Q&A #14 Calif. Bd. Reg.

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The California Board of Chiropractic Examiners has passed an informed consent regulation which, as I understand it, says that chiropractors must inform patients of the inherent risks of “serious bodily harm” in a chiropractic adjustment. Is there any inherent risk to an adjustment, understanding that an adjustment means to “make right?” Here’s the question: “When you move a bone from the incorrect position to the correct position (or enable the body to do it) can it have a negative side-effect” and is that inherent in the procedure?

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This article has 10 comments

  1. encinitas chiropractor 11/11/2011, 5:29 pm:

    hey joe, this is correct, i had to add it to my form. the only risk i tell them is i am putting a thrust, tho gentle, into the body and it may be uncomfortable. i also mention the risks of being subluxated which invariably outweigh any “risks”. plus, there is no guidelines of what to mention as far as “serious bodily harm” and i’ve seen no proof of that anywhere. i’ve written them and am waiting response.

  2. Dallas Chiropractor 11/11/2011, 6:29 pm:

    It appears that “governing” boards of chiropractic examiners represent the “people” instead of chiropractors these days.

    Can a bone moving into the correct position have a negative effect? I don’t believe so, because chiropractic works 100% time. When a subluxation is corrected, innate intelligence is able to express itself more fully and innate intelligence does what is best for body 100% of the time.

  3. Steve 11/11/2011, 7:57 pm:

    Do the MDs have to do this? I know that nobody told one of my patients about the possibility of Steroid Psychosis from what he thought was a simple short term prescription.

  4. Dave 11/11/2011, 11:32 pm:

    Any negative side effect would be perceived, not actual. “Serious bodily harm” is subjective and can include falling off the adjusting table. Does the local government of LA need a consent form for all new residents due to air quality side effects? Will auto sales people require consent forms for the side effects of driving? Who’s allowing this stuff to pass legislation anyway?

  5. Been there, done that 11/13/2011, 3:20 pm:

    Now that others have weighed in with philosophical answers about how adjustments are making thing right, so there is no harm and no need provide consent, I will tell you the way things ARE. Yes, chiropractic governing boards in ALL states represent the people and not the profession. That is simply a fact and you should not believe otherwise.

    Second, although injuries in chiropractic offices are very rare, they do occur, These include fractures, burns, intercostal cartilage injury, claims of disc herniation or worsening of per-existing disc herniation and stroke. Just because you have never seen these occur, or do not believe that they cannot happen, does not matter. What matters is that the BOARD is coming at this issue from this perspective and this is what they will enforce.

    Finally, you must understand that informed consent is a process that requires the doctor to discuss the risks of the treatment, alternative options for treatment, risks of the alternatives and the risk of the patient doing nothing. Only then can the patient be “informed” and then able to give “consent.” And the best part? Even if you have such a form, discuss it with the patient, have it signed and witnessed by three people and print it in two languages, the patient’s attorney will still say the patient was not informed. On the bright side, your expert at your malpractice trial will have good ammunition to help fight your case and the chiropractic board will have one less issue when they attempt to take your license away after the suit.

    • JStraussDC 11/13/2011, 5:54 pm:

      Dear been there done that, First, this is a philosophical forum and philosophical viewpoints are important. You are correct that state boards represent the public, not the chiropractor. I’m not sure much of anything else you have said is correct as far a law is concerned, only the courts can decide that. I would like to hear a few others “weigh in” before I voice MY OPINION. Like you, I am only a chiropractor, not a judge and jury. But I do believe our philosophy can be successfully argued before a court of law and demonstrate that our approach to chiropractic is the most legally defensible as well as the most consumer oriented. In any event thank you for sharing your perception as to “the way things ARE”.

      • Jim Peck 11/14/2011, 3:16 pm:

        Wow! If boards were truly representing the consumers they would not be expecting practitioners to scare consumers off with fear tactics. Certainly there is a chance for things to go wrong, even fracture of a rib, but serious bodily harm is a real stretch. It seems that in the interest of consumer protection we have gone overboard and the only people who are hurt are the consumers who lose out on care.

        • JStraussDC 11/14/2011, 4:15 pm:

          Good points Jim. The real issue is not frx ribs (rare). The real issue is mistaken diagnosis that causes all the problems. Until chiropractors stop trying to diagnose medical conditions (and treat them), it will not be resolved. Delay of medical care is what causes “serious bodily harm”. Non therapeutic chiropractic solves that problem.

      • Been there, done that 11/14/2011, 10:51 pm:

        Thank you for your kind response. Perhaps those on the site would benefit from a discussion of the subject by an attorney who has represented chiropractors for years for both malpractice and board actions. I would refer readers to a free interview with Ed Stark, Esq. on the chiroceonline.com site. Simply go to the site, click the course catalog, then look under the group entitled “Free Courses and Interviews.” Mr. Stark is very experienced in these areas and will shed light on the subject. By the way, the site also offers a free CE course concerning ligament injury for those doctors licensed in California.

        • JStraussDC 11/15/2011, 5:13 am:

          You know, BTDT, I believe it could be much more productive if Mr. Stark could hear a discussion from a non-therapeutic chiropractor. I would venture to say he would hear an approach to chiropracti that 1. He has never heard before and 2. He would agree is the most defensible approach to chiropractic and 3. Would shed more light on the subject than he ever has. If he would like a copy of my downloadable book Case Management for Straight Chiropractors, I would gladly send him a free copy.

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