Serving Chiropractors and Their Patients

Archive for the Standard of Practice Category

Examining Board Considers Significant Changes to Code Affecting Profession

During recent meetings, the Chiropractic Examining Board has been evaluating more significant changes to the Administrative Law Code controlling chiropractic in this state.  This is part of an ongoing effort by various regulatory boards to comply with the Governor’s request that existing administrative laws be reviewed and updated.  The Board has already made relativity uncontroversial updates to Chapters 1, 3, and 11, but is beginning to evaluate more pronounced changes to chapters 4 (“Practice”), 10 (Delegation), and eventually 5 (Continuing Education) and 12 (Nutritional Counseling).  The Board’s actions with these chapters of the Code will have a more significant impact upon the  chiropractor’s standard of practice and should be carefully monitored by all interested doctors. With regard to Chapter 4, the Board considered changes which dramatically simplify the text, but leave open for future interpretation those techniques, procedures, and instruments which can be used in the course of a doctor’s practice.  Initially, the Board approved a scope statement to insert into the code the definitions of “chiropractic science”  and “practice of chiropractic” based upon existing language from the statutes (Chapter 446).  Significantly, this statutory language replaces administrative code language from 1985 and excludes reference to “spinal subluxations”,  “nerve energy expression”,

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Addressing Patient Threats of Injury or Violence

Particularly at this time of tragic school shootings and heightened sensitivity for public safety,  chiropractors are interested in properly responding to patients who threaten injury to themselves or others.  There is currently no express legal duty on the part of chiropractors to report these patients to law enforcement or others.  Unfortunately, there is also very little other directive for the Wisconsin chiropractor on how to handle these situations.  This article offers some practical suggestions on how to deal  with this critical situation.

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Examining Board Holds Public Hearing on Latest, Proposed Changes to Code

The Chiropractic Examining Board will hold a public hearing on December 21, 2017 to consider its latest, proposed rule changes to the Administrative code relating to chiropractic.  This time, changes are being proposed to Chapters 1, 3, and 11 of the Code.   These changes are not as dramatic as those proposed earlier this year involving the roles of CT’s and CRT’s together with the  delegation of adjudicative services.  This latest BLOG will review all of the latest proposals with an analysis of their impact on the profession.

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Over-the-Counter Medication Debate Needs Accuracy and Transparency

The Wisconsin Chiropractic Association’s (“WCA”) most recent legislative initiative has once again caused division within the profession and was initiated without accurate and open discussion of the issue.  This time, the WCA sought to use the budget reconciliation process as a means of surreptitiously obtaining an amendment that would allow Wisconsin chiropractors to advise and counsel patients on the use of over the counter medication.  (“OTC”) Although the initiative appears to be “dead” for now, this manner and method of introducing dramatic changes in the scope of chiropractic has to be done accurately and openly in the future in order to unite, rather than further divide, doctors within the state. First, the profession requires accuracy with important changes of this nature. In advancing the proposal, the WCA disseminated information that doctors cannot “advise and counsel” on OTC within this state’s current scope of practice.  Depending upon the definition of these terms, this position can be disputed for several reasons, including: The statute broadly relied upon by the WCA for prohibiting treatment by drugs, more specifically references  the definition for that word to only include those “drugs” listed in s. 450.01(10) of the statutes.  Those “drugs” listed do not include many

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Gift Giving to Patients

Particularly at this time of year, many doctors consider providing a gift or other form of renumeration to a patient. Over the years, we have seen that the contemplated gift can come in a variety of forms and amounts. Although the motivation for a gift if well founded, doctors must be careful in their gift giving. There are both state and federal limitation on the nature of gift giving by a physician. In a recent directive, the OIG clarified what gifts will be regarded as acceptable and which should be avoided.

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It Is now OK to Say: “I’m Sorry” to Patients

Although apologies are common place to many during various times in our lives, it could have gotten a Wisconsin doctor into malpractice “quicksand”… until just recently.  Now, there is a new law in Wisconsin which generally allows a health care provider to apologize to an injured patient without fear that the apology can or will be used against them in any subsequent lawsuit.  In the past, doctors were often reluctant to show any remorse to a patient in fear that such a statement could be used as a negative admission in any malpractice claim. In April 2014, this state adopted a law which is now codified into the evidentiary section of the statutes (Wis Stats. 904.14) which ensures that a provider’s statements or gestures of compassion, fault, liablity, remorse, or responsibility to a patient or patient’s relative remains inadmissable as evidence of liablity or as an admission against interest.  This preclusion from evidence applies to a wide variety of situations including civil actions, administrative hearings, disciplinary hearings, and mediation type proceedings.  However, it is noteworthy that the law applies only to such statements or gestures made BEFORE the commencement of such a proceeding. The percieved benefits of the new law include a reduction

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