It's that time of year. For some chiropractors, the start of the school year brings the opportunity to offer free or low-cost physicals to students participating in sports activities. Sports physicals serve a need in the community – they are generally required of student athletes and many parts of the country are experiencing a shortage of qualified healthcare providers.
by Mike Whitmer in Clinical Risks on Wednesday, August 29, 2018
But, before you begin promoting this service, it’s important to know the regulations in your state. Chiropractors may not be allowed to perform sports physicals in all locations, so be sure to know what is permitted where you practice.
If you decide to proceed, here are 10 keys to successfully and safely providing student exams.
- Have a copy of your policy declaration page on hand in case the school or organization requests verification of your malpractice insurance coverage.
- Some states protect providers offering free services at community events from liability, but not all do. Know where your state stands on liability issues before you begin.
- Make sure the school or organization has proper consent from parents or guardians for conducting physicals on minors.
- Take the same history you would in a regular patient encounter. Having a detailed and thorough patient history can be key to a positive outcome in the event of a lawsuit.
- Know your skill-set and limitations. For example:
- If the physicals include checking for hernias or potential hernias and you’re qualified to provide this evaluation, make sure to document your observations for the athlete to share with a parent or guardian.
- If the physicals include checking for heart and/or lung abnormalities, make sure you’re able to identify normal and abnormal sounds before performing this part of the exam. If you notice any abnormality, contact the athlete’s parent or guardian and refer him or her to the appropriate specialist.
- When performing physicals on an athlete of a different gender, have a chaperone of the same gender in the room with the athlete.
- Be prepared to document thoroughly and clearly at the time of the visit, even if you’re meeting with students in a corner of the school gym. Trying to remember specifics about each student later—or rewriting documents after the fact—can create additional problems.
- Although this service is by nature more casual than a regular office visit, you may still be held liable if you don’t perform a sufficient exam, document appropriately, or fail to identify a condition and provide guidance on next steps. The limited scope of the physical does not reduce the expectation of quality of care.
- If the patient is receiving state or federal insurance coverage, be knowledgeable about whether you may collect additional funds from the patient to cover any gap. Balance billing is often prohibited, particularly by government-funded insurance.
- Comply with HIPAA expectations as you would with any other patient encounter.
Supporting the community is a great way to build both awareness of your services and goodwill. As long as you’re mindful of the expectations and outcomes and your state allows you to provide these services, student sports physicals might be a home run for your practice.
If you’d like to know more about chiropractic and athletes in general, check out this article.