For more than 30 years, I have been both a supporter and blaring critic of the Federation of Chiropractic Licensing Boards (FCLB) and the National Board of Chiropractic Examiners (NBCE). That support was initially recognized in 1993, as I became the FCLB’s first recipient of the George Arvidson Award for Meritorious Service to Chiropractic. My critiques, applause and commentaries of the NBCE’s and FCLB’s actions have been expressed in the pages of Dynamic Chiropractic for just as long; observations that came from attending the annual meetings and having detailed discussions with board members, as well as in-depth investigations.
The NBCE is a professional trust. It has no competitors and it can charge chiropractic students as much as it wants to sit for the minimum four exams required for licensure in every state. This situation has allowed the NBCE to build up a large bank account (currently around $40 million in cash and investments).
In the past, the NBCE attracted individuals who became board members with an eye on how the NBCE’s income (around $15 million this past year) and assets could provide them with extravagant travel and other benefits. Fortunately, much of that has been curtailed in recent years.
Conversely, the FCLB has generally lived on a shoestring budget, operating primarily on cash and in-kind contributions made by the NBCE. The most recent agreement between the two organizations provides the FCLB with $500,000 (5%) of the NBCE’s prior-year chiropractic testing revenue annually.
Without the NBCE’s financial support, FCLB would be unable to operate, as this represents approximately 65% of the FCLB’s income. This is in addition to NBCE providing other assistance including shared conference expenses and office space for the FCLB headquarters.
The two organizations have their annual meetings at the same event to reduce the travel costs for state licensing board delegates. While there is a separate list of delegates and alternates for each organization’s annual meeting, many of the names on these voting delegate lists are redundant.
Combining the FCLB into the NBCE makes sense on an organizational level. The headquarter locations, annual meetings, and voting delegates are essentially the same, with most of the income for both organizations coming from student examination fees. But there are legitimate concerns being expressed by those who have witnessed abuses of power in the past.
The new NBCE board will be expanded from 11 to 13 director positions, with eight directors (previously seven) elected by the delegates. The remaining five (previously four) are board at-large positions elected by the board members themselves. The board at-large positions have been used in the past to maintain control of the NBCE by small groups with self-interests. And while it will now be harder for any group to gain control under the new board configuration, history has shown that it’s still quite possible.
The mission of the new NBCE/FCLB is to assist the state licensing boards in their efforts to protect the public by ensuring professional competence and promoting clinical excellence. But the NBCE board needs to do so more efficiently and more cost-effectively to best serve our profession.
Moving the Part IV test to a central facility in Greeley, Colo., was a good start to revitalizing the NBCE exams. This enhanced the quality of the practical test, reduced the associated expenses, increased the opportunities to take the test, and hastened reporting so graduating DCs can begin practicing up to five months sooner.
The next step is to bring the testing structure into the 21st century. Our profession no longer needs to prove our competency with four exams. We appear to be the only profession to require this much testing of those who have already achieved professional degrees. There is no reason why at least two of the computerized tests can’t be combined in a manner that still meets the licensing requirements of all states.
As we have seen recently, when dedicated doctors sacrifice their time and energy to improve our profession through their service in the NBCE, our profession moves forward. When, as we have seen at various times over the past four decades, doctors use the NBCE resources to create their own little empire, our profession is left wanting among the carnage of misdirected funds and missed opportunities.
The future of the NBCE/FCLB will be the same as it has been in the past. Ultimately, it is up to the state licensing boards and their delegates to continually scrutinize the actions of the new NBCE’s leadership and safeguard its critical mission. And it will continue to be the responsibility of this publication to critique, applaud and comment on how the NBCE is serving our profession.
Editor’s Note: Read the news report of the NBCE-FCLB merger here.
