Dr. Hammett is a chiropractor in private practice in Kenosha, Wisconsin. After graduating from Life College in 1979, he completed several post-graduate programs in Physical Impairments, Diagnostic Imaging and Rehabilitation. He completed his Juris Doctor in 1995. He has written articles for several Journals and has lectured to numerous Chiropractic groups on the topics of Practice Management and Risk Prevention.

AJCC Jan 2000

The Board and Other Beasts

by R. J. Hammett, D.C.

The purpose of most chiropractic “Boards of Examiners” is to ensure that the public is protected by determining the competence of those chiropractors they examine. Additionally the Board, under the heading of “Protecting the Public Trust,” also investigates complaints against those doctors licensed. These groups of men and women are mostly appointed by the state. They are supposed to be unbiased, non-political trustees of the state’s laws governing the practice of chiropractic.  In the last twenty years, the boards have been given more and more power, backed by state laws, to review chiropractors. I believe that the majority of board members think that they are performing an admirable duty for the public and doctors in their respective states. But in the last 15 years, the intrusion of political agendas, power plays, and just plain jealousy has crept into the meeting of board members’ meeting rooms.

      It is true that the boards must address all complaints…“That’s the law”…however, are they impartial? Speaking with several doctors around the country who are presently engaged in board complaint activities, a similarity of actions and complaints are seen. Legitimate claims about billing abuse, sexual misconduct, or negligence are complaints that must be taken seriously and investigated.

      But moreover, complaints by insurance companies and insurance company attitudes about chiropractic care or billing are appearing more and more. The problem that exists is a problem that has existed in chiropractic for many, many years, and that problem is the approach to taking care of the individual patient.

      You, the reader, will probably agree that every chiropractor has a slightly different approach in the treatment and care of patients. A standard of sorts exists for basic record keeping of case history and notes, but when it comes to the type and length of treatments, the arguments begin. For example: the board member assigned to review your care is one who believes in pain reduction and restoration of function in patient care. But he/she does not believe that any spine can be “straightened” or permanently “corrected.” This doctor will typically treat a patient for 12 to 20 manipulations and then place his/her patient on a maintenance care schedule. In reviewing your case, he/she finds that you have adjusted a patient for 60 visits over a year’s period of time, reexamined them every 10 to 12 visits, re-x-rayed them two or three times, and charged for all your services. Do you really believe that the board doctor reviewing your case, can at all, be objective in the way you treat your patients, especially when they were pain free on the tenth visit???

      To assume that there is not a double standard when it comes to board reviews is being naive. Add to this, a board-appointed “independent” D.C. (usually a friend of a board member) reviewing your case from the board, who has now backed up the opinions of the board member that you overcharged and over-treated patients. Finally, the board member looks at what you have been paid. Talk about a green-eyed jealous monster, when your friendly board member is working his/her butt off seeing 20 patients a day and believes that he/she is doing a good job, and then you come along seeing a patient for a year and collecting the amount of money you collect. Well, you must be a threat to the public, or at minimum, a thief.

      Now, you may think the scenario I have written about is nonsense. But the majority of complaints from doctors about the boards are about just these types of situations. Can any board be totally impartial? I believe they cannot. When there is no democratic way of determining the right or wrong of an individual, that individual is doomed to the whims of his or her peers. The boards, for the most part, are politically-appointed positions without prior accreditation of its members. If the FCLB (Federation of Chiropractic Licensing Board would wake up and look at real issues of examining DCs and protecting the public, all board members appointed to a board would be required to take and pass examinations on all the facets of chiropractic practice, including the majority of all techniques taught at chiropractic colleges, the five different styles of chiropractic practices, and the goals of the different types of care rendered and their procedures.

      The final question remains as always, “Who’s watching the watch dogs?” Our government has three branches designed to keep in balance the power of government. Who keeps in check the board members? The legislature? Most of them do not understand chiropractic and could care less what we do to ourselves. The local chiropractic associations—these bodies of men and women, in most cases, are nothing more than organized, political action committees (PAC) designed to get officials elected, have “pro-chiropractic” laws passed and to recommend the “next” board member to the state government.

      So in the end, what are you going to do? Since the 1970s, board members are protected under state laws and are immune to civil lawsuits regarding frivolous board action. Most states cannot be sued for passing board laws or electing biased board members. There are only three remedies in this case. First, demand that the FCLB request written examinations of all board members. Second, all citizens have a right to seek justice under federal laws superceding state’s immunity laws to protect basic civil rights. Third, have legislators enact laws demanding examination of the examiners, holding them to a higher standard. For the present, the system sucks… in the future hopefully it will be righted. In the meantime, walk on egg shells…don’t hop!!!

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