IS SPORTS CHIROPRACTIC IN YOUR FUTURE? What you need to know

Sports are a way of weekend life in America. Consequently, you may be thinking about specializing in sports. And even if you don’t specialize, you will undoubtedly treat patients for sports-related injuries.

As a result of this keen interest in athletics, it’s important for you to understand risk management in sports chiropractic.

GYM ADJUSTMENTS

Many doctors who are interested in building a sports chiropractic practice start out by going to a local gym, giving advice, and providing on-the-spot chiropractic manipulations.

It really concerns me when I hear, “This chiropractor came into the gym and heard me complaining about my shoulder. He gave me an adjustment. Now I feel great.” I wonder if the doctor took a proper history? Performed an examination? Conducted any other diagnostic tests? Acted professionally? Took notes? Recorded the treatments and findings?

My advice: Always schedule an appointment in the office, explaining to the patient this is where you can do your best work. It’s never appropriate to do less than your best work.

One of the areas in which some doctors take shortcuts is with offering sports physicals. While there is nothing wrong with offering sports physicals, doctors need to be careful they don’t lower their standards just because they expect these children to be healthy.

A colleague of mine never documented sports physicals, and he didn’t think he needed parental consent. His philosophy was, “We live in a small community and the parents are all good friends of mine.” My response back to him was, “They’re good friends until something goes wrong with their children.”

My advice: Use the same level of care and documentation with sports physicals that a doctor would use in the office.

One of the key things to a successful sports chiropractic practice is recordkeeping. In our practice, everything a patient told us is always recorded. One of our cases was a female power lifter.

She had back pain, and the orthopedic surgeon and I both suspected a herniated disc. We told her she should not compete, and we recorded that. She disregarded our advice and continued to lift. Her condition deteriorated to the point she ultimately wound up in surgery. Later, she filed suit against our organization, but we were cleared because our records reflected we had told her not to lift.

Doctors need to be aware that if they’re sued, their records probably will be projected onto a 10-by-10 screen for everyone in the courtroom to scrutinize. A lot of doctors don’t think patient records can be used in a courtroom due to their confidential nature. And some doctors believe they’ll be able to alter records later, if necessary. However, they soon find out that records can be displayed in the courtroom, and any attempts to change the records after an allegation is made will only jeopardize the doctor’s credibility in court.

Many doctors go into sports chiropractic with the intent of specializing in a particular area of the body. While this may be a good way to build the practice, doctors need to be aware that problems in the extremities can affect other areas of the body — including the back.

One time I saw a young man who was injured playing roller hockey. When the young man complained of knee pain, his primary-care physician x-rayed the knee and diagnosed him with Osgood-Schlatter’s Disease.

The young man continued to complain of knee pain and later complained of hip pain on several occasions, yet the physician maintained the same diagnosis.

When the young man finally came to see me, I took a history and noticed the patient limping due to one leg being shorter than the other. I immediately x-rayed the patient’s hips and found avascular necrosis of the femoral head.

What the physician forgot was that the hip can refer pain to the knee and vice versa. So, any time you have an adolescent who has knee pain and negative orthopedic tests for knee disease, you must look at the hip for pathology. The physician is now in jeopardy of losing his license.

It is understandable for DCs to want to specialize in a particular area of the body, and in some states, chiropractors are limited in the areas they can treat. Even so, it’s important for doctors to be cognizant that many things in the body interrelate and are causative in nature.

Thomas Hyde, DC, DACBSP, wrote this article on behalf of NCMIC, a provider of malpractice insurance and financial services. He has served as the chiropractic coordinator for the United States Powerlifting Federation, International Powerlifting Federation, and United States Weightlifting Federation. In addition, he was the chiropractic consultant for the Miami Dolphins and he co-edited Conservative Management of Sports Injuries.