"Life should not be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways, chocolate in one hand, wine in the other, body thoroughly used up, totally worn out screaming "WOO HOO what a ride!"

November 20th.

The summer months are hotter and November is colder than I ever remember it.  That being the case it is time for me to take my bi-annual (ie. every two years) vacation.  This is definitely going to have to happen more often -- as in a trip to Italy in May.

Anyway, we are heading to south of the 49th parallel where there is no discussion about politics, religion, gun control, crime, and likely hockey, baseball and basketball.   My discussions will have to focus on cigars which will likely lead to an argument about which are better -- cuban or domenican.  The answer is always the same  -- it depends!   My favorite cigars still remain OPs and in "other peoples".

be well.


What is with the chiropractic profession.   I know that there are lawyers who call themselves criminal lawyers, real estate lawyers, family law lawyers.   I know that there are medical doctors who are called family practitioners, or surgeons or radiologists, etc.   Even chiropractors may be described as sports chiropractor, radiologist, animal chiropractor.   These all deal with some specificity and as a member of the public I can understand what is being described.

BUT I have never ever heard of a principled medical doctor, a vitalistic lawyer or an evidenced based accountant.

When I first became familiar with the profession I was amazed to be informed that there are straight, mixers, fuse busters and vitamin selling chiropractors.  Wow, is there specialty that teaches "mixing"? 

Then as the years went by more adjectives popped up  -- "principled, vitalistic, mechanistic".  All describing an individual and I suppose how they practiced.  Like any patient really gives a damn!

No wonder the profession is fractured -- not separated ie. subluxated (if that is a term)  -- just fractured.   Until the adjectives are stricken from the words emanating from the lips of chiropractors there is no hope whatsoever for unity within the profession. 

So let the patients/clients describe the practitioner as being passionate, warm, and caring.   But no patient/client I have ever met has ever referred to me or any other lawyer I know as being principled or even evidence based.    Actually, I am both evidenced based (when my opinions are based on case law) and vitalistic when I have to dream up a claim or defence which is unique and without precedent.

have a great day


Everything has a value if someone is willing to keep it or buy it.  That includes reputation.

In the case of a chiropractic practice there is no question that the practice has a value whether large or small.  The value is dependent on what is being valued and all of the factors affecting its saleability.  Formulaes and equations for valuations of a practice are tossed around like spaghetti and in some cases they stick to the wall, sometimes to the dismay of the purchaser or seller.

Prior to any negotiation, a proper valuation of a practice should be undertaken.  The price for a practice whether created by the seller or the purchaser should be based upon a proper valuation and not just a figure pulled out of the air.  If bank financing is required for the transaction the finance company may require the valuation.  But not unlike a home inspection, the valuation is part of a due diligence process that has to be properly undertaken.

And remember, you almost always get what you pay for.  A $200.00 inspection will likely get you exactly what you paid and not much more.  The same relates to a practice valuation.   It is amazing that individuals buying a property for a half-a-million dollars more will balk at paying $1,000.00 for a home inspection.  The same applies to a business valuation.   So, be careful.

Have a great day.

Letters - you've got mail!!!

Instead of a visit from your friendly insurance representative demanding an immediate meeting without an appointment, you receive a two or three page letter from an insurance company requesting (demanding) a detailed reply concerning your office, your policies, information about your staff and billings.   They are likely to set out a list of patients whose files they want copies of.  The letter requests that you confirm that you will provide the information and failing which they may take other action -- contacting your "association".

The first thing you should do is take a deep breath and contact your lawyer.  Why your lawyer?  Because he or she will advise you as to whether you are obligated to provide some or any of the information being requested by the insurance company.  Unless you invoice the insurance companies directly, and even if you do, you are not under any compulsion to provide a "history" of your office. 

If the insurance company is not happy with your lack of a reply, they may terminate any direct billing you may have with the company, but remember that it is your patient who is ultimately responsible for your invoice.

You may be required to provide a copy of your patient records, including billings, but that is dependent upon whether a consent has been provided by the patient.  And remember, if the consent is part of an insurance application then an up to date consent should be obtained from the patient, since it is likely that the patient is unaware that he or she ever provided the consent for the release of the information.

The insurance company will likely also advise you that you must provide the information at no cost.  That is also not correct.  It will be the responsibility of whomever you are producing the records for to reimburse you for the time and cost.  But be reasonable.  A reasonable charge is not inappropriate but there is no common sense involved in creating a situation where the insurance company or the patient is irritated by an invoice for production of the material.

Again, the best thing to do when receiving a request for production of patient information is to seek legal advice to ensure that the documents are provided in accordance with the requirements of your licencing body.

have a great day

Insurance Guests

The scenario that is presented to me over the telephone involves an individual appearing at a doctor's office to see the doctor.  The purpose is to interview the doctor and review some patient files.  No appointment had been arranged for the individual and doctor to meet.

The phone call is usually from a distraught staff member who has been told to call me and find out what obligations exist for the doctor to meet with the insurance individual who is somewhat forceful in their approach to the fact that the doctor must meet with the uninvited individual.

The last time this occurred, this is what happened:

I asked the staff member whether a meeting had been arranged.  She indicated that the insurance person showed up uninvited.  I asked what the individual requested.  The insurance person requested a face to face discussion with the chiropractor and a review of approximately 10 files.

I told the staff member to put the individual on the phone with me.  I introduced myself to the individual and asked her to introduce herself.   I then indicated that by chance I had an insurance policy in place with the insurance company that she represented.  I asked her if I was to go to downtown Toronto, walk into the very large office tower in  which the insurance company was situate, was to take the elevator to the floor on which the president of the insurance company was located and advised the secretary that I wanted to meet the president and review my file without an appointment do you think that the meeting would take place.   I told her that it was a rhetorical question  -- that she should contact the office by mail or email -- make an appointment and otherwise leave the office.

The insurance person was a little astonished by the response, gave the phone back to the staff member and left the office.

If a person visits your office who is duly authorized to meet with you without permission, ie. the police or the licencing board then they may well be entitled to meet with you  -- but even that requires advice and most likely intervention by appropriate legal counsel prior to the meeting actually taking place.

While it may seem polite, it is a disaster waiting to happen when a doctor is ambushed into such meetings  -- and remember "no good deed ever goes unpunished".

have a great day.

October 25th

So am I lazy or just not interested.   Neither, I am just busy with other things which may or may not be as important. 

I am still here.   I get asked (as a senior citiizen) if I am retiring.  My response is:   "Lawyers don't retire, we just lose our appeal."

Anyway, I am also still writing and lecturing.  The latest presentation was on issues involved in chiropractic and medical legal reports.  It was a power point presentation with a paper presentation.  I did my usual fast talking  - at about 200 words a minute - which is pretty fast -- in order to finish within 90 minutes.   If you want a copy of the paper just send me a note  -- reply to this blog or send me a note at allan@amf-law.ca.

There are still dozens of issues involved in health care law and basic risk management which I can comment on -- actually I can comment on anything whether I know anything or not  -- that is the best part of the internet.

So for today -- over and out.
It has been years since I last posted  -- why -- because.   Like the answer to 90% of all questions -- which is "depends";  "because" works just as well.

I had nothing special to say - at least to strangers.  If I had something of use to say  -- I would say it.  I suppose I can now do an update, but that will come later in the day.

Right now all I can say is  -- see you soon.