Perceptions Matter: Risks at Educational Seminars
If you're like many D.C.s, you strive to inform others about the benefits of chiropractic care, and you may even hold seminars in your community to educate people about chiropractic and other health topics.
Posted in Risk Management on Friday, July 28, 2017
However, as an attorney who defends Doctors of Chiropractic in malpractice cases and board allegations, I know there are risks for doctors who:
- Fail to disclose that they are chiropractors.
- Cross the line into providing advice outside the licensed scope of their practice.
Many times Doctors of Chiropractic fail to follow state statutes specifying how a D.C. should be designated. For example, some states require the use of the title of “Dr.” be accompanied by the kind of doctor. Other states require noting that it’s the practice of chiropractic. It’s particularly important that D.C.s be forthright about their credentials in advertisements or lectures on topics not normally associated with chiropractic (e.g., thyroid conditions, hormone and endocrine imbalances, fat reduction or hair removal).
Another potential problem is when there is perception of a warranty or promise of a cure. If a doctor says, “Don’t worry, we can take care of this condition,” it creates an impression of a warranty to the audience.
In many cases, educational events are sponsored by the D.C. with an inducement, such as a “free” dinner to attend. This can create problems because there is a fine line between legitimate education and a solicitation with enticements, which may be prohibited by the state.
Seminars where diabetes and thyroid issues are discussed have become especially problematic for D.C.s lately. There have been instances where chiropractors have promised to help individuals reverse diabetes, promised thyroid help or where patients were unaware of the credentials of the presenter. Here is a case from recent years:
A Doctor of Chiropractic placed full-page advertisements promoting free dinner seminars on “nonsurgical, drug-free approach to relief from peripheral neuropathy.” The ads included a headline asking “Do You Suffer From One of the Symptoms of This Often-Misdiagnosed Problem?” The advertisements stated that the seminar discussion would include the real cause of peripheral neuropathy, its crippling effects and the dangers associated with medication.
Thereafter, the chiropractor was arrested on felony charges of practicing medicine without a license and for claiming to be a thyroid and diabetic specialist. He was ordered not to practice chiropractic after his arrest for eight felony counts of grand theft and one felony count of practicing medicine without a license.
How to Prevent Trouble
The way to prevent these kinds of issues is to conform to your state’s statutes. Here is an example from Massachusetts, where I practice law, about regulations specific to advertising:
- A chiropractor or agent, servant or employee of a licensed chiropractor or of a chiropractic facility may properly advertise the services offered, but shall not engage in advertising which is false, deceptive, misleading or unfair.
- A chiropractor or chiropractor of record shall preserve a copy of each advertisement for a period of at least two years, and shall make a copy of the same available to the board or its duly authorized representative upon request.
- Violation of any provision of 233 CMR 4.13 shall be considered “unprofessional conduct” within the meaning of M.G.L. c. 112, § 93, and shall be grounds for disciplinary action by the board.1
The Massachusetts Board of Registration of Chiropractors went further to educate their chiropractors and also issued a memorandum on January 6, 2012, regarding policy guidelines on dietary and nutritional advice:
On numerous occasions, the board has been asked if a licensed Massachusetts chiropractor may properly give dietary and nutritional advice to an individual without also providing a chiropractic adjustment. The purpose of this guideline is to clarify for licensees and members of the public that chiropractors may provide dietary and nutritional advice as an independent service without any other accompanying primary chiropractic procedure, provided the chiropractor complies with all applicable laws and board regulations.2
Conform to Your State’s Standards
As you can see, it is essential that your advertising conforms to expected standards and is not deceptive to the public. Failure to do so could lead to discipline of your license, or worse, criminal charges.
If you’re unsure, it is advisable to have your advertising reviewed by an outside auditor or by your state board (some boards have a method for you to ask for clarification). Additionally, many associations and societies offer seminars that discuss the issue and provide guidance.
The final word: sharing information about the benefits of chiropractic and increasing your patient base should not have the opposite impact of causing harm to you, your license or the practice.