0 A Dangerous Courtesy
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Dynamic Chiropractic – January 15, 1993, Vol. 11, Issue 02

A Dangerous Courtesy

By Louis Campbell, JD, C. Jacob Ladenheim, Rob Sherman, Esq. and Louis Sportelli, DC
Anyone who has been to seminars sponsored or attended by chiropractors is familiar with the practice of "courtesy" adjustments. This tradition is time-honored and pervasive throughout the profession. From a lawyer's standpoint, the malpractice implications of rendering treatment without benefit of adequate history, exam, x-rays, and proper facilities is appalling.

Advising chiropractors to refrain from rendering such adjustments is, however, as fruitful as telling lawyers to draft documents in plain English.

Worst Case Scenario

Potential malpractice risks from such treatments can be exacerbated by the statutory provisions of the state in which such services are delivered. For example, Idaho law provides that:

When a person has been a recipient of services constituting the unlawful practice of chiropractic, whether or not he knew the rendition of the services was unlawful, proof of the rendition of unlawful services ... in an action against the provider ... for damages allegedly caused by the services, constitutes prima-facie evidence of negligence, shifting the burden of proof to such provider ... (emphasis supplied).

What that means is that instead of the injured patient having to prove negligence, the defendant doctor must prove that he did not deviate from the appropriate standard of care. While many doctors will scoff at warnings about such problems as typical lawyer paranoia, the colleague being adjusted may not be the one to file the suit. If, for example, a stroke should occur, it may well be a widow or guardian of infant children bringing suit. Those potential plaintiffs may feel absolutely no sympathy, camaraderie or brotherhood militating against filing suit.

Overcoming a prima-facie case while admitting that one performed no comprehensive history, exam or other diagnostics is certainly an uphill battle. Moreover, the Idaho code provides that in such cases plaintiffs may also recover reasonable attorney's fees and court costs.

What It Means to You

It is hazardous to adjust friends, colleagues or even relatives while attending seminars. That hazard can increase greatly when the doctor performs such services outside his state of licensure. The hazard can be compounded more by the statutory provisions of the state in which the manipulation is given.

As if these problems aren't sufficient, standard malpractice insurance policies have exclusions for any injury resulting from "an act in violation of any United States or state statute governing the commission of a crime." (NCMIC sample policy language). In Idaho, as in all states, practicing without a license is a criminal offense. Not only may the doctor doing a favor for a colleague find himself faced with prima-facie evidence showing negligence, but his act may void his insurance coverage leaving him personally exposed for any judgment or the expense of retaining counsel.

Finally, any doctor unfortunate enough to be charged and convicted of the offense of practicing without a license faces license suspension in his home state for the criminal conviction.

Doctors are urged to never provide services in states in which they are not licensed and to be extremely circumspect in ever providing services outside of their offices.

Louis Campbell, J.D.
C. Jacob Ladenheim, J.D.
Robert P. Sherman, J.D.
Louis Sportelli, D.C.

Click here for previous articles by Louis Sportelli, DC.

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