Our client is a chiropractor whose patient had complained to the GCC about a treatment given. With our assistance through DAS legal expenses insurance a detailed response was provided to the IC. The IC when finding no case to answer and exhonerating our client commented on the detailed response from our client. They found that the chiropractor's and the GP notes did not support the patient's claim.

John Williams commented

"This case is a good example of how early intervention of lawyers and providing a detailed response can be instrumental in stopping disciplinary proceedings at the IC stage. This avoids all the stress and trauma of a fully blown PCC hearing, not to mention the risk to livelihood and career of an adverse outcome. Last but not least it emphasises how crucial it is in your practice to have full and detailed notes. I cannot stress too highly how important it is to take full and legible notes at all stages of a patient’s  care. These should cover full assessment (including negative findings), rationale for treatment, patient consents for all treatments, not just at the outset but on reviews and changes, SOAP notes,  a clear record of the treatment provided and if more than 12 treatments are provided appropriate reviews and notes thereon. If x-rays are necessary it is vital that the justification for x-rays is clear. Also be careful to consider where you decide against x-rays to record your reasons when x-rays would be expected. Record in your notes in inverted commas a patient’s account of how they are progressing under your treatment.

Good communication between you and your patient is crucial to avoiding complaints but full and comprehensive notes are your best defence to unjustified patient complaints. Not only are poor notes a breach of the COP in their own right but if they are poor it is likely, in the eyes of the GCC Committees, to add weight to a patient’s complaint. Poor notes will also make our job in defending you more difficult. Remember the lawyers’ maxim “if it is not written down it didn’t happen”.