The Weekend Coverage Request
Dr. Reyes holds an active Arizona chiropractic license and practices in Tempe. A physical therapy clinic in Mesa asks her to cover for an injured colleague for two Saturdays, performing spinal adjustments on the clinic's existing patients. The clinic's owner tells her the arrangement is fine because the patients are already under chiropractic care and she will not be diagnosing or creating treatment plans, only delivering the scheduled adjustments. She is not an employee of the clinic and will be paid per visit. Dr. Reyes reviews her own malpractice coverage, which names her Tempe office address, and notices the clinic's intake paperwork lists the injured colleague as the treating physician. She has never worked at a second location and is unsure whether her license permits it, whether the clinic's paperwork is adequate, and what she must document for the two Saturdays.
1. Does Dr. Reyes's Arizona license permit her to deliver adjustments at the Mesa clinic, and what conditions should she confirm before agreeing?
Read the worked answer
A license is not location-bound in the sense of restricting a chiropractor to one address, but the arrangement still has to satisfy several independent requirements, and the question is really about those rather than about a geographic permission.
First, she should confirm the Mesa clinic is a lawful setting for chiropractic services and that the patients' care is properly supervised by a licensed chiropractor. Delivering adjustments to patients whose treating physician is someone else, without any diagnostic role, edges toward technician-style delegation. She should insist that the covering relationship be documented so that she is the treating chiropractor of record for the visits she performs, with her own brief assessment and a plan for each patient.
Second, she should verify her malpractice coverage extends to the Mesa location and to per-visit contractor work. Practicing outside the covered scope is a business and ethics exposure even where the license is valid.
Third, she should confirm the clinic will correct the intake paperwork so patients know who is treating them, and that she will have access to prior records sufficient to treat safely. If any of these cannot be resolved, declining the arrangement is the defensible choice.
2. What must Dr. Reyes document for each of the two Saturdays, and why does the clinic's existing charting not substitute for it?
Read the worked answer
For each patient she adjusts, Dr. Reyes needs her own entry: date and time of service, the presenting complaint or reason for the visit, relevant subjective and objective findings, the specific areas adjusted and the technique or method used, the patient's response, any adverse reaction, and her recommendations or plan, plus her signature and credential. If she observes anything suggesting a new problem, the entry should reflect that assessment and any referral.
The clinic's existing charting does not substitute because it attributes care to the injured colleague. A record that names a physician who was not present misrepresents who rendered the service, undermines continuity of care, and creates a documentation gap if the visit is later examined in a complaint or audit. Her entries must make clear that she, not the absent colleague, performed and evaluated the service.
She should also keep a simple log of the dates, patients seen, and the covering agreement itself, so the arrangement can be explained if questions arise later.
3. The clinic owner proposes that Dr. Reyes simply sign the colleague's pre-written notes for the two Saturdays. Evaluate this proposal.
Read the worked answer
Signing another practitioner's notes would be false documentation. The signature on a clinical entry represents that the signer performed or directly supervised and verified the service described. If Dr. Reyes did not perform the service recorded, or did not verify the findings herself, her signature misstates the facts.
Even where the colleague drafted notes in advance based on an expected plan, Dr. Reyes must actually see the patient, form her own findings, and record what she did. She may reference the prior plan, but she cannot adopt a note describing an encounter she did not have.
Beyond the recordkeeping problem, the proposal creates a billing misrepresentation if services are billed under the colleague's name or as the colleague's work, and it exposes both practitioners in any complaint. The correct response is to decline, document her own encounters, and, if the clinic insists on the pre-signed arrangement, withdraw from the coverage. The professional obligation to keep accurate records is not waivable by an employer's convenience.