Chiropractors and the Insatiable Desire to Write Reports

We have a lot of cases where patients have treated with chiropractors.

And I’ve treated with chiropractors.

(You know where this is leading. It’s a little bit like starting a story with: You know, I have a lot of friends who are ______________________________.)

But there are a lot of chiropractors who create this impression that it’s almost malpractice for attorneys not to request “narrative reports” or “closing reports” from them.

I’m not sure whether it’s something they learn at chiropractic college. Or if it’s a technique taught at continuing education seminars. But it’s extremely prevalent.

It plays out like this:

The chiropractor expresses surprise that the attorney hasn’t requested a “narrative report” or a “closing report.”

“Patient, it’s unusual that I haven’t heard from your attorney. Most attorneys would have requested a narrative report by now….”

The patient doesn’t know any better and calls our office in a panic: “I was talking with Dr. Bob and he said that you need to get in touch with him right away….”

I’ve occasionally had my arm twisted to the point that I’ve green-lighted these reports. And more recently received some sua sponte from chiropractors (along with their invoices).

Usually these reports reiterate what’s in the records and don’t really move the needle.

Sometimes the reports include new opinions that can be very detrimental to the case.

I don’t think I’ve ever had an adjuster pay more money on a case because there’s been a report from the chiropractor (especially when the client has been treated by, e.g., a board certified physical medicine and rehabilitation doctor or, really, any MD).

And even though I don’t have proof, I suspect that providing a narrative/closing report signals some level of unsophistication to insurance adjusters.

What we can count on with a narrative report is a charge (usually around $1,000) that I will advance and ultimately will come out of the patient/client’s share of the recovery.

I think this opportunity to bill (and get paid—at least initially—by the attorney) is the reason so many chiropractors raise the narrative/closing report issue with patients.

The patient manipulation component is somewhat gross and unfortunately casts a shadow over the entire practice of chiropractic.