Beyond the “Bad Apple”: Why Chiropractic Must Look Beyond Individual Misconduct to Protect Patients and Staff

“If harmful behavior repeatedly follows recognizable patterns, then the issue is no longer about a few bad apples. It is about understanding the orchard.”

By Lori-Anne Vogel, CEO Cornerstone Service Corp

When concerns are raised about inappropriate behavior, dangerous practices, boundary violations, harassment, or abuse by a chiropractor, the profession often responds with a familiar phrase: “That’s just a bad apple.”

The intention behind this statement is understandable. Most chiropractors dedicate their careers to helping patients and would never knowingly cause harm. Many feel personally accused when criticism is directed at the profession they love.

Yet the “bad apple” response may unintentionally prevent the profession from confronting a more important question: What if these incidents are not simply isolated acts of individual misconduct? What if recurring patterns of behavior reveal vulnerabilities within the profession itself?

A profession committed to patient safety cannot stop at declaring that most providers are ethical; it must also ask why similar complaints continue to emerge, how harmful individuals gain access to positions of trust, and whether existing safeguards are sufficient to protect patients, employees, students, and colleagues.

The Defensive Nature of the “Bad Apple” Argument

At its core, the “bad apple” response is often defensive. When someone shares concerns about misconduct, boundary violations, unsafe workplace environments, or predatory behavior, the listener may hear an implied accusation and immediately respond:

“I’m not like that.”

“Most chiropractors aren’t like that.”

“That’s just one person.”

While these statements may be true, they do little to address the concern being raised.

A patient who experienced misconduct is not asking whether most chiropractors are ethical. A staff member who witnessed inappropriate behavior is not questioning whether every chiropractor behaves the same way. They are asking whether the profession recognizes the problem, understands it, and is willing to address it.

Defensiveness shifts the conversation away from the concern and back toward protecting the profession’s image. Listening, by contrast, creates space for understanding what actually happened and why. A profession grows stronger when it can hear criticism without immediately attempting to explain it away.

Similar Complaints Suggest More Than Random Events

When misconduct occurs, it is often described as a unique event caused by a uniquely flawed individual; however, the stories shared by patients, staff members, students, and healthcare colleagues frequently contain striking similarities.

The details may vary, but common themes often emerge:

• Blurred professional boundaries.
• Isolation of patients during examinations.
• Disregard for informed consent.
• Lack of chaperone policies.
• Power imbalances between providers and staff.
• Intimidation of employees who raise concerns.
• Inconsistent reporting practices.
• Fear of retaliation.
• Minimization of patient complaints.
• Colleagues looking the other way to avoid conflict.

When the same patterns appear repeatedly, the profession must ask whether these are merely individual failures or whether systemic vulnerabilities are allowing similar behaviors to occur.

Recognizing patterns is not an attack on chiropractic. It is an essential component of quality improvement and risk management.

Finding the Chink in the Armor

Every profession has vulnerabilities.

Medicine has them.

Nursing has them.

Education has them.

Law enforcement has them.

Religious institutions have them.

Chiropractic is no different. The question is not whether vulnerabilities exist. The question is whether the profession is willing to acknowledge them.

• What attracts harmful individuals to positions of authority?
• What systems fail to identify problematic behavior early?
• What cultural norms discourage reporting?
• What educational gaps leave practitioners unprepared to recognize boundary violations?
• What assumptions prevent colleagues from questioning concerning behavior?

These questions can be uncomfortable because they force the profession to look inward rather than outward.  Yet meaningful progress begins precisely where discomfort starts.

How Do Bad Actors Find Their Way In?

Every profession grants access to trust. Patients allow providers into moments of vulnerability. They share private information, accept physical examinations, and rely on professional expertise. Most chiropractors honor that trust; however, professions built on trust can also attract individuals who misuse it.

The challenge is not simply identifying bad actors after harm occurs. The challenge is understanding how they entered the profession, why warning signs were missed, and whether existing educational, licensing, and workplace systems effectively identify concerning behaviors before patients or staff are harmed.

This requires examining:

• Admissions processes.
• Professional training.
• Clinical supervision.
• Reporting systems.
• Workplace culture.
• Continuing education.
• Disciplinary procedures.

A profession focused solely on punishment after harm has already occurred is operating reactively rather than preventively.

What Happens After Harm Occurs?

Another difficult question is whether consequences for harmful behavior are consistent and proportional.

When misconduct occurs:

• Are complaints investigated thoroughly?
• Are victims treated with respect?
• Are reporting pathways accessible?
• Is retaliation addressed?
• Are outcomes transparent?
• Are corrective actions implemented?
• Are lessons learned shared broadly?

Inconsistent responses create uncertainty and undermine trust. Patients need confidence that their concerns will be taken seriously. Employees need confidence that reporting misconduct will not jeopardize their careers. Furthermore, ethical chiropractors deserve to have confidence that the profession will protect its integrity rather than protect individuals who violate professional standards by turning a blind eye.

Patient Safety Is a Community Conversation

Perhaps the most important mistake the profession can make is believing these discussions belong only within chiropractic circles.

Patient safety is not solely a professional issue, it is a public issue. Patients, families, employees, healthcare partners, educators, regulators, advocates, and community members all have legitimate perspectives that deserve to be heard.

Some may worry that public discussion damages the profession’s reputation. The opposite is often true. Public trust grows when professions demonstrate transparency, accountability, and a willingness to confront difficult realities. Trust erodes when concerns are dismissed, minimized, or discussed only behind closed doors.

A profession confident in its future should not fear scrutiny. It should welcome it.

Moving Beyond Defensiveness

The chiropractic profession has made significant contributions to patient care and has helped millions of people improve function, reduce pain, and enhance quality of life. Those contributions are worth protecting, but protecting the profession does not mean protecting it from criticism. It means protecting it from the conditions that allow preventable harm to occur.

The next time concerns are raised about dangerous practices, boundary violations, inappropriate behavior, workplace safety, or patient safety, perhaps the most productive response is not: “That’s just a bad apple.”

Perhaps the better response is: “Tell me more. What are we missing? Where are the vulnerabilities? What can we do better?”

If harmful behavior repeatedly follows recognizable patterns, then the issue is no longer about a few bad apples. It is about understanding the orchard. Until the profession is willing to examine the orchard itself, opportunities to improve safety, strengthen accountability, and build public trust will remain just out of reach.

The goal is not to condemn chiropractic. The goal is to make it safer for patients, staff, students, providers, and for every person who places their trust in the profession.