Editor's Note: The following is excerpted from DC columnist Dr. James Edwards' upcoming article in our October issue.
As a chiropractic expert on many malpractice cases for both plaintiff and defense lawyers for over a decade, I've discovered there is a huge problem with asking a new patient to sign an informed-consent form in the reception room before he or she has ever visited with the doctor.
I have had the opportunity to discuss with my doctor the nature and purpose of chiropractic adjustments and other procedures and understand that spinal manipulation involves the doctor placing his or her hands on my spine and delivering a quick thrust or impulse to the involved area(s). I also understand and am informed that, as in the practice of medicine, in the practice of chiropractic there are some risks to treatment including, but not limited to: fractures, disc injuries, strokes, dislocations, sprains, soreness, and physical therapy burns. I understand and comprehend all such risks and complications, and realize that alternatives to care might include medical treatment, surgery or doing nothing. I, by my signature below, confirm and accept care, and therefore consent to and agree to those treatments deemed necessary by my doctor to be in my best interest.
To be perfectly honest, that type of an agreement by a patient in the reception room is as worthless as the paper it is written on unless and until the patient has had the opportunity to actually "discuss" the benefits, risks and alternatives to chiropractic treatment with the doctor and then give informed consent. So, if you think you are protected by your reception-room form, you are not!
What is the proper way to meet the standard of care of a reasonably prudent doctor of chiropractic when obtaining informed consent? At some point early in the process, have a "knee to knee" verbal discussion with the new patient about the benefits, risks and alternatives to chiropractic, and then obtain verbal consent to proceed. That is the first step.