Q:

Dr. M

	One bad thing happened today and I wanted to mention this to 
you as to how you would handle this. Never in a million years would I 
thought that even the thought of this would happen to me.  This lady 
about 23 years old came into my office off of one of my screenings.  
She came in about 7-8 weeks ago. She has been in my office a total 
of 7 times including the first visit in which I don't adjust. She has 
been with three insurance companies due to her changing jobs three 
times that I have known her. I told her to pay for her deductible. 
Never paid a cent in the two months I have known her. I haven't 
adjusted her in three weeks or so.  She did call and tell me that she 
woke up one morning and her neck was sore and was having a hard 
time moving it.  This was two weeks after an adjustment.  She went 
to her MD and told him this and he said it was because you went to 
the chiropractor.  Her neck has been bothering her for two years 
straight every day prior to me even meeting her. She is friends with 
one of our workers in the office that puts people on therapy etc .... 
She had a falling out with her. Our worker says she is seriously 
crazy---into like casting spells on people and voodooo etc....  I don't 
get into that garbage, but this gives you an idea of who I am dealing 
with. Notes are in order with 2 cervical xrays and 2 lumbar xrays.  
She mentioned this to her PCP who said it is up to her to follow 
through with legal action etc.... This girl has a sore neck.  She even 
called me and told me she slept on it wrong one day a few weeks 
back and couldn't move it one morning.  She even admitted to 
sleeping wrong on it that night.  You know sometimes people get sore 
from the first couple of adjustments. I even explained that soreness 
does happen sometimes when getting adjusted in the beginning etc... 
She even had massages with us that often times breaks up scar 
tissue and gives you a tinge of soreness too.  Now she is thinking 
about legal action against me. How am I supposed to take this one?  I 
didn't do anything wrong. The MD supposively according to our girl 
that works with us who is friends with her doesn't like chiros.  They 
really are bastards to come up with this notion.  How and what 
would you do in this circumstance?  Thanks 

A:

Sorry you have to go through this but this is the nature of the 
business .. we work with our hands and at times some patients may 
have a poor reaction. But .. this may not be the case here so relax.

First things first. Be sure your office notes of each visit is complete 
and without embellishment or incrimination. Just be clear what you 
did and if the patient left without any incident you may wish to note 
that as well. If she called you on a day that you did not see here .. 
mark that on your office note chart as well as it being a non office 
visit phone conversation .. what was said and what you told her. 
There is no place here for any „hearsay history or opinions from your 
CA or yourself of a motive ¾ just what you told her and any 
conservative advice that was offered. 

Second .. I would write your thoughts about the incident .. here you 
may wish to note any „evidence¾ that she may be embellishing her 
problems .. the number of insurance companies and jobs she has had .. 
the mention that she has never paid .. the fact that she is a friend of 
the CA and they had a falling out .. the mention that the MD may be 
somewhat hostile to DC¼s etc. This letter is not for any use other 
than a clear recollection and opinion in defense of what you did and 
didn¼t do and possibly her motives at this time. Send this to yourself 
certified and when you receive it don¼t open it.  This will he helpful 
if you were sued. 

Third .. it doesn¼t seem that what she is suffering with would be 
very permanent .. so any lawsuit would be somewhat futile .. was 
there was a rupture of her cervical disc as demonstrated by an MRI .. 
and loss of strength in her arms .. parathesia or radiculitis as 
demonstrated with an EMG .. then she may have some ammunition but 
there may also be pre-existent history. She¼ll have to do her 
homework and spend some money to defend her position. 

Fourth .. if she continues to call or threaten you .. just be calm and 
never admit to anything other than you in good faith have always 
attempted to conservatively assist her and will continue to if she 
wishes further help. But .. you would be more than willing to help her 
find another DC closer to where she lives or works. 

Fifth .. take a deep breath and hang in there. These issues are never 
pleasant and ruins your peaceful day .. if you are doctoring you are 
prone to these issues coming up .. just hope you can handle it 
without getting too overwhelmed. Usually you can discuss things 
calmly with a patient and work their fears out .. this is called 
patient management

Have a Good Day

Dr. M