statistic. Most of our efforts are geared toward preventative strategies patients can take to have a healthy spine and nervous system. We might also counsel our patients on proper diet, nutrition, exercise, rest and a positive mental attitude.

Sometimes we might also have concerns regarding the medications our patients are taking. If you find yourself concerned about the medications your patient is taking its time to be very careful and thoughtful about what you say or do.

Obviously if it’s a life or death situation you should either contact the doctor who prescribed the drugs or have the patient do so immediately. If it’s more of a situation where you are concerned the patient may be taking drugs they don’t need or drugs for conditions that you feel could be better managed through lifestyle changes – you should also get on the phone and discuss this with the doctor who prescribed them. Do it with the patient sitting there with you so they can hear your conversation.

What I don’t recommend is creating unnecessary concern or fear in the patient’s mind to the extent that they believe you are giving them medical advice regarding these medications and then they stop taking them without any concern for untoward effects that might result from abruptly stopping them.

I also suggest refraining from general attacks and the painting of all of allopathy as dangerous, greedy etc. This is especially true for comments made on blogs, websites, brochures and other forms of advertising. All of this wil be used against you in the event of a lawsuit - even if the reason for the lawsuit doesn't have to do with medications.    

Let’s cut to the chase and imagine that something you said or wrote led a patient to stop taking their medications which led to some adverse outcome. Now its three years later and you are being deposed by your now ex-patient’s attorney. Do you want to have to answer questions related to your scope of practice and whether or not you are trained and legally authorized to prescribe, administer or otherwise advise patients regarding prescription drugs?

The answer is of course “no” and you don’t want to sit through the pain of the hour long questioning on this. If you are concerned that your patient is experiencing side effects from the drugs they are taking then tell them to go see the provider who prescribed them, make a note in your file that you did so and focus on what you do best and what you are legally allowed to do.         

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures
drmccoy@chirofutures.org
http://www.chirofutures.org