The Standard of Care is the Backbone of Risk Management

Owning and operating a practice is difficult in today’s world.  Health care risk management ensures that the organization achieves its mission to serve the public and improve health while protecting the organization’s ability to make a profit.  In doing so, risk management must be based on sound principles. In litigation issues, we are judged based on what was the “Standard of Care” in this situation.  Standard of care is defined as “The type and level of care an ordinary, prudent, health care professional, with the same training and experience, would provide under similar circumstances in the same community.”

We are faced with the ongoing threat of COVID-19.  As society reopens, we are faced with the Delta variant of the SARS – COVID-2 virus.  We are faced with a mutation of the disease that can kill people and where vaccinations are not assured to thwart infection.  The chiropractic philosophy is ingrained in our minds, but as physicians, we must also rely on the scientific evidence emerging on this threat.  Ultimately, to minimize the danger of exposure and possible death, we must assess the risk, rely on recommendations for our communities, and act in the best interest of our patients, our staff, and our families.

Risk identification is just what it sounds like – what risks are presented to me/my patient/my organization with the scenario in front of me?  As one can see, the analysis part of the risk management process should take the individual through several of these “what if” questions to help arrive at the potential frequency and severity of an event.  In the COVID virus, death is possible, loss of productivity and income is probable, and litigation may be inevitable.  Our patients and staff look to us to make sound decisions based on fact and not opinion. If the risk is not minimized, patients may be inclined to take legal action against us.  If we do not provide a safe work environment, our staff may file a complaint with OSHA, resulting in fines, temporary closure, or jail time.

I believe it is the responsibility of all physicians to tackle challenging situations and arrive at trusted solutions based on sound guidance from authorities, governmental agencies, and our professional societies.  When risk management and ethics are the backbones of your policies and procedures, you will be able to conduct business without hesitation.  Each physician should consider what the CDC is recommending and apply it to their office.  In following government and state guidelines, each office will enjoy continued business while mitigating any risk.

CDC Update:

The Centers for Disease Control and Prevention emphasized that the new masking recommendations for people fully vaccinated against COVID-19 do not apply to health care settings. “This means that staff, patients, residents, and visitors should continue to wear masks as recommended in all healthcare facilities,”

CDC said health care facilities should continue to refer to CDC’s infection prevention and control guidance for recommendations regarding source control and physical distancing in health care settings.

May 17, 2021,

  • If you are fully vaccinated, you can participate in many of the activities that you did before the pandemic.
  • To maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.
  • Wearing a mask is most important if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated.
  • You should continue to wear a mask where required by laws, rules, regulations, or local guidance.

July 27, 2021,

Dr. Mario Fucinari is a Certified Insurance Consultant, Certified Professional Compliance Officer, and a Certified Physician Practice Manager.  For further information, you may email him at

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