Malpractice Insurance Checklist

Evaluate Your Current Procedures

It's easy to assume that lawsuits only arise from major mistakes and negligence. But the truth is, malpractice cases often stem from simple oversights and common errors that could be prevented.

Now you can quickly pinpoint your practice’s malpractice challenges with this convenient “10-Point Risk Checklist.” It’s an easy guideline to help you evaluate your current procedures and implement simple solutions to dramatically lower your risk of a lawsuit.

1. Do you have a standard procedure for evaluating new patients?

YesNo

GOOD. ACTION REQUIRED. The simple step of having standardized forms helps you avoid the potential risk of missing information when you begin treating any new patient. It's important to obtain critical health history details and capture the findings from your physical examination on your intake and evaluation forms.

2. Do you regularly use informed consent forms?

YesNo

GOOD. ACTION REQUIRED. Informed consent is more than getting a patient's signature on a form. It's a process of educating your patient. Before any treatment protocol is implemented, your patient should always understand the following: (1) the nature of the treatment (2) all material risks for the treatment (3) the possibility that risk will occur (4) alternative treatments available and associated risks and (5) consequences of going without the recommended treatment. Your patient's signature on an informed consent form simply serves as documentation that you've done a thorough job of educating your patient. But check with your state board to determine the exact requirements: www.fclb.org/Boards.aspx (opens in a new window).

3. Is your practice HIPAA compliant?

YesNo

GOOD. ACTION REQUIRED. Keeping your patient's information confidential is of the utmost importance under the law, even including the fact they are a patient. Make sure that you keep their name and all other identifying information confidential and only release it if you receive the appropriate authorization from the patient or the court. If you think you could use some help in this area, please think about taking a training course.

4. Do you check your state board's regulations?

YesNo

GOOD. ACTION REQUIRED. Upon renewal, always make sure to review your state board's website for information on their guidelines and procedures. Generally, the boards are constantly updating their information and requirements in response to changes in the practice. It is a good idea to proactively review these requirements to make sure you are up to date. It protects your license and your reputation! So take a look at your state: www.fclb.org/Boards.aspx (opens in a new window).

5. Do you use written letters of notification when deciding not to treat a patient?

YesNo

GOOD. ACTION REQUIRED. If you decide not to treat a new patient or to discontinue treatment of a current patient, proper documentation of your decision can reduce your risk of later claims, alleging a doctor-patient relationship still existed. Your notification letter to the former patient should outline the reasons why you will no longer be involved in that person's care. In addition, any healthcare concerns should be highlighted while clearly stating that you will not be responsible for treatment of that patient after the reasonable time frame suggested in your letter. The reasonable time frame is generally considered to be 30 days, as you do not want to seem like you are abandoning the patient. You may also wish to provide the information for your state society if they wish to obtain a referral, depending on the reason for termination. A copy of your chart should also be provided with an offer to copy their X-rays at their cost. The letter should be sent by regular and certified mail with return receipt requested.

6. Do you consistently create patient records at the time of treatment?

YesNo

GOOD. ACTION REQUIRED. Experts generally point to poorly kept patient records as one of the most common weaknesses in today's busy practices. Failure to consistently document patient visits can become a red flag during a malpractice proceeding. Patient paperwork should be considered an integral part of patient care with time set aside to complete the task at the time of treatment. Good documentation of the care rendered is also beneficial to the patient and a good defense for a claim made later based upon your treatment. If more than one chiropractor is at the practice, make sure it is clearly delineated who provided treatment at any given appointment.

7. Do you review patient records before treatment?

YesNo

GOOD. ACTION REQUIRED. Providing quality care to your patients includes being "up to speed" on past care and exam findings. Patient records should contain subjective statements regarding whether a patient is getting better or worse, new complaints and any contraindications of further treatment. Reviewing this information BEFORE every patient visit helps you provide top quality care for your patients.

8. Are new techniques closely monitored when implemented in your practice?

YesNo

GOOD. ACTION REQUIRED. It's crucial for all members of your practice to integrate the use of new techniques carefully. Many times, practitioners learn new techniques or procedures at a seminar and then try that new procedure on a patient shortly after returning to work. Extreme caution should be used until each new procedure has been validated by or taught by accredited colleges or post-graduate continuing education.

9. Does your bedside manner put patients at ease?

YesNo

GOOD. ACTION REQUIRED. Bedside manner counts-even to the point that doctors who are considered "warm" and "friendly" may be less likely than their aloof counterparts to face lawsuits. Simply put, if a person likes you, that person is less likely to sue you. It's much easier to initiate legal action against someone you don't like or don't really know. Many malpractice suits stem from patient dissatisfaction with and breakdowns in communication. Of course, always be careful that you are not overstepping any boundaries on becoming too friendly with a patient.

10. Do you have a standard procedure for billing—including a standardized collection letter?

YesNo

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Designed with Chiropractors in Mind

As a longtime leader in chiropractic malpractice insurance, NCMIC understands the unique risks healthcare professionals face. Our checklist is built specifically for chiropractors and other health practitioners, combining our decades of experience with insights from real-world claims and risk management experts.

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Using the checklist is just the first step. As your ally, NCMIC offers additional tools and guidance to help you strengthen your practice's defense against claims. From continuing education resources to experienced legal defense, we're here to help you practice with confidence.

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GOOD. ACTION REQUIRED. Many malpractice experts point to direct or indirect disagreements over billing practices as the genesis of many malpractice claims. Effective billing and collection procedures can help you avoid the risk of this type of claim-while also avoiding patient misunderstandings that can sour valuable relationships.