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Chiropractic Research Review

Malpractice Issues: Opening Doors for Interdisciplinary Patient Care

All health care professionals must be concerned with the malpractice implications of the services and products they provide. The growing popularity of alternative medicine has made medical physicians particularly concerned about their legal liability for services provided by alternative practitioners to whom they have referred their patients.



This JAMA article on health law and ethics addresses the malpractice issue from the perspective of physicians referring patients to alternative providers, but its conclusions are of particular interest to chiropractors. To research this idea, the authors examined the rates of claims against chiropractors, acupuncturists, and massage therapists. Then, they explored situations in which medical doctors may be exposed to liability for referrals to alternative health care providers. Lastly, court assessments of malpractice liability of the chiropractors, acupuncturists and massage therapists were observed.

Results: The rates of claims against the professions studied are very low. Of the three, chiropractic was highest at an average of 2.67 claims per 100 policyholders over a seven year period. However, this was substantially lower than the average of 7.61 claims per 100 policyholders for primary care MDs.

Unlike many other providers of alternative medical services, most chiropractors meet the legal and professional criteria the authors consider basic to protecting patients and doctors who refer them. That is, chiropractors are members of a recognized health care discipline with its own educational institutions and standards of licensure, and chiropractors tend to be insured against malpractice suits (42 states require such insurance). Moreover, it has been established and accepted that chiropractic is effective for treatment of conditions medical doctors are likely to refer to them and that patients can safely be assigned to the autonomous care and responsibility of a doctor of chiropractic.

The authors of this article contend that the opening of a professional dialogue between physicians and practitioners of alternative medicine is crucial to better health care for those patients who choose alternative therapies. Chiropractors who desire consultation with and referrals from medical doctors should find this proposal reasonable and attractive.

Studdert DM, Eisenberg DM, Miller FM, et al. Medical malpractice implications of alternative medicine. Journal of the American Medical Association, Nov. 11, 1998;280(18), pp1610-15.

Chiropractic Research Review

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