HOME / Featured News / WORLD NEWS
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
Taking Multiple Meds Ups Fall Risk
Published 02/01/2012 - 12:44 p.m.  CDT

Working-age adults who use two or more prescription medications may be at risk for becoming seriously injured after falling in the home, researchers found.

In a study of young and middle-age adults, using at least two medications was associated with an increased likelihood of dying from or being hospitalized for a falling injury …. Antihypertensives and cholesterol-lowering drugs were the most common medications involved.

"The risk of falls may be increased as a result of both the intentional and unintentional effects of pharmacological therapy such as orthostatic hypotension, psychomotor impairment, extra-pyramidal symptoms, and dizziness."

...Read More
Overuse Accounts for Up to 30% of Healthcare Spending
Published 01/31/2012 - 11:50 a.m.  CDT

Overuse of therapeutic procedures, diagnostic tests, and medications is an understudied problem that may account for as much as 30% of healthcare spending in the United States and result in harm to patients.

The 4 most common health services examined in the studies included in the review were antibiotics for upper respiratory infections, coronary angiography, carotid endarterectomy, and coronary artery bypass grafting and revascularization.
...Read More
Credit Rating to Drive Future of Health Care
Published 01/31/2012 - 7:33 a.m.  CDT

Ratings agency Standard & Poor's warned it may downgrade "a number of highly rated" Group of 20 countries from 2015 if their governments fail to enact reforms to curb rising healthcare spending and other costs related to ageing populations.

"If governments do not change their social protection systems, they will likely become unsustainable."

"If no reforms are adopted, healthcare-related credit downgrades would likely start within three years..."

"... developed nations will eventually become the victims of their social safety nets."

"S&P said it was not too late for G20 countries to tackle the problem, but reforms to contain age-related spending needed be coupled with efforts to balance budgets by 2016, which would be enough to offset rising healthcare costs by 2050."



...Read More
Reader Login
Username:
Password:
 Save Login?
Free Sign-up
Forgot Password?
Reader Control Panel
Article Popularity
Views
Ratings
Comments

despite well-publicized stories of people dropping dead during or after running a marathon, the race isn't all that risky, researchers found.

The death of a loved one can literally be heart-breaking, or at least heart-attack-inducing, researchers have found.

Among a cohort of 1,985 people, the rate of myocardial infarction was more than 21 times higher than normal within 24 hours of losing a loved one.

ACA member Dr. Steven Shoshany, will make his second appearance on The Dr. Oz Show on Wednesday, Feb. 8.

ACA member Dr. Rob DeStefano, team DC for the NY Giants, will be on the field in Indianapolis treating players during the big game.


The Centers for Medicare and Medicaid Services (CMS) recently ruled that providers not successfully/satisfactorily participating in PQRS by the 2013 reporting period (Jan. 1 - Dec. 31, 2013), will have their Medicare reimbursement decreased by 1.5 percent beginning in 2015, and 2 percent in 2016.

Therefore, the 2012 reporting period is the last opportunity providers have to voluntarily participate in PQRS and learn how to report successfully/satisfactorily while incentives are still offered and their Medicare reimbursement is not subject to penalties.

ACA needs your help!  Over the course of the past several years, ACA has been examining the practices of chiropractic networks. Recently, concerns about these networks has increased dramatically to the point of additional investigative efforts being put forth by ACA.

In order to effectively capture the voice of DCs regarding these issues, a questionnaire has been developed to give both members and non-members the opportunity to share their experiences about chiropractic networks. Responding to this questionnaire will help ACA understand the effects these networks have on profession, and will also help the association better position itself for future efforts.

Concussions are getting much-needed attention in the press, especially given the short- and long-term cognitive loss, early-onset dementia, physical disability and even death resulting from traumatic brain injury (TBI).

Smokers are no more likely to give up cigarettes for good by using nicotine replacement products such as patches and gum than if they did not use those quit-smoking aids, a prospective cohort study showed.

Working-age adults who use two or more prescription medications may be at risk for becoming seriously injured after falling in the home, researchers found.

In a study of young and middle-age adults, using at least two medications was associated with an increased likelihood of dying from or being hospitalized for a falling injury …. Antihypertensives and cholesterol-lowering drugs were the most common medications involved.

"The risk of falls may be increased as a result of both the intentional and unintentional effects of pharmacological therapy such as orthostatic hypotension, psychomotor impairment, extra-pyramidal symptoms, and dizziness."


This study suggests that the addition of an adjunct therapeutic mirthful laughter Rx (a potential modulator of positive mood state) to standard diabetes care may lower stress and inflammatory response and increase “good” cholesterol levels.

The authors conclude that mirthful laughter may thus lower the risk of cardiovascular disease associated with diabetes mellitus and metabolic syndrome.