Fitness to Practise Learnings: Professionalism in all aspects of life

Background to the case

The Professional Conduct Committee (PCC) recently heard a case where a chiropractor (the registrant) was accused of fabricating records and evidence.

The matter was referred to the GCC by a patient who had been seeing the chiropractor for non-chiropractic care (both the patient and registrant were in agreement that the care he was providing was not chiropractic in nature).

Their professional relationship broke down and the following day the patient requested her records from the clinic through a Subject Access Request. She followed up with civil proceedings and a complaint to the GCC, as the registrant refused to refund her substantial upfront payment.

Neither the records provided to the patient in response to the subject access request, nor the report provided from the clinic (clinic investigation report) in response to her complaint contained any reference to a document titled “serious incident report” which was presented as a contemporaneous account by the registrant of what both had said on the day of the relationship breakdown. This is despite the clinic investigation report being dated only 10 days after this document was apparently written. 

The serious incident report only came to light later, when the patient pursued the registrant through the civil court for a refund. The patient further alleged that there were factual inaccuracies within the serious incident report.

Professional Conduct Committee Finding

The registrant claimed he made near contemporaneous notes. The Committee, however, has concluded that some of these notes were made some time after the event and that some of the forms were fabricated. Furthermore, the Committee found that the registrant created the Serious Incident Report for 7 April 2022 some time after the event and most probably after the internal clinic investigation report was completed on 17 April 2022. The Committee found there to be multiple inaccuracies within those records and that the registrant fabricated entries to disguise his shortcomings and to portray the patient in a poor light, probably to support his defence against her civil claim.

The Committee found that the behaviour fell far below that required by a registrant. It is behaviour that clearly, and understandably, caused the patient a great deal of distress and anxiety and would be considered deplorable by other members of the profession and the public alike. The Committee was in no doubt that this behaviour amounted to Unacceptable Professional Conduct and that the allegation was therefore well-founded.

In considering the appropriate sanction the Committee took account of the details of the case, and the mitigation offered by the registrant.

However they agreed that acting dishonestly and fabricating records is wholly incompatible with the profession of chiropractic. The registrant’s behaviour caused emotional harm to his vulnerable patient, who was desperate for help. It was an abuse of his position of trust and of his professional standing and there was a persistent lack of insight on his part. Additionally, there was a real concern that he would behave in this way again, putting patients at risk.

The Committee decided that the only appropriate and proportionate sanction in this case would be removal from the Register. They imposed a 28 day suspension to cover the appeal period should the registrant appeal (he did not) and then he was removed from the Register.

Learning

Chiropractors are expected to act professionally in all aspects of their life whether acting in their capacity as a chiropractor or not.

Standard B5 of the Code (2016) makes it clear that behaviour outside of a Registered Chiropractor’s role is captured and that Registered Chiropractors must act with honesty and integrity and maintain the highest standards of professional and personal conduct at all times:

B5 - ensure your behaviour is professional at all times, including outside the workplace, thus upholding and protecting the reputation of, and confidence in, the profession and justifying patient trust.

While the registrant and the patient in this case both agreed that he was acting outside of his role as a chiropractor, this does not allow the registrant leeway to act any less professionally.