Expert: Dr. Victor Dolan, DC, DACBSP - 6/17/2010

Question
You say that MDs and DOs will generally point blame to the chiropractor....my question is    If I was seeing a chiro who couldn't figure out why there was no improvement with my symptoms, yet an MRI(which he ordered of the spine) indicated that a Chiari Malformation 1 was sighted and he NEVER mentioned that to me...would he be responsible?
The MRI was done Dec 15, 2009, he continued to manipulate my spine AND NECK 3x a week for 6 weeks, before my PRIMARY doctor informed me of the Chiari in Feb, 2010.  I had surgery on April 21st.

Answer
Hello Eileen,


Thank you for your question.

I am sorry to hear of your complicated condition.

I am very surprised that your Doctor did not review your tests with you.  In my Staten Island Chiropractic office, when I send someone for a test; whether an Xray, Blood Test, MR, CT, EMG, NCV, whatever,,,, I discuss the findings, Line by Line with the patient.  I give the patient a xerox copy of the report.  I think most Chiropractic Doctors do that.

Some findings can be VERY VERY significant, some findings are not important at all.  I do try to explain the whole report, I give a copy of the report, and I invite the patient to ask questions about that report on ANY followup visit, I also tell them to share the report with their Medical Doctor(s) as well.

Are you sure your Doctor did not go over the report of the test with you?  I would be surprised and disappointed.  Did your Doctor give you a copy of the report?  I think this is good practice to do (I always give copies out), it invites questions and explanation.

There are many Chiropractic Techniques.  Some techniques I would not utilize with a patient with Chiari Malformation, some techniques would be acceptable.  Did the Doctor's treatment of you make you better?, worse?, have no effect?
         Ultimately you proceeded to surgery, was this BECAUSE of the Chiropractic intervention? (did Chiropractic make you worse?), was this IN SPITE of Chiropractic intervention- the Chiropractic did not make you better OR worse?,  Did the Doctor CAUSE your need for surgery?, certainly there are safe techniques that should not have worsened your condition.

I do think ANY Doctor of ANY discipline should order appropriate testing, review and EXPLAIN that testing with any and every patient.  Testing MUST influence our plan of care, our treatment choices.

You ask "........would he be responsible?....", should he have told you and explained the condition and treatment options available; yes, I think he should have reviewed the test results with you.  Your question "........would he be responsible?....", do you mean for the surgery?- that I do not know, I cannot answer that; the Doctor's records and your memory would help determine that- did the Doctor worsen your condition?, did the treatment do nothing?

The Doctor of Chiropractic should have informed you of your MR test results- good and bad, the normal and the abnormal should have been discussed with you.

The DC should have been well aware of these findings, particularly if he(she) had ordered the test, and adopted an appropriate treatment approach based upon the findings.

Perhaps the MRI used words such as 'minimal', or 'insignificant', or perhaps 'partial' or something like that.  Some Doctors do not want to alarm patients if a report is only 'slightly' 'abnormal'.  Perhaps, depending upon the report's verbiage, perhaps that is why the Doctor did not discuss this with you.  Again, in my office, I review the tests I order, the tests I can get a hold of from other Doctors and report the normal/ abnormal/ etc with my patients- I think most Chiropractic Doctors do this, but perhaps there are still some that do not.

But, as stated before- The Doctor of Chiropractic (as with any Doctor) should have informed you of your MR test results- good and bad, the normal and the abnormal should have been discussed with you.  This test result should have weighed in on the decision as to the TYPE of treatment the Chiropractic Doctor may have decided to apply or refer to.

I understand your frustration, EVERY day I review test findings with patients- sometimes tests that I have ordered, sometimes tests that a different Doctor has ordered,,,, and EVERY day patients tell me that their Doctor ( MD, DC, DDS, whatever) did not review their test at all, or did not take time to explain things.

I hope this helps you.  If you need further information- do not hesitate to RE-contact me here at AllExperts.com , your Staten Island Chiropractic Expert at  http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Again, Thank you for your question.  I hope you are feeling much better now after surgery!
Good Luck and Good Health to You.

Dr. Victor Dolan, DC, DACBSP