He Said, She Said: Managing Conflicting Patient Accounts
Originally published: 2025-11-18
Few things make chiropractors more uncomfortable than being caught between conflicting stories. Whether it is a disagreement over what was said, a complaint about a fee, or a patient claiming you promised something you did not, these “he said, she said” moments happen in every practice. The key to protecting yourself is avoiding emotional responses and relying on your documentation, not your memory.
Why Conflicts Escalate
Most disputes start small, a misunderstanding about a recommendation, a missed appointment charge, or a perceived slight during care. When communication is not documented and expectations are not clear, those misunderstandings can grow into formal complaints.
“In a dispute, the person with the clearest documentation wins, not the loudest voice.”
Step 1: Stick to Facts, Not Feelings
When a patient calls or confronts you about a disagreement, listen without defensiveness. Take notes immediately, summarize what they said, and clarify your understanding. Never argue or accuse. Your goal is to diffuse tension and document the encounter, not to win an argument.
Include in your notes:
What the patient stated
What you responded
Any resolution offered
Whether follow-up or dismissal is appropriate
Step 2: Review Your Records Before Responding
If a patient disputes something from a prior visit, review your notes before commenting. Avoid relying on memory, even if you are sure of what happened. Respond only to what is documented. If the notes are incomplete, add a dated clarification rather than altering existing entries.
Step 3: Communicate Clearly and Professionally
Always respond to disputes in writing when possible. Thank the patient for bringing their concern to your attention, restate the facts neutrally, and describe any corrective action or explanation. Do not include personal judgments or frustrations.
Step 4: Involve Your Malpractice Provider When Needed
If the conflict involves an accusation of harm, inappropriate behavior, or billing fraud, contact your malpractice carrier before responding further. They can help craft a professional reply and ensure your language does not inadvertently admit fault.
Lessons From Previous Incidents
In one situation, a patient alleged that a chiropractor promised “guaranteed results” that never came. The doctor’s notes included an entry stating, “Patient informed that outcomes vary.” That single sentence ended the dispute immediately. In another case, lack of documentation allowed the patient’s version to stand uncontested, resulting in a formal complaint.
The Risk Management Bottom Line
Conflicting accounts are inevitable, but defensible documentation makes them manageable. Stay calm, stay factual, and let your records speak for you.
ChiroFutures provides tools and training to help chiropractors maintain objective documentation and professional communication that prevent minor misunderstandings from becoming major disputes.
