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Chiro Assistance Roll With testig

Exit forum ID Forum Discussion Chiro Assistance Roll With testig

This topic contains 3 replies, has 3 voices, and was last updated by   Jamie Hansen April 8, 2019 at 2:58 pm.

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    Jamie Hansen

      Hey Everyone,
      A few questions/concerns regarding the roll of a CA.
      I understand completely the roll of the CA to help with note taking, SX update prior to the dr coming coming into the room, and even testing while dr is present. I wanted to know everyones thoughts and feed back regarding the CA doing an exam with out a Dr present in the room.
      My concern with this is its our license and our signature, and I for one am not comfortable without over seeing what is being done during an exam that I will ultimately be liable for.
      I was thinking about how an MD office works and yes while the nurse does all the HX, “pre” work-up, before the dr comes in at the end of the day the nurse is a registered nurse with a nursing degree, not a college grad or someone we hired.

      Thank you in advance for all the feed back.



      Adam Holen D.C.

        Hi Joe, I don’t operate at this level quite yet, but I’ll take a stab at it. First, your CA has to be very dialed in on testing in order to gain an accurate representation of function. You can always re-measure something if you aren’t sure they did it right or it’s an outlier. This is analogous to a nurse reading your blood pressure and the Dr. interpreting the data. Before you’d allow your CA to do this, they’d have to show complete competency of what and how they’re measuring. You can always be in the exam room while they do their thing for a while until you feel comfortable with them. As far as I know, there’s nothing legally wrong with someone else measuring function as long as they are competent. A dentists assistant does all the work then the dentist comes in to make sure everything looks good. The “doctor” part of the encounter comes from interpreting the data and establishing a diagnosis, then clearly communicating that with the patient. You are as liable for a competent CA doing their job as you are for the patient to provide accurate clinical information. It’s not always straight forward which is why we ask patients to clarify details. A CA is only collecting information, not interpreting it, which leaves the liability to the accuracy of data collected and your confidence in their ability to do that. Hopefully, this helps, again this is not the clinical level we operate at yet, but this is my understanding. Others who do have CA’s doing a lot more data collection may have other points to make.


        Drew Ruebbelke


          The role of the CA is to do be able to do everything that doesn’t require “Dr.” in front of the name. They should be proficient in being able to perform the examination, especially when using forms that guide them along the way. Making the diagnosis is something they cannot do, not just because of training but also because of the law and licensure issues. I understand where you’re coming from when it comes to being liable. The best bet is to have them get started on the exam, and you come into the room to double check and confirm their tests, establish the diagnosis, and go over the ROF with the patient. I have my CA in the exam room with me as a scribe only. They also take photos and mark them up. I put my signature at the bottom of all notes, including the exam as a confirmation of the diagnosis and that it was made by me. Hope this helps.


          Jamie Hansen

            Thank you guys for your input. I am currently on the same page as Drew with having the CA in the room asking questions, and writing notes and after the initial exam, doing the exam measurements but with me watching.
            It’s a process to get comfortable with, even having them grade any follow up exam.

            Thanks again for the feed back.

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