After multiple red flags, a patient filed a board accusation against her chiropractor. What could Dr. Richardson have done differently?
Posted in Case Studies on Friday, December 6, 2024
Malpractice claims are always top-of-mind for chiropractors—but board accusations are just as concerning. Even seemingly minor interactions with patients can result in a board investigation, which can escalate into significant professional and legal consequences. Here's what happened when one chiropractor ignored his instincts and took on a patient with a number of red flags.
Dr. Richardson’s Gut Feeling
Dr. Alan Richardson, a chiropractor with more than 25 years of experience, was well-respected in his community. When new patient Christina Thompson presented with lower back pain, she volunteered details about prior chiropractic experiences, stating she felt her former doctors were "too handsy." Although Dr. Richardson had an uneasy feeling, he decided to take her on as a patient.
Immediately, Christina had some specific requests that stood out and added to Dr. Richardson's discomfort. First, she insisted she could only make late appointments due to her work schedule, meaning Dr. Richardson was often alone in the office when she arrived. She also requested his personal cell phone number to exchange links and photos for home exercises.
Red Flags and Escalating Behavior
The situation became increasingly concerning when Christina began sending vacation photos to Dr. Richardson and eventually added him as a friend on Facebook.
The professional boundary blurred further during a treatment session where Dr. Richardson was applying electrodes for electrical muscle stimulation. During the placement, Christina made inappropriate comments, including asking if she needed to completely undress. Dr. Richardson attempted to defuse the situation with humor, but unbeknownst to him, Christina had been recording their interaction. She canceled her remaining appointments shortly after the session and filed a board complaint three months later. On the recording, Dr. Richardson’s attempts at humor painted him in a negative light, leading to a disciplinary action by the board.
Legal and Ethical Consequences
As a result of the board's findings, Dr. Richardson was required to take a boundaries and ethics course. This action marred his professional record. The patient also filed a civil lawsuit, alleging inappropriate touching and comments. Although the lawsuit was ultimately dismissed, the toll on Dr. Richardson—emotionally and professionally—was significant.
The recording, while not proving inappropriate physical contact, highlighted the risks of casual remarks in professional settings. It served as a double-edged sword, emphasizing the importance of maintaining professionalism at all times.
What Can We Learn? Recognizing and Addressing Red Flags
This case underscores the importance of recognizing early warning signs in patient behavior. Christina's unusual requests, late appointments, and inappropriate comments were all red flags. Dr. Richardson’s initial discomfort was valid, but his decision to proceed with treatment despite these concerns led to the escalation of the situation.
Healthcare professionals should trust their instincts and consider dismissing patients who raise significant concerns. Proper documentation is also critical. Detailed records of treatment, including communication and patient consent, can be invaluable in defending against claims. For example, noting the areas of the body being treated and confirming patient understanding can protect practitioners in the event of disputes.
Maintaining Professional Boundaries
Professional boundaries are crucial in the doctor-patient relationship. Friendships on social media, casual text exchanges, or overly familiar interactions can blur the lines, leading to misunderstandings or accusations. Dr. Richardson’s case highlights the need for strict boundaries, such as:
- Using a separate work phone for patient communication.
- Maintaining an open-door policy during treatments, especially with new patients or those of the opposite sex.
- Avoiding personal connections with patients on social media.
- Establishing clear policies about recordings in the office.
Final Thoughts
Dr. Richardson’s experience serves as a reminder of the risks healthcare professionals face, even with the best intentions. By recognizing red flags, maintaining boundaries, and documenting interactions thoroughly, doctors can protect themselves while providing excellent care.
For healthcare providers navigating similar challenges, resources like ethics courses and legal guidance are invaluable. When in doubt, trust your instincts, document everything, and prioritize professionalism.