COLUMN BUSINESS “The buck stops here” T Don’t blame mistakes on someone else BY ALLAN FREEDMAN his immortal phrase was popularized by President Harry S. Truman who had it written on a plaque on his desk in the Oval Office of the White House. The sentence was to signify the fact that the President had the ultimate responsibility for deci-sion-making and the ultimate respon-sibility for all decisions. What relevance does that phrase have to do with the practice of chiro-practic? Frankly, everything! A doctor who is a sole practitioner may well acknowledge that the “buck stops with them.” That would seem like a logical conclusion since he or she may be the only “doctor in the house.” While that is the apparent conclusion, the result is not always the case. Sometimes the importance of the phrase seems to be lost on practition-ers who may be associates or inde-pendent contractors within a health care team. A chiropractor may operate such practices, another regulated health care practitioner or a non-reg-ulated individual who owns the office, equipment and provides the support staff and all facilities necessary to carry on chiropractic practice. In the situations involving group practices – whether with another chi-ropractor or a non-regulated individ-ual, the phrase “the buck stops with the doctor” may, unfortunately, be replaced by: “teamwork is essential so that you can blame the mistakes on someone else.” As might be expected, the last phrase doesn’t work within the context of professional practice. Serious consideration must be un-dertaken by every doctor, whether a sole practitioner or practising in an environment owned by another individual, as to the responsibilities of and privacy of his or her patient re-a chiropractor as it relates to the stat-cords. When carrying on practice ute, regulation, by-laws, standards, within an environment established by guidelines and policies of the regula-a non-regulated health care practi-tory body in all aspects of the practice. tioner, serious concern must be under-Every file, intake form, computer re-taken by the associate practitioner to cord, financial statement, billings and ensure that the records are appropri-receipts, together with anything that ately secured and privacy is maintained. emanates for or on behalf of a patient If or when the relationship between the is the ultimate responsibility of the two parties is terminated, the health care practitioner has a responsibility to practitioner. There are far too many examples of ensure that a properly regulated prac-disciplinary hearings wherein a prac-titioner becomes the subsequent titioner will espouse the fact that the “HIC” for patient records. It is of no billings or insurance forms were pre-interest to the patient or a regulatory pared or submitted by someone in the body that the doctor and the owner of office other than the doctor. Who the clinic have an agreement relating to provides the forms or does the billings patient files. The appropriate legislation in the office is irrelevant when consid-regarding privacy and patient records ering that it is the practitioner who is supersedes any such contract. The pa-responsible for ensuring that tient files cannot be abandoned. everything – and no less than In conclusion, every part of profes-everything – is correct. Blaming the sional practice is the responsibility of owner of the practice, the support staff the doctor, whether as a sole practi-or even the computer program will not tioner, associate or partner. The ben-justify practice errors, and there efits of being an associate and having should be evidence that such a review a lack of apparent contractual obliga-took place. This also applies to matters tions when dealing with the office and such matters as cleaning, like the consent form signed by the patient. It cannot be Blaming the staffing or even turning off the left to staff to deal with its owner of the lights at night, does not dimin-execution, failing which, the practice, the ish the responsibility of ensur-ing compliance with patient document has no substance support staff, interaction, billings, patient or validity and may well be or even the records, etc. To ensure regu-used contrary to its intended computer latory compliance, a chiro-purpose. program will practor has to be cognizant of The responsibilities set out not justify what is happening in the office above are not merely related practice and ensure that everything to financial issues but also errors. that has to do with his or her include matters relating to professional practice complies patient records. Regulated health care practitioners are accus-with what is required by the regulatory tomed to the term “HIC,” which is the body and any other relevant organiza-acronym for “health care custodian.” A tion such as an insurance company, a doctor is responsible for the security privacy commissioner or worker’s compensation board. To paraphrase ALLAN FREEDMAN is a Toronto-based lawyer and an instructor at the Canadian Memorial Chiropractic the adage: “the buck stops with the College, teaching risk and practice management. You can contact him at [email protected]. doctor.” www.canadianchiropractor.ca 24 Canadian Chiropractor July/August 2019
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