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Dynamic Chiropractic – September 23, 2012, Vol. 30, Issue 20

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Convention Adjusting Is Risky Business

Dear Editor:

Over the years, I've always found it ironic that the chiropractic profession will fight "tooth and nail" (and rightfully so) for the ability to utilize diagnostic assessment tools (X-ray, CT, MRI, EKG; you name it), under the guise of being discriminated against and not being "allowed" to properly diagnose their patients.

The mantra generally goes something like: "It is dangerous to put a force into a spine without knowing the status of the underlying vertebral column." And then, they revert to banal imbeciles by disregarding standards of care and common professional, ethical tenets.

With standards of care, professional ethics and statuary licensing well-established for decades, more recently, convention vendors have on-site chiropractors demonstrate their equipment by inviting volunteers to submit to an "adjustment" on their machines, tables, chairs, etc. These so-called "demonstrator chiropractors" will nonchalantly, indiscriminately and casually adjust anything and everything that moves – without knowing an iota about the person they are adjusting and without any objective diagnostics whatsoever! All without the benefit of knowing what they are dealing with and what might be lurking under the skin, so to speak.

Under these circumstances, liability is very real and the malpractice implications of rendering treatment without benefit of adequate history, exam, X-rays, and proper facilities are dire. But for some reason, the brains of these demonstrator DCs turn to mush as ego compels them to "show off" their particular technique on someone they have never attended to before professionally.

However, come Monday morning, all new patients must go through the usual physical and diagnostic examination ritual. Why? To "find out what's wrong with you" and because SOAP notes must be memorialized just in case of an audit and/or lawsuit.

In many cases these demonstrator DCs performing at out-of state conventions may not be licensed in that state (or country); should an injury occur to an unsuspecting volunteer, this would constitute prima-facie evidence of negligence, shifting the burden of proof to the demonstrator-DC. What this means is that instead of the injured patient having to prove negligence, the demonstrator DC would have to prove that they did not deviate from the appropriate standard of care.

While many doctors will scoff at warnings, the colleague being adjusted may not be the one to file the suit. If, for example, a stroke should occur, resulting in severe injury or death, 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. In addition, in the event of a death occurring, the demonstrator DC administering the adjustment will be indicted for manslaughter.

Overcoming a prima-facie case while admitting that one performed no comprehensive history, exam or other diagnostics is an open- and-shut case. For demonstrator DCs to perform chiropractic services outside their state of licensure is extremely hazardous and can be greatly compounded by statuary provisions of the state in which the manipulation is given. This, of course, applies to the average conference attendee as well.

As if these problems weren't sufficient, standard malpractice insurance policies have exclusions for any injury resulting from an act in violation of any federal or state statute governing the commission of a crime. In all states, practicing without a license is a criminal offense. Not only may the demonstrator DC showing off their technique find themselves faced with prima-facie evidence showing negligence, but their act also will probably void their insurance coverage, leaving them personally exposed to any judgment or the expense of retaining counsel. Additionally, if the demonstrator DC is unfortunate enough to be charged and convicted of the offense of practicing without a license, they will face license suspension in their home state for the criminal conviction, not to mention manslaughter indictment should their adjustment cause injury resulting in death.

The solution is obvious, but from what I have observed at conferences, chiropractors continue to expose themselves legally by "pushing the envelope," and disregarding principles of ethics and standards of care – until Monday morning, of course, when the show must go on.

Peter G. Furno, DC
Indianapolis, Ind.

Big Pharma Won't Last Long

Dear Editor:

Kent Greenawalt is correct that we need more media exposure and that the Foundation for Chiropractic Progress is doing what it can with the funds it has. [Kent's column, which often discusses the foundation, appears every 3-4 issues in DC.] We are still underfunded and will always be underfunded while Big Pharma is allowed to advertise to the public. Even when the day comes that it is no longer allowed to advertise to the public, it will still have media influence and the ability to buy politicians.

Big Pharma is a reality we must contend with, like it or not. However, in spite of that fact, we have gained ground where it has lost it. No longer is Big Pharma an untouchable, organized crime syndicate. In fact, throughout the world as I type these words, eight major pharmaceutical firms are being investigated for bribing public officials, scamming the public and unfairly restricting competition in health care markets.

In the United States the CDC is facing a federal indictment for fraudulently misleading the public on the safety of vaccines, while deliberately and fraudulently falsifying research in order to sway public opinion on vaccination safety. The sheer criminality of its conduct in this matter is the direct result of Big Pharma's influence on the FDA, WHO and CDC – each employed by the very industry they were meant to regulate. What resulted is, metaphorically speaking, a snowball: a growing mass rolling down a mountain, gaining so much speed and mass that nothing, not even the law could stop it – or so they believed.

Big Pharma has grown so massive and powerful that its sheer mass has begun to work against itself; particularly since the worldwide economic collapse was caused by corporate greed and criminally negligent behavior. Big Pharma's forward progress and belief that it is above the influence of the law is now working against it. Still making money, still gaining momentum, Big Pharma has failed to understand that its own size and weight will now be the very thing that brings it to a crashing halt. Money-hungry governments will be seeking to seize funds from these wealthy corporations once their criminal conduct can no longer be ignored.

It is said that familiarity breeds contempt. If this is true, then considering the fact that Big Pharma has been sleeping with world governments for decades, we may well soon be witness to a bitter divorce followed by a vicious custody battle over the fruits of that association. Governments will likely seize the funds and leave Big Pharma gutted, broke and all alone. All we have to do is sit back and watch.

Richard Bend
Monterey, Calif.

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