When a Dallas-based chiropractor reached out to us last spring, her question was blunt and specific:
“Can a virtual assistant actually handle my SOAP notes? Like, correctly?”
She had tried a local assistant before—someone part-time, in-office—but it never worked out. The assistant didn’t understand the chiropractic flow, would skip the “Plan” section altogether, and let visit notes pile up for days. The result? Delayed billing. Frustration. Burnout.
We hear this a lot in the chiropractic space. Many D.C.s want to offload documentation but worry that outsourcing it, especially virtually, might compromise accuracy, compliance, or both.
The short answer? Yes, a trained virtual assistant can absolutely manage your chiropractic SOAP notes. But there’s a right way to do it—and a few caveats we’ve learned firsthand.
Let’s walk through the reality, not the hype.
What Chiropractors Really Need in a Documentation VA
We’ve staffed VAs across dozens of specialties—cardiology, dermatology, orthopedics—but chiropractors present a unique workflow. Shorter visits. More frequent appointments. Higher volume of hands-on data that has to be recorded fast and precisely.
From our experience, a good VA in this field needs three things:
- Proficiency with SOAP structure—Subjective (pain level, complaint changes), Objective (ROM, palpation findings), Assessment (response to prior treatment), and Plan (adjustment approach, next steps).
- Familiarity with chiropractic terminology and documentation shorthand (e.g., “C5-Sublux”, “PT modalities”, “Gonstead”)
- Real-time or near-real-time availability—because you can’t afford to have notes lag behind more than 24 hours.
And most importantly: They need a sharp ear. Because in many cases, the chiropractor is talking through the case while moving through the adjustment.
The Misconceptions: Let’s Clear a Few Up
Misconception #1: “They’re not licensed, so they can’t legally chart.”
Nope. VAs don’t need to be licensed to chart notes. As long as they’re working under your direction—and the notes are reviewed and attested by the provider—they’re functioning as documentation assistants. Just like in-office scribes. What matters is training and HIPAA compliance.
Misconception #2: “Only someone physically in the room can chart accurately.”
In our experience? Not true. We’ve onboarded chiropractic VAs who chart more thoroughly—and faster—than some in-person scribes. Why? Because we train them to listen actively during live Zoom or Teams sessions, understand context cues (like when the doc pauses to inspect ROM), and insert pre-approved phrases that reflect clinic-specific flow.
That said—video clarity, audio quality, and structured handoff processes matter. You can’t expect magic with a fuzzy mic and no template.
Step-by-Step: How a Chiropractic Virtual Assistant Can Document SOAP Notes
Step 1: Establish the SOAP Flow Unique to Your Clinic
Every chiropractor we’ve worked with has their own rhythm. Some dictate as they go. Others do a short voice memo after each session. Some prefer live scribing during the encounter.
We map out:
- Your preferred documentation method
- Your EHR system (ChiroTouch, Jane, or legacy platforms)
- Any shorthand, macros, or phrasing quirks you like
One client used “A/P rotation with stiffness” while another wrote “L3 restricted with mild tenderness.” We train VAs to speak your language.
Step 2: Create Clinic-Specific Templates and Quick Text
We’re big believers in front-loading the process. A well-structured template reduces time, error, and the dreaded back-and-forth.
We’ve helped clinics build:
- Baseline templates for common visit types (initial evals, re-exams, maintenance care)
- “If/then” phrasing logic based on patient status
- Modifiers for Medicare, worker’s comp, and personal injury visits
This is where our internal QA process shines. We’ve caught things like improper use of outcome measures in PI cases that would have delayed reimbursement. Lesson learned: PI visits need tighter documentation logic than standard visits.
Step 3: Live or Asynchronous Charting—You Choose
Live scribing isn’t always feasible. Some chiropractors prefer to record audio notes after each patient and have the VA chart from those.
We support both models:
- Live Virtual Scribing: VA joins via Zoom or secure VDI and charts in real-time
- Asynchronous Audio Charting: Chiropractor sends 30-60 second voice memos post-visit, and the VA completes notes within 6–12 hours
One of our Fort Worth clients started with live scribing, then switched to audio after realizing her internet lag disrupted patient flow. We adapted within 2 days.
Step 4: EHR Entry + Provider Review
VAs log into your system (we assist with secure credentialing) and enter notes into the EMR. You review and attest.
This workflow keeps you compliant with:
- HIPAA—we provide Business Associate Agreements, audit logging, and encrypted tools
- Documentation regulations—final attestation always lies with the licensed provider
- Billing standards—VAs trained to support compliant coding by referencing CPTs appropriately, especially for time-based procedures
In some states, chiropractors have had claim denials due to lack of clear documentation on modalities. Our VAs are trained to avoid that.
Step 5: QA Feedback Loop
Here’s where most staffing agencies drop the ball.
At Vital Virtuals, we conduct regular documentation audits. For chiropractic clients, we look at:
- Incomplete SOAP structures
- Repetitive phrasing (yes, even AI triggers this in payer audits)
- Errors in Plan documentation (especially frequency and duration misalignment)
We once caught a pattern where a VA was documenting “improved ROM” without matching it to the previous visit’s findings. We retrained the VA and updated the feedback system to prompt checks for baseline comparison.
Industry Trends We’re Watching
A few months ago, Chiropractic Economics published a piece on how EHR vendors are racing to add AI-powered charting features. The tools sound promising… but so far, what we’ve seen are clunky integrations and a lot of over-documentation.
In my view, the human ear still wins—especially in practices where tone, nuance, and patient phrasing matter. For now, AI might help with summaries. But humans still make the better scribes.
Especially when it comes to understanding the difference between “tightness” and “pain” when a patient says, “It’s just uncomfortable right here.”
Lessons We’ve Learned (and Improved)
Early on, we made the mistake of assigning a generalist VA to a chiropractic client without enough specialty-specific training. She was a great medical scribe—but unfamiliar with adjustment techniques, spinal abbreviations, or SOAP pacing.
We re-evaluated our onboarding flow and built a chiropractic-specific training module with input from licensed D.C.s we contract with. Since then, documentation error rates dropped by over 70% in the first 30 days of new assignments.
It taught us: Specialty matters. One-size-fits-all staffing doesn’t work in this industry.
The Insider Detail No One Tells You
Most people don’t realize: chiropractors often face tighter time windows for documentation due to their billing structure. Because many accept PI or workers’ comp cases, visit notes need to be ready for review by attorneys, case managers, or payers—sometimes within 24–48 hours.
So it’s not just about speed. It’s about accuracy under deadline.
And virtual assistants? When trained right—they excel at that.
FAQ: Real Questions Chiropractors Ask Us
How do I know if my virtual assistant is HIPAA-trained?
We require all VAs to complete HIPAA certification before assignment. Plus, we issue our own internal assessments and include a Business Associate Agreement (BAA) with each client engagement.
Can a VA log directly into my chiropractic EHR?
Yes. We support secure access via VPN, VDI, or IP-restricted login methods. We also help configure audit logs and session timeouts for compliance.
What happens if my VA misses something in a SOAP note?
You retain final sign-off. But we also do weekly QA audits and real-time feedback loops. If we spot repeated issues, we retrain the VA at no cost to you.
Will a VA understand my specific charting style?
Yes. During onboarding, we have a “charting voice” interview where you walk the VA through a few example notes. We record preferred phrases and structural flow for reference.
I’m worried it’ll slow me down. Is it worth the switch?
It takes about 1–2 weeks to fully ramp. But after that, most clients save 5–8 hours/week. Plus, they sleep better knowing documentation isn’t piling up after hours.
Final Thought from the Field
If you’re curious about how this might work in your practice—start small. Assign the VA just your maintenance visits. Or just your voice memo follow-ups. Let them earn your trust.
In my experience, the chiropractors who delegate just enough to start end up surprised by how quickly they gain back their time—and their evenings.
We built Vital Virtuals for exactly this kind of clinician. The ones who care deeply about accuracy but don’t want to do everything themselves anymore.
And yes—your SOAP notes can be offloaded. Smartly, safely, and effectively.
Let us know if you’d like to see what it could look like for your practice.
