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Dynamic Chiropractic – October 1, 2019, Vol. 37, Issue 10

Is Your Informed-Consent Form Putting You in Jeopardy?

By James Edwards, DC

As a chiropractic expert on many malpractice cases for both plaintiff and defense lawyers for more than a decade, I've discovered there is a huge problem with asking a new patient to sign an informed-consent form in the reception room before he or she has ever visited with the doctor.

For example, many informed-consent forms ask the new patient to sign a document that has the following or similar language:

I have had the opportunity to discuss with my doctor the nature and purpose of chiropractic adjustments and other procedures, and understand that spinal manipulation involves the doctor placing his or her hands on my spine and delivering a quick thrust or impulse to the involved area(s). I also understand and am informed that, as in the practice of medicine, in the practice of chiropractic there are some risks to treatment including, but not limited to: fractures, disc injuries, strokes, dislocations, sprains, soreness, and physical therapy burns. I understand and comprehend all such risks and complications, and realize that alternatives to care might include medical treatment, surgery or doing nothing. I, by my signature below, confirm and accept care, and therefore consent to and agree to those treatments deemed necessary by my doctor to be in my best interest.

Seriously? To be perfectly honest, that type of an agreement by a patient in the reception room is as worthless as the paper it is written on unless and until the patient has had the opportunity to actually "discuss" the benefits, risk and alternatives to chiropractic treatment with the doctor and then give informed consent. So, if you think you are protected by that reception room form, you are not!

The Right Way: Step #1 – Have a "Knee to Knee" Conversation

So, what is the proper way to meet the standard of care of a reasonably prudent doctor of chiropractic to obtain informed consent? At some point early in the process, have a "knee to knee" verbal discussion with the new patient about the benefits, risks and alternatives to chiropractic care, and then obtain verbal consent to proceed. That is the first step.

Step #2 – Document the Discussion

The second and most important step is to document that discussion in your treatment file. It can be as simple as, "Discussed the benefits, risks and alternatives (BRA) to chiropractic care and the patient gave informed consent (IC) to proceed." Should you wish to also get the patient's written consent, the time to get the form signed is after – and only after – the above discussion has taken place.

Practice Pearls

I strongly recommend you visit your front desk and review your reception-room intake forms. If an informed-consent form references a discussion with the doctor (before it has taken place) remove it. After having the "knee to knee" discussion with the patient and documenting it in the patient's treatment records, as detailed above, should you wish to also have a signed, written informed-consent form, it is your responsibility to have the new patient execute it after your discussion.

Click here for more information about James Edwards, DC.

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