How best do you minimize the risks associated with MUA?  Consider the participants:

The Patient                

Of primary import is patient assessment to determine if s/he is a good candidate for the proposed treatment(s).  Consider contraindications such as osteoporosis, cancer, stroke history, uncontrolled diabetes or hypertension, heart disease, and the like. 

The Anesthetist

Who administers the anesthetic agent(s)?  Are you, the chiropractor, certified in MUA, do you employ or contract with a New Jersey-licensed anesthesiologist or do you provide this service through an ambulatory surgical center or outpatient, same day setting within a larger healthcare organization?  Do you employ or utilize an MUA-certified assistant as recommended by The International MUA Academy?  And finally, make sure you are comfortable with the skill sets of these professionals.  Have you taken the time to learn of their training, proper licensure and certifications as appropriate, current and adequate professional liability insurance and do you know something of their history with patient complaints and/or lawsuits?  In other words, if you are contracting or hiring directly these folks, do you have a mechanism to conduct a mini-credentialing process?

The Chiropractor       

You make certain the following is completed prior to commencement of treatment, including a complete medical screening, including blood work (as recommended by the National Academy of MUA Physicians, blood work includes a CBC, SMA 6), a chest x-ray, an EKG, and for women, a pregnancy test, as well as any additional tests as may be indicated (such as MRI, CT scan, X-rays, etc.).

The Setting                 

Chiropractic office is appropriately equipped for procedure, recovery, etc. if not using a same day surgery center, outpatient surgery in hospital or ambulatory surgical center and is equipped for anesthesia-related untoward events, such as cardiac arrest, anaphylactic reactions to anesthetic agents, etc. (monitoring and resuscitative equipment, swift transfer to inpatient setting if needed).  And the patient released to a responsible party following a monitored recovery that includes fluids and light snack.

Following the steps below routinely will serve to protect your practice from allegations of unprofessional care while affording your patients the highest quality healthcare services:

1. Be thoroughly knowledgeable and trained for each procedure or treatment you provide.
2. Review in understandable terms the risks, benefits and alternatives of a procedure with the patient before doing anything.  Be sure to document what was said and include any questions the patient had and your response to same.
3. Make certain the patient is a suitable candidate for the proposed treatment.
4. Follow up with the patient to get a status report on outcomes. 
5. Keep equipment properly maintained and adhere to maintenance schedules and suggested inspections.
6. Document recommendations, demonstrating your rationale for a treatment choice over other options.
7. Keep current with new treatment modalities, expanded or new applications for existing procedures and equipment, etc. and maintain a record of continuing education.

A benefit to being a late arrival in mainstream healthcare is understanding the lessons learned by those professionals coming before you who have suffered through allegations of unprofessional care and the requisite, annoying, time-consuming legal morass.

As many physicians, nurses and allied healthcare providers have discovered over time, a proactive mindset goes a considerable distance in preempting any opportunity to find fault and initiate litigation.  Better it is to contemplate the potential for a problem to arise, address it appropriately before it becomes a reality and by so doing, immobilize prospective plaintiffs choking the legal system (and your schedule).