The 'Board-Certified' Groupon
Dr. K opens a new clinic and advertises: 'Minnesota Board-Certified Chiropractor-Guaranteed Cure for Asthma, Colic, and Migraines.' The website says 'Free New Patient Exam' in large type and, in 8-point type at the bottom, 'Free exam only with purchase of a $1,200 12-visit package; otherwise $95.' A patient testimonial says, 'After three adjustments I stopped using my inhaler-never going back to my doctor.' Dr. K also sells Groupons for a '60-minute massage and adjustment' performed by a newly hired massage therapist who is not licensed in Minnesota. The clinic's fee schedule is not posted, and staff quote prices only after treatment. Dr. K says the state board 'approved' the wording because a friend on the board liked it.
1. Identify the advertising problems and explain the standards that apply.
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The advertising is misleading in several ways. A claim of 'Minnesota Board-Certified' can imply certification by the state licensing board when the chiropractor may hold a private certification; any certification must be clearly identified and not overstated. 'Guaranteed Cure' for asthma, colic, and migraines is false or unsubstantiated and creates patient-safety risk, especially where the testimonial suggests stopping an inhaler. Patient testimonials require written authorization and cannot imply guaranteed results or discourage necessary medical care. The 'free' exam is deceptive if the real condition is buried in small print. A board member's personal approval does not constitute Board approval of advertising. Advertising must be truthful, not misleading, and within the chiropractor's scope; the clinic should revise the website, remove the cure and inhaler claims, make all conditions conspicuous, and keep substantiation for any comparative or outcome statement.
2. What are the fee-disclosure and Groupon issues?
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Patients should know the cost of care before treatment. A 'free' offer with a hidden $95 or $1,200 condition is not clear and conspicuous, and quoting prices only after service deprives patients of the ability to consent to the financial terms. The clinic should post or provide a current fee schedule, explain package terms, expiration dates, refund policy, and whether the package is transferable, and obtain written acknowledgment before care. The Groupon must accurately describe what is included and who will perform each service. If the massage therapist is not licensed in Minnesota, the massage portion cannot lawfully be provided unless an applicable exemption applies; the chiropractor should verify licensure before advertising or delivering the service. The adjustment portion must be performed by the licensed chiropractor, not the massage therapist. Groupon revenue does not change the underlying licensing and disclosure requirements.
3. May the massage therapist perform the adjustment, and what supervision is required?
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No. A massage therapist, licensed or not, cannot perform a chiropractic adjustment. The adjustment is reserved to a licensed chiropractor. The chiropractor may employ or collaborate with other licensed providers only within their own scopes, and must verify Minnesota licensure, maintain appropriate space and equipment, and follow delegation and supervision rules for any unlicensed assistive staff. The massage therapist may perform massage only if properly licensed or exempt. Dr. K should correct the Groupon, stop any unlawful cross-delegation, document credential verification, and train staff not to describe massage as an adjustment. If the therapist has already performed adjustments, Dr. K should consult the Board and his malpractice carrier and review the affected records.