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Saboteurs In (The) Waiting (Room)

Nearly all doctors I work with have a sort of dichotomy they deal with every day.  It is that personality split between the altruistic, virtue-based, compassionate health care provider and the cold, hard business person who makes the tough decisions. Over-dominance by one or the other can kill your practice.  We all are in a service industry because, among other things, we get a personal, intangible satisfaction from helping people.  You probably don’t like to think with your wallet.  However, doing so in the right way will help you balance your practice in a logical, pragmatic approach that allows your business to thrive while staying rewarding in other ways.  This is a reality you likely know all too well, and one that has given birth to an entire seminar industry.  Lucky for you, I am not a psychologist, spiritual guru or philosopher.  I’m not going to tell you how to find the right balance.

However, it is against this backdrop that I inform you of an incident that happened recently to one good DC who was simply trying to help someone in acute pain.  This doctor had a new patient come into his office who had been experiencing severe low back pain.  After a thorough examination (where he determined this person, while legitimately in pain, had a poor attitude), the DC reluctantly offered the patient some minimal treatment on an intersegmental traction table, set on the lowest setting.  He then had her lay face down on a spinal distraction table, also at a minimal setting.  When there was no pain relief at this point, this DC, using his good judgment, decided that any further treatment would not be appropriate, and recommended that she follow-up with an MD to get some pain relief medicine.  He sent her on her way, and charged her an unremarkable, average fee for the exam and the minimal treatment.

This DC was later contacted by this patient who was unhappy about the charges.  The patient acknowledged that this DC’s time was worth something, but thought he had charged too much.  The DC disagreed, but compromised his charges and sent a partial refund check to the patient.  A few days later, this DC received a letter from an attorney at one of the largest downtown law firms in the state, demanding a full refund, and also threatening legal action in the form of a lawsuit and a complaint to DOPL.  The letter stated that this patient had gone straight to the emergency room following the treatment by this DC, and suggested that this DC had injured the patient (although the letter never said what was wrong with the patient or what additional injury was allegedly caused by this DC’s actions).

Lost in the facts of this story is one simple detail: the patient was an employee at that large downtown firm from whence the nasty letter was sent.  That firm is crawling with insurance defense attorneys itching to take a shot at a chiropractor.  This patient should have been turned away without the doctor touching her.  In hindsight, this DC knew it from the outset by her attitude in the exam room and from the employer listed on the intake forms.  However, this DC simply came out on the wrong side of the internal struggle between compassionate physician and hardened business professional.

The story has a happy ending.  This DC called Larson Law, and we were able to get the matter resolved quickly.  In exchange for a refund of the charges, this DC now has a signed release form from the patient, releasing him from any legal action or liability.  We recommended he not even offer the refund, but this DC wanted a quick and simple resolution, which is understandable.  The moral of the story is that while the claims against this doctor were without merit, the potential trouble could have been avoided by listening to his business self and turning this patient away.  The DC knew going in that this patient may be troublesome. Know who is sitting in your waiting room.  If there is potential for trouble, decline to treat that person.  There are plenty of others who need your help.

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