State Board Bullies: Lessons Learned
Rate This Article:
0
Dynamic Chiropractic, in a report posted HERE by James Edwards, DC, points out the necessity of diligent observance of one's state chiropractic board.  We invite readers to check the full article. This report contains excerpts from Dr. Edward's original article.

Says Dr. Edwards "Most of you probably believe that if you follow the rules and run an ethical practice, you have nothing to fear from your state board. In most cases, that is true. However, if your state board has one or more rogue members who are using their powerful positions to further their own personal agendas, look out! I share the following with you in the hopes that you can make the right decisions if a licensing board action is ever filed against you or someone you know."

Dr. Edwards recounts his experience on various boards and licensing entities  and notes  "on each and every one of those disciplinary panels, I used every ounce of my being to try to objectively evaluate the facts, fully knowing that both the doctor's career, and the protection of the public, hung in the balance."

As an active participant in the national leadership of the chiropractic profession Dr. Edwards notes "Believe me when I say that the overwhelming majority of state board members are highly principled, public servants who are true pillars of the chiropractic profession. In fact, I have twice written about the debt of gratitude we owe to state board members who are willing to sacrifice their time and energy on behalf of the public, with little to no reimbursement for the many hours they are out of their offices."

He reports, however, that "I've also met a few rogue state board members who were unquestionably using their powerful state board positions to further their own personal agendas, often at the expense of good doctors of chiropractic who had the misfortune of appearing before them in disciplinary investigations. Yes, just because a state governor appoints a doctor to a state licensing board does not guarantee that they are capable or have the right intent or motives."

"Nevertheless, I have almost always sided with licensing board decisions in regard to disciplinary actions against doctors of chiropractic, for two reasons. First, I truly believed that state boards and their staff had properly investigated the matter. Second, I truly believed that protecting the public was the full board's sole motivation for disciplinary action that was taken against the doctor."

But, Dr. Edwards states, "based on my recent personal experience and my observation of other cases, I no longer hold that position because I have learned that just one or two renegade state board members can seriously, and permanently, damage a doctor's license, practice and reputation. At the same time, they can destroy the integrity of the entire process."

"A former patient filed a frivolous complaint with the Texas Board of Chiropractic Examiners against our associate doctor alleging an injury as a result of a spinal adjustment. For lack of a better term, the patient also filed a "ricochet" complaint against me. After submitting a detailed, written response to the patient's complaint against both our associate doctor and myself, the staff of the Texas Board Enforcement Committee recommended dismissal of both complaints. For that reason, I was surprised to be "invited" (but not required) to appear before the three-member enforcement committee."

"Once my informal hearing began, I was stunned when the DC members of the committee began a full inquisition into anything and everything in my patient file, well beyond the allegations of the complaint, and did so in what I considered to be an extremely aggressive, rude and disrespectful manner. Far from being 'presumed innocent until proven guilty,' this lack of respect demonstrated to me that certain committee members were determined to find some basis to find me 'guilty' of something."

"While this type of inappropriate behavior would intimidate the average practicing doctor, my state board experience allowed me to respectfully, yet forcefully, defend against their unfounded accusations. At the end of the 90-minute grilling, and after having fully addressed all their questions, I left the hearing very confident that the complaint against me would finally be dismissed."

"Well, I was wrong. While the enforcement committee did indeed dismiss the complaint against our associate doctor, I was sent a "Proposed Agreed Order" in which I would pay a $250 administrative fine, and the disciplinary action would become part of my permanent record. Even though this would have been an easy way to get the matter behind me, I rejected their offer because I will never admit guilt when none exists. Since I strongly disagreed with the committee's ad-hoc and arbitrary standard, I then filed to have the matter decided by an administrative law judge."

"Fortunately, the enforcement committee ultimately closed my case...the matter finally ended."

Dr. Edwards states "every doctor of chiropractic is entitled to a courteous and professional proceeding and to fair notice of the allegations against them. By publicizing what I went through during the ordeal, it is my hope that the process can be improved and good doctors will not have to endure the same type of treatment. The following comments are based on my case and my observations of other cases:

  • Enforcement committee members should not be allowed to sit in judgment of a doctor of chiropractic with whom they have had a dispute, particularly one involving the corporate names of their practices in the same city.

  • The enforcement committee should stick to documentation standards that have been published, giving all doctors fair notice of conduct proscribed. For example, the CMS Trailblazer Medicare Manual should not be touted as the "Bible" for clinical documentation for a non-Medicare patient. Absent a published board standard, the enforcement committee should use an accepted standard, like the American Chiropractic Association's Clinical Documentation Manual, instead of making up a higher documentation standard in an attempt to make a case against the doctor.

  • The enforcement committee should stick to examination standards that have been published, giving all doctors fair notice of conduct proscribed. Absent a published board standard, an examination that meets the necessary components under Current Procedural Terminology (CPT) for reporting a particular E/M service is sufficient.

  • The enforcement committee should stick to X-ray release standards that have been published, giving all doctors fair notice of conduct proscribed. Absent a published board standard, it is inappropriate to attempt to discipline a doctor on that basis and especially when the X-ray release form contains language that has been in widespread usage throughout the profession for years.

  • The enforcement committee should respect and trust the board's investigative staff's recommendation to dismiss a complaint, unless there is a compelling reason for not doing so.

  • Finally, the standard should be the same, regardless of who the doctor of chiropractic is. The enforcement committee should not declare that some doctors are held to a higher standard because they have been a state and/or national leader in the profession."
As an observation, Dr. Edwards notes "So, should you always fight a licensing board action? Based on my experience as a member of the Kansas Board of Healing Arts, the answer is: heck no! If you realize that you were materially deficient in some manner or were indeed guilty of a violation, I advise that your attorney attempt to negotiate the best settlement possible, pay the fine, correct the deficiencies, and move on."

"However, if you truly did nothing wrong and are being treated unfairly by one or more board members, then fight back. Based on my experience, here is my advice about how to protect yourself from a renegade enforcement committee and/or renegade board members who may have a personal agenda or a vendetta against you."

"First and foremost, make sure your malpractice insurance policy affords coverage for licensing board disciplinary actions....I cannot overemphasize the importance of having this coverage. In my opinion, this coverage is not a luxury, but an absolute necessity. If you do not have it, don't wait until tomorrow to get it..."

"Second, if and when you receive a notification from your state board about a possible disciplinary against you, get a lawyer immediately. Do not try to reason with the board members in an informal hearing because, to a great degree, you are "playing another man's game." The members of your state board have been through this process many times before and know all the rules. You, on the other hand, likely have no experience in this area and, without expert legal advice from a competent health care attorney, will likely become cannon fodder."

"Third, consider retaining chiropractic experts who will evaluate the complaint against you and offer objective, expert advice regarding the case and your options."

"Fourth, never ever agree to a settlement agreement and/or monetary fine and/or letter of reprimand if you believe you did nothing wrong. Your admission of guilt could invite a malpractice lawsuit against you. Also, you will have to forever answer "yes" in managed care applications that ask if you have ever been disciplined by a state licensing board. Your positive response may cause you to be dropped from participation in that managed care organization, and possibly even prevent you from participating in others from that point forward."

Dr. Edwards invites questions when he states "Please feel free to contract me (jamesedwards@jamesedwards.com ) if you have any questions or feel you need assistance in regard to a licensing board complaint."

 
Post A Comment
* Indicates Required Field
Comment Title:
* Comments:
Nickname:
* Validation:
Most Recent Comments
Added: April 19, 2010. 09:39 AM CDT
Kudos to Dr. Edwards.
In a society where there are people who value money and/or control over others above all else, I find Dr. Edwards' opinion extremely apropos. Thank you, doctor.

Greg Zygmont, D.C.
Anonymous
 
 
FeaturedNews
Input Sought on Osteoporosis Guidelines
Published 07/28/2010 - 3:00 p.m.  CDT

The U.S. Preventive Services Task Force is considering whether to broaden the group of women it recommends to get routine screening for osteoporosis, and it wants physician input. Physicians and others can comment on the draft recommendations through 5 p.m. EST Aug. 3 online
...Read More
ChiroVoice Registration is UP
Published 07/21/2010 - 3:00 p.m.  CDT

ChiroVoice is growing ever larger now up to over 51,000 users.  Texas still ranks seventh in the nation in ChiroVoice Registrations, but our chiropractic colleges rank 12 and 13.

It’s more important than ever that you ask your patients and colleagues to sign-up on ChiroVoice.  Check it out HERE
...Read More
It's OK to Waive EXTRA Medicare Co-Pay, if...
Published 07/21/2010 - 8:02 a.m.  CDT

This article, written by Susan McClelland and distributed by COCSA, reports that it's ok to waive the extra portion of the Medicare co-pay that the 2.2% Medicare pay increase has caused.  Read more of the details in this article.
...Read More
Reader Login
Username:
Password:
 Save Login?
Free Sign-up
Forgot Password?
Reader Control Panel

The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) is accepting public comment, and has scheduled public hearings, on several rules proposals.  Comment deadline is Monday August 16, 2010.

The U.S. Preventive Services Task Force is considering whether to broaden the group of women it recommends to get routine screening for osteoporosis, and it wants physician input. Physicians and others can comment on the draft recommendations through 5 p.m. EST Aug. 3 online

Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more crowded with longer wait times under the nation's new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER crowding.

One of the reasons cited includes: "...ER patients ready to be admitted...must compete for beds with patients scheduled for elective surgeries, which bring in more money. "If you've got 10 ER patients and 10 elective surgeries...which are you going to give the beds to?"

A Government task force now says all younger postmenopausal women should get checked if their risk of a broken bone is the same or greater than the average 65-year-old woman. Factors that can increase risk include low weight, certain drugs, smoking, heavy alcohol use and a parent who broke a hip.

Faced with a ballooning deficit in Germany's health care system, Chancellor Angela Merkel's government decided...to raise premiums and cut into the profits of doctors, dentists, hospitals and pharmaceutical manufacturers.

Germany's once highly regarded mandatory health insurance covers about 72 million people, or 90 percent of the population. It has already gone through a series of reforms to stabilize its financial base. Costs are rising swiftly because of ever more sophisticated treatments and an aging population.

Poor health literacy -- an individual's ability to seek, understand, and utilize health information -- has been linked with limited self-management skills, but the influence of health literacy has not previously been investigated in low back pain.

An Australian study investigating this found that among patients with low back pain, negative beliefs and behaviors -- such as believing their problem will not get better -- are important correlates of increased disability.

They also found that patients named health professionals as their primary source for information about low back pain and favored physiotherapists and chiropractors over [medical] care physicians for specialized information.