On-Field Adjustment Liability Questioned
The Illinois Chiropractic Society is examining a case study where a soccer tournament adjustment preceded a later cervical disc diagnosis, raising questions around liability. The incident is sparking a professional conversation about the risks and protocols for providing chiropractic care in on-field, acute settings.
Federal law, the Sports Medicine Licensure Clarity Act of 2018, was enacted to protect chiropractors and other sports medicine professionals who travel with teams. This legislation ensures their license and liability insurance remain in effect when crossing state lines to treat athletes, addressing previous jurisdictional issues that created legal and financial risks. For coverage under this act, the practitioner must be a "covered sports medicine professional" providing "covered medical services" to an athlete, athletic team, or team staff member in a secondary state. This law applies to professionals working with professional, Team U.S.A., high school, or college athletes and teams. Malpractice insurance policies now often include "travel-to-treat" provisions, allowing a chiropractor's license and coverage to follow them from their primary state to secondary states. Malpractice insurance for chiropractors is available with features like 24/7 portable coverage, ensuring the policy is valid anywhere services are provided, including off-site events like sporting competitions. These policies can offer coverage limits up to $1 million per claim and may also include license defense coverage and telemedicine coverage. It is recommended that chiropractors treating high-level athletes consider a malpractice policy with a minimum of $1-$3 million in coverage due to the increased liability. The Council on Chiropractic Guidelines and Practice Parameters is developing the Chiropractic Clinical Compass, a best-practices document to guide practitioners. This document aims to provide a comprehensive approach to patient health, incorporating the latest research, the doctor's experience, and patient preferences, moving beyond a "cookbook recipe for a particular condition." Research indicates that heading a soccer ball can generate forces of up to 450 lbs on the head, neck, and spine, leading to a higher incidence of cervical spine degeneration in players. Pathologies found in soccer players include disc bulging, bone spurs, and loss of the normal neck curve. While chiropractic adjustments are used to manage such conditions, the on-field setting introduces complexities regarding immediate post-adjustment care and monitoring. Following a chiropractic adjustment, soreness can be a normal side effect, and patients are typically advised to avoid high-impact activities and heavy lifting. The acute and often uncontrolled environment of a sporting event presents challenges to these standard post-adjustment protocols, raising questions about the appropriate level of care and patient education that can be provided on the sidelines.
