Do physicians have a legal obligation to report fraud by chiropractors?

SDN Members don't see this ad. (About Ads)

A family member has been talking to me about this amazing chiropractor for the last couple years, and most of what I've been hearing has sounded very fishy. This past break while I was home visiting, I went in to watch a treatment. The chiropractor uses a "Toftness radiation detector" to supposedly detect variations in the patient's magnetic field. Then the chiropractor waves his hands over their body in a certain manner to correct this. He sometimes uses "cold laser" therapy on especially problematic areas. His entire practice is based around this, and he does no manual manipulation. He has a certificate on his wall from some craniology program, and this relative has told me he sometimes feels her head and has pressed around inside her mouth a few times.

This obviously sounds like fraud. I've read the Toftness device he uses was banned by the FDA, and nothing he does sounds remotely like chiropractics, despite him billing insurance for such. I feel he should be reported, but I'm a little afraid of blowback from relatives and the community. The state doesn't allow anonymous reporting, and a copy of the report would be sent to the chiropractor and most of the investigation made open to the public eventually. Do physicians have a legal obligation to report this? Any suggestions on how to handle this?

Is it possible to report him to whatever licensing board? Or is that the group that has no anonymous reporting? Is it possible to report him to your state's attorney general instead?

Originally Posted by tehdude

A family member has been talking to me about this amazing chiropractor for the last couple years, and most of what I've been hearing has sounded very fishy. This past break while I was home visiting, I went in to watch a treatment. The chiropractor uses a "Toftness radiation detector" to supposedly detect variations in the patient's magnetic field. Then the chiropractor waves his hands over their body in a certain manner to correct this. He sometimes uses "cold laser" therapy on especially problematic areas. His entire practice is based around this, and he does no manual manipulation. He has a certificate on his wall from some craniology program, and this relative has told me he sometimes feels her head and has pressed around inside her mouth a few times.

This obviously sounds like fraud. I've read the Toftness device he uses was banned by the FDA, and nothing he does sounds remotely like chiropractics, despite him billing insurance for such. I feel he should be reported, but I'm a little afraid of blowback from relatives and the community. The state doesn't allow anonymous reporting, and a copy of the report would be sent to the chiropractor and most of the investigation made open to the public eventually. Do physicians have a legal obligation to report this? Any suggestions on how to handle this?

Tricky area, no? Some people consider chiropractic itself a sham therapy, and the evidence for its efficacy is pretty weak in the first place. How do you prove that someone is only pretending to perform a therapy that is itself essentially nothing more than a placebo (per the evidence)?

I have been helped by real adjustments coupled with PT, but not the stuff he's talking about... either way, it's a personal preference... anyway, since the state doesn't consider chiro in and of itself a sham, you need to move beyond that in regards to this question...

It's not fraud because of a lack of evidence for chiropractics. It's fraud because the Toftness device exam and fixing people's auras are not chiropractic procedures. He is billing for services/procedures that are not being provided. And since the FDA banned the sale and production of the Toftness devices and ordered chiropractors to surrender ones they had purchased, is it even legal to use one now?

Originally Posted by tehdude

It's not fraud because of a lack of evidence for chiropractics. It's fraud because the Toftness device exam and fixing people's auras are not chiropractic procedures. He is billing for services/procedures that are not being provided. And since the FDA banned the sale and production of the Toftness devices and ordered chiropractors to surrender ones they had purchased, is it even legal to use one now?

This is partially correct. Even though this is not a "chiropractic procedure" it's still fraud if the DC is intentionally misleading his patients and gaining financially. Oddly enough, if he believes it is curative, he has at least a little legal ground to stand on in denying the fraud. Now, if the evidence is clear that this therapy is valueless and just so grossly negligent that he refuses to believe the evidence, then he could still be held liable. I don't know anything about the Toftness device, but if what has been noted is true (banned by the FDA due to ineffectiveness), I think that would go a long way to establishing his intent.

Back to the OP's questions, I have never heard of any physician being sanctioned for not reporting a bad DC.

Ed

Call the state chiro board and ask if Toftness is a legit technique in that state. If it is, end of story.

Be aware that there are many chiropractic techniques and that this DC may indeed be performing a legit form of treatment, aside from Toftness, that is legal and billable.

Fraud may be a tough case to make. If Toftness is expressly prohibited in that state and Toftness is exactly the only thing this chiro does, then perhaps you've got something. Otherwise forget it.

Originally Posted by Tin Man

Tricky area, no? Some people consider chiropractic itself a sham therapy, and the evidence for its efficacy is pretty weak in the first place. How do you prove that someone is only pretending to perform a therapy that is itself essentially nothing more than a placebo (per the evidence)?

Nothing more than placebo per the evidence? I'd ask you to explain, but I'm fairly certain that would be a waste of everyone's time. Please, at least do a little reading before pretending to be informed on an issue.

Originally Posted by facetguy

Nothing more than placebo per the evidence? I'd ask you to explain, but I'm fairly certain that would be a waste of everyone's time. Please, at least do a little reading before pretending to be informed on an issue.

Actually, he's right.

In fact, chiropractic spinal manipulation has been found to be ineffective for every medical condition. At one point it was believed to be effective for certain types of lower back pain, but the more recent systematic reviews find it ineffective for all conditions:

http://www.ncbi.nlm.nih.gov/pubmed/21952385

Some SBM skeptics wrote about it here:

http://www.skepticalhealth.com/2012/...ble-profession

Some of the biggest fears of chiropractic treatment is the recruitment of patients to all of their quackery, such as the bogus "aura" diagnostic machine, or their anti-vaccination propaganda, and all of that. I've spent a long time working in an orthos office during college and saw at least 2 patients a week who were diagnosed with scoliosis, or spinal spurs, or "uneven hips" by chiropractors, and nearly every time the patient's xrays were completely normal. And let's not even mention vertebral artery dissection.

Originally Posted by LouisianaDoctor

Actually, he's right.

In fact, chiropractic spinal manipulation has been found to be ineffective for every medical condition. At one point it was believed to be effective for certain types of lower back pain, but the more recent systematic reviews find it ineffective for all conditions:

http://www.ncbi.nlm.nih.gov/pubmed/21952385

Some SBM skeptics wrote about it here:

http://www.skepticalhealth.com/2012/...ble-profession

Some of the biggest fears of chiropractic treatment is the recruitment of patients to all of their quackery, such as the bogus "aura" diagnostic machine, or their anti-vaccination propaganda, and all of that. I've spent a long time working in an orthos office during college and saw at least 2 patients a week who were diagnosed with scoliosis, or spinal spurs, or "uneven hips" by chiropractors, and nearly every time the patient's xrays were completely normal. And let's not even mention vertebral artery dissection.

May I recommend that you read a little more broadly, i.e. more than one article by a well-known chirobasher (Ernst). Thanks, and happy reading (you'll be awhile).

Uneven hips... I have them... because my right leg is .5" shorter than my left. Scoliosis, my cousin has the worst case I've ever seen because her parents didn't treat it when she was a kid, she looks like the Hunchback of ND... moveable joints can and do slip and slide, if you weren't behind a computer I could show you how my clavical slips out of place and I have to 'crack' it back into place... if you've never been blessed with it be thankful...

I sent a rather lengthy letter to the state board detailing my experience with him, the Toftness detector, his treatment of correcting patients' auras, and included a copy of the FDA ruling on the device. I asked how investigations were typically conducted, if an investigator needed my contact info, etc... This is the reply I just received from the state board:

Never heard of it.

Whats that? How does it work? Did he learn this through his chiropractic college?

I need more information about this device, then I should be able to answer your questions.

I know it's a chiropractic board, but I was expecting a more formal and professional reply. Why are they asking me if it is taught at chiropractic colleges? Isn't that something they should know? Why are they asking me to look into it? Are they not responsible for investigating **** themselves? What a ****ing joke.

Originally Posted by tehdude

I sent a rather lengthy letter to the state board detailing my experience with him, the Toftness detector, his treatment of correcting patients' auras, and included a copy of the FDA ruling on the device. I asked how investigations were typically conducted, if an investigator needed my contact info, etc... This is the reply I just received from the state board:



I know it's a chiropractic board, but I was expecting a more formal and professional reply. Why are they asking me if it is taught at chiropractic colleges? Isn't that something they should know? Why are they asking me to look into it? Are they not responsible for investigating **** themselves? What a ****ing joke.

Don't let it get your aura in a bunch.

Originally Posted by facetguy

Don't let it get your aura in a bunch.

LOL. I like that reply.

I don't think you have a "legal obligation to report" as you've asked. You do have a legal obligation to not get involved in the fraud.

I can't imagine any reason why you'd be obligated to report this practice. We are typically legally obligated to report things that will harm a patient. Although this guy may be emptying his clients wallets he's not harming them. As far as billing fraud, that might be something to report to his insurer or one of the larger health insurance companies in your town. It may not be looked into, but at least you'll rest easier.

That chiropractic board response is frightening.