False hope may lead to malpractice

Despite the positive results doctors and patients claim from decompression therapy, healthcare insurers still consider this spinal therapy “experimental,” and many do not reimburse for it.

It is not the “experimental” tag that bothers malpractice insurers, however. Their concern relates to the marketing, often provided by table manufacturers, distributors, or independent marketers.

“The problem is their advertising,” said Timothy Feuling, president of CBS Malpractice Insurance. “[Sometimes] they go way overboard.”

Feuling’s company conducts an annual review of the advertising its policyholders use, but has not increased premiums for chiropractors who use this modality.

Matthew McCoy, DC, editor of the Journal of Vertebral Subluxation Research (www.jvsr.com) and an expert witness/consultant in malpractice cases and board actions, concurred with Feuling. McCoy noted that “concerns and problems arise relative to making unfounded or unsubstantiated claims.”

He cited one popular advertisement: “Spinal decompression has an 86 percent success rate for treating chronic, non-resolving back pain, sciatica, and herniated or bulging discs.”

According to McCoy, the research quoted did not include a control group; it measured perceived pain on the part of the patient; and it did not use more objective measures such as a post MRI or electro-neurodiagnostic studies.

There was also no follow-up past 90 days, and the authors themselves called for more advanced longitudinal studies.

Another ad gives the perception that NASA did the study, which it did not. Some ads use the word “miracle,” though McCoy said it appears their use of a question mark after that word might be to offset any concept of a promise.

“I would urge chiropractors to be very cautious with aggressive advertising, be explicit regarding the level of the research, and not give the impression of a guarantee of cure,” said McCoy.

No additional premium

Kiran Edwards, marketing specialist with OUM Chiropractor Program (www.oumchiropractor.com) in Nashville, Tenn., reported that OUM does not charge an additional premium for spinal decompression therapy. OUM does not specifically exclude the modality, and as long as it is within the scope of practice in the state the chiropractor practices in, OUM provides coverage.

NCMIC Insurance Company has a similar position, according to Bruce Beal, its vice president of claims.

“At NCMIC, we appreciate all approaches to chiropractic. We believe it is the role of the chiropractic profession — not NCMIC as an insurance company — to determine the best means to deliver chiropractic care, be it chiropractic as we know it today or through the use of new and emerging therapies,” said Beal.

“That’s why NCMIC gives our doctors the prerogative to choose the procedures they want to incorporate into their practices, based on their states’ scope of practice regulations,” he added.