July 2002

FCLB & License Renewal Credits To Protect the Public

By RJ Hammett, DC

During a May 2002 meeting of the Federation of Chiropractic Licensing Boards (FCLB), several interesting recommendations for Continuing Education for Chiropractors in the U.S. were proposed.

1. Chiropractors must do a differential diagnosis using “scientific” methods.

2. FCLB wants approval of all continued education programs.

3. FCLB will decide which speakers will be approved by using a “credibility criteria” they approve.

4. On sight visits to continuing education programs to “monitor” compliance.

         5. Examinations (tests) after each 12-hour program. No pass — no C.E. hours are given!

6. All courses offered must be a sound “scientific” basis — read no philosophy courses.

7. FCLB will “determine” how best to run internet education. (Big Brothers).

In an effort to “protect the public,” the FCLB has determined that the chiropractic colleges in the U.S. must not be capable of providing field doctors with proper continuing education programs that would protect the public  from incompetent doctors.

First, let’s look into protecting the public. The FCLB was organized in 1926. There has been no governmental or third party oversight of the FCLB’s activities ever. It is a “non-profit” interest group of individuals, the majority of which are chiropractors. A look on the internet shows that a group interested in “protecting the public” should have at least 50 percent of its board members of the public background, and not professionals. The FCLB does not fit this criteria.

Next, true public interest groups should have no conflicts of interest in regards to where they receive their funding. On FCLB’s web site, a “special thanks to NCMIC Insurance Co. for additional funding.”

Additionally, the ACA, National Board, and CCE all have an interest in FCLB to one extent or another. A conflict of interest? One has to wonder! Duh! Next, is licensing itself.

What reason would the FCLB need to monitor continuing education, if in fact the license examination for new chiropractors was sufficient to begin with (don’t we have enough parts already)?

The purpose of a license examination of a chiropractor is to ensure that the D.C. meets technical, professional and legal standards and protects the safety and welfare of the public by assessing the new D.C.’s ability to competently practice. If a new D.C. has been evaluated by a CCE-approved college and graduated, then examined by a national board, then examined by the individual state of licensing, one would think the new D.C. competent to practice and not a threat to the public. Three different groups have evaluated this doctor, is the FCLB saying all three are missing uneducated chiropractors?

Evidently, the FCLB believes all these safety measures of test after test isn’t enough. How much is enough? Or is it not so much about safety and protecting the public, as must as it is about politics and money? Think who funds the FCLB, think how much money the FCLB would generate approving continuing education courses, testing individuals, certifying program speakers, and testing you after every 12 hours? (Can you spell control and money?). Then, think about the lost revenues from the chiropractic colleges. Think about how easy it would be to control only the types of post-graduate education you want. How would you be affected, if someone else (FCLB) determines what was good for you, and what wasn’t when it comes to post-graduate courses? The FCLB does have a positive purpose. That purpose is to monitor and exchange information regarding the different state boards. It is not a policing or policy agency of the chiropractic profession, it has no charter, or recognized authority to do so, found anywhere.

Looking over the proposed actions of the FCLB reminded me of a legal case involving the Department of Justice regarding anti-trust liability. Any organization gaining too much control over others and causing amendment rights violations, constitutional violations or the restructure of fair trade, can be deemed anti-trust. If only one faction or group is being represented by the FCLB, even though it may be a majority, anti-trust is a question to be explored.

The second issue is of the public’s voice (the profession) not being heard in the recommendations of the FCLB. Any recommendations must be presented to the profession and public at large. Most state boards are in violation of this part of anti-trust laws protecting the public by not informing the public and profession before any law or policy changes take place. Many boards make changes to administrate policy and procedures, and never notify the individual practitioner. People affected by the outcome of policy or legal changes must be told. To hold “committee” meetings and recommended changes to the chiropractic profession without informing the profession is to beg for a legal fight.

Lastly, the FCLB will constrain/ impose on those field doctors, who have developed chiropractic techniques, equipment, diagnostic aids and treatment enhancements without FLCB’s consent, certainly will have adverse economic effects on these entrepreneurs. These individual’s rights to free trade and commerce will be restricted or eliminated, if the FCLB doesn’t think they meet FCLB’s “scientific criteria” (whatever that is).

The active supervision of the FCLB, upon the profession’s continued education program, must become a point of concern, not just for the chiropractic colleges, but for the field doctors themselves. It is shades of Orwell’s 1984. Let’s face facts, the majority of chiropractors’ advancements have come from entrepreneurial doctors, who had a great idea for improving chiropractic and went to it. What will the FCLB’s ideas of continuing education do to this important aspect of chiropractic?

Final thoughts — should we take a test after each 12 hours of continuing education? In my opinion, yes. It is a good assurance that the D.C. was in the seminar and not out golfing. But I believe, that the colleges have the ability to do this already, if they wanted to. As to the rest of the FCLB’s proposed measures, I think they should and must be “voted” down by the majority of the profession. Protecting the public is one thing, over regulating and infringing on the rights of the individual is another.

Til’ next time . . .

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.