We Get Letters & E-Mail

Editor's Note: This group of letters address the recent controversy surrounding the National Board of Chiropractic Examiners.

Dear Editor:

Let's hear it for competition! The current board is a shame!

David J. Madeira,DC
Shavertown, Pennsylvania

Dear Editor:

Couldn't agree more! You have excellent ideas, especially about the competition factor. Maybe the ACA and ICA could get together for once and pursue this matter. Then there would be a test that is geared toward any type of chiropractor. When a corporation that is classified as nonprofit clears the kind of cash that the NBCE does annually, it is definitely an eye opener.

As a recent graduate, I got that money order to the NBCE, trusting that those funds were exactly the amount needed for those tests to be administered. WOW, was I naÜve. I really noticed how Mr. Tullio conveniently disregarded the questions about the liquor bill and the private audit. I wonder if the invitation to NBCE headquarters by Mr. Tullio in the final question would include drinks at the Greeley Country Club?

Ashly Ochsner,DC
Rockville, Illinois

Dear Editor:

Your interview with Dr. Tullio was right on target, as was your editorial. Those pompous SOBs need to be knocked down a few notches. Your recommendations were good, but I would add a couple. Dr Tullio never answered your question about allowing an independent audit of their books. This should be done before anything else. The need for a Part IV should be studied seriously and without bias, with a report on the outcome by the end of this year. Lastly, I believe that input from the colleges should be used when formulating exams. If all of our colleges would be allowed to have more input it, would not be the "tail wagging the dog" situation that we appear to have now. Thank you for tackling this head-on, and I hope that this results in a fairer and better testing program for our student DCs.

Jeff K. Stout,DC
Normal, Illinois

Dear Editor:

I took the NB over would suggest that meeting once a year at a more exotic location is not a bad thing. Most of these people do make sacrifices, and while they know that going in, it is a nice gesture to be rewarded in that manner. That is not to suggest that all bets are off and once a year they are allowed to "let it all hang out." It is just a nice thing to do for someone who has paid the price. Great article, keep up the good work!

Ken Perkins,DC
Conroe, Texas

Dear Editor:

Just a quick comment about the NBCE. I am so stinking tired of the leadership in our profession taking us for a ride every chance they get. First the Sid Williams exposé, and now this. It literally makes me sick to think that while in school I was borrowing money to take the national boards, which I'm still repaying, while these %#*# jerks are getting a travel allowance of $55,000 per year. We have many in our profession who are not even making that amount to feed their families. I was so angry with "the establishment" when I first got out of school that I did not want to belong to any professional organization. I've since decided that I should belong and support the cause. Now I read stuff like this and start thinking that my professional dues are better spent investing in my children's future, rather than supporting leadership of a profession that can't seem to get it together. Chiropractic will always be relegated to a second-class status with the mentality of our leadership. I have decided to drop all my professional memberships and send that money to my undergraduate university instead. Thanks for the excellent reporting on our profession being taken for a ride, one more time.

Jeffery S. Kinnard, DC
Lecanto, Florida

Dear Editor:

Thank you so much for the article on the NBCE. It was most enlightening. Being the parent of a very bright chiropractic student, we could not understand why she kept failing her national boards. She was valedictorian of her high school class. She graduated from SMU. We kept putting out another and another and another $750 for her to repeat exams, while she assured us she could not understand why she had failed. She thought she had answered almost 100% of the questions correctly.

I NOW UNDERSTAND. I do wish there was some way I could recover some of that money. I would love to belong to a country club. I would love to take a trip to Bermuda. I would love to spend six days at the Venetian in Las Vegas. Somewhere there has to be criminal wrongdoing by the NBCE.
Thank you for the article. I will gladly join a class-action suit against them, if needed.Patty Dingle

Editor's note: The chiropractic profession may be interested to learn that despite our original article and position statements by both the ICA and the ACA, the NBCE Executive Committee meeting was just held in New Orleans, rather than at their multi-million-dollar corporate headquarters in Greeley, Colorado.

Dear Editor:

I am thoroughly impressed with the exposé on the NBCE. The dialogue with Dr. Tullio was exceptionally presented. I'm titillated at the communication by fax - this medium allowed him enough time to cover his "you know what," and cross-check any lies that might slip out in casual conversation. He apparently did not do such a good job, as the exposâ is inset with disparaging remarks to Tullio's comments. It is an overwhelming article with historic value.

I am calling for their heads on a platter. This board of horrors has suckled off us and continues to desire more. They are vampires feeding on the young, weakening and beating them down. This is reprehensible behavior, malicious and devious: fattened bureaucrats with per diem payouts and expense accounts. Corruption, corruption, corruption. They must be punished.

Let's clear the board, roll a grenade in the book of bylaws and start over. Having experienced the trough of swill called parts I, II, & III, I can say that this should be condensed into one exam comprising parts I and II, and a second board, eliminating part III and comprising its redeeming qualities (if any) with part IV. Replace the board with practicing chiropractors and college faculty. Throw in a representative each from the ACA, ICA, CCE, and me, and start over.

It's a new millennium. Let's throw out 10 years ago and I still felt that they were overpriced.

I'm glad you brought up this issue.

Jim Palmer,DC
Philadelphia, Pennsylvania

Dear Editor:

I read with interest your report on the NBCE. Of course, Dr. Tullio was stonewalling for all he was worth. I do admire him for submitting to the interview, even if it was on his own terms.

Considering that he was defending an indefensible position, I guess that was somewhat noble. I am quite sure that he has high morals and ethics or he would not be where he is. At least, that is probably the way he was to start with. Having had some experience with such nonsalaried "volunteer" work, I can give you an idea of the mechanism of what has happened. An individual starts with lofty goals and desires to make the (chiropractic) world a better place. After some time, that is diluted by the thought that you are owed something because of all the sacrifice away from home and practice. So, you stay at a better hotel or eat a better meal because you deserve it, and there is some truth in that, which makes it easier. It is also easier if there is no one keeping close watch or if "that is the way we've always done it." Well, over time it becomes policy, and then it is really easy.

With that in mind, I applaud most of your recommendations, particularly term limits and a more open method of acquiring membership on the board. I the baby with the bath water and get a real chiropractic exam, not a pseudo medical miscarriage.

I have a new respect for Dynamic Chiropractic. You did one helluva job. Let's get the pheasants in the wire.

John F. Przybylak,BS,DC
Buffalo, New York

Dear Editor:

I appreciate your publication bringing this misapplication of funds to our attention. I have been practicing for five years and still remember the sting of the fees associated with the boards. I can see no reason for a necessary and required entity such as the NBCE to feel obligated to market itself with a "social presence" in any community. I would think the profession would be better served with tests that more accurately evaluate a doctor's ability than paying for country club memberships. Dr. Tuillio's answers were evasive and defensive.

While reading this article, I could not help but get the feeling that he has a future in Congress.

I would appreciate information on how members of the board are elected. I also think that some of the $10 million in reserves should be tapped by an independent organization for an investigation into this.

Lance P. Cook,DC
Marshall, Texas

Dear Editor:

My question is, "Why would the board members want to resign if it meant giving up their cushy jobs and getting a real job?" It is hard to believe that the chiropractic profession has let this problem get so far out of hand. But then again, we've never been unified enough to get anything accomplished!

Ben Higbee,DC
Carrollton, Texas

Dear Editor:

An excellent article on the national boards! Your suggestions should be applauded. I would like to suggest abolishing the national boards altogether and returning the licensing of new DCs to the states and colleges. As a second-generation DC and a graduate of two years ago, I have seen the massive and rapid growth of the controlling and power-hungry national boards. It seems that without the local political ability of doctors and students, everyone is at the mercy of their greed at the national level. Obviously, the national boards couldn't care less about the health and well-being of the populace, or producing qualified doctors of chiropractic. If one is qualified to graduate from chiropractic college, then one should be qualified to practice chiropractic. Thank you for your efforts.

(P.S. My father, Hugh L. Crowe,DC, brought your article to my attention and suggested I write. He applauds your efforts as well!)

Keith H. Crowe,BS,DC
College Park, Georgia

Dear Editor:

With all the confict and nonunity in our profession, this is the most sickening thing I have read. These people, who are supposed to be representing our profession, are blatantly taking advantage of students coming out of school with an incredible amount of debt. If these guys want the luxury of country clubs and travel, maybe they should treat patients like real doctors do, and earn the money. I understand that some of them may be in practice-or so they say-but this just sounds ridiculous to me. Obviously, these people have no ethics, and I am sickened by the thought that they probably consider themselves doctors. This organization needs to be regulated! I would write more but I have to get back to taking care of my patients.

Mike R. Diamond, DC, CCSP
Los Angeles, California

Dear Editor:

Finally someone is on our side. I'm only a few years out of Palmer, but I can still remember the bull I had to go through to pay for these country-club jerks. I haven't even spent $55,000 in my 39 years on travel/vacations, etc. Just for me to take these exams was a three-month affair, working to pay for the Gold's seminars, the boards themselves, and trying to study. If I didn't love this profession, I'd stop today and tell every chiropractic student to leave. This is outrageous, and one hell of a slap in our face. Get rid of these old country-club parasites.

Growing up on a dairy farm and working in my family's concrete construction company didn't hold a candle to the effort required to pass these boards. I'm proud of the good chiropractic does for people. We need these tests, but we don't need to pay for the luxury of being a board member. I'm on two boards of directors, the Rotary and The Blue Line Club (U.W.-Madison Hockey). I pay for everything. Though neither is a million-dollar operation, this kind of senselessness doesn't happen. Give us further articles and an agenda to get rid of these parasites that prey on the poorest of our profession.

Mark A. Meister,DC
Sun Prairie, Wisconsin

Dear Editor:

I read with interest every word of the story about how Dr. Paul Tullio is "carefully" managing the affairs of the National Board of Chiropractic Examiners. According to the article, he is taking advantage of the responsibility that the profession has placed upon his shoulders by spending lavishly, like so many other public officials do when they supervise spending of monies that were not earned by them.

According to your investigative reporting, Dr. Tullio is spending the chiropractic students' hard-earned dollars on lavish vacations at resorts for meetings, and on prestigious country club memberships, while asking the chiropractic student examinees to dig a little deeper to support the luxury for him and the board of directors. Your article states that each board member receives $42,000 for meeting and travel allowances. I assume that you meant that the $42,000 was given each board member per year. That seems extravagant to me. I wonder what the chiropractic students would think after reading your well-researched article.

If your story is accurate, and I believe you, Dr. Paul Tullio needs to apologize to the chiropractic profession, especially the students, and resign, allowing someone with integrity to steward those funds and the workings of NBCE. The few elite members who run the NBCE, who have tied down their positions for many years, need to resign and let men who have demonstrated accountability and integrity take the reins of leadership.

I appreciate the article and keep up the good work. Our profession needs to be kept informed about issues like this.

Chiropractically,

Wayne Kerch,DC
Phoenix, Arizona

Dear Editor:

I am appalled, but not surprised, to see documentation of the abuse in our profession by those in power. Give most people a little authority and it tends to be abused when adequate checks and balances are not instituted.

Competition, as was mentioned, is severely lacking with the NBCE. I support fewer board members and cutting costs. I know that $200 to a practicing doctor isn't a lot, but to a student it is an incredible burden, especially when it's borrowed money. My student loans just came due after a year's forbearance; they want $2500 a month. I for one left school with a very bitter taste in my mouth regarding wasted funds and the country club living of the few in charge.

Part III of the national boards was supposed to replace all of the state boards some years ago. About half the states accepted it at first, and then rescinded their decisions, by my understanding. Then we were left with an additional exam, additional expense and additional time to licensure. Part II and Part III test nearly identical material; one or the other should be eliminated.

Part IV is another attempt at universal licensure. Only about half the states accept it in lieu of the state boards. Some states require all four boards before taking the state board as a deterrent to competition in those states. Part IV is far more expensive, due to its nature of live testing. I think we will see another failed attempt at universal licensure with part IV.

Did the NBCE get approval from the profession or even ask our opinion about adding these additional exam requirements? I've heard rumors of trying to test licensed DCs every 10 years: additional revenues for the examiners and administrators, and more paid travel. The medical doctors that I see as patients and friends take fewer board exams than we do. What are we trying to prove?

Part IV is one more roadblock, and another reason our profession suffers embarrassing default rates on student loans. It wasn't mentioned that many students spend as much for board reviews as the exams themselves. I am all for computerized testing. I graduated a quarter early by transferring some courses from my bachelor's with good grades. This threw off my graduation and board schedule, as my school requires certain courses for approval to sit for certain boards. A mixed-schedule student is hard-pressed just keeping a full load every quarter. I had to choose between getting into the clinic on time and taking my boards on time.
With computerized testing I could have done both. The current twice-yearly testing isn't practical for quarterly and trimester graduates.

Thanks for the research, now what do I do to help change these problems?

Robert K. Wheeler,BS,DC
Anchorage, Alaska

Dear Editor:

I have read the ICA comments directed toward the NBCE, and have the same concerns myself. Petitioning a monopoly such as the NBCE for change is useless. We need another testing board to bring some fairness to the testing of material and pricing of the tests. In my last 18 months of school, I had no money for seminars, even though I was working two part-time jobs most of the time, because I was saving money for test reviews, Parts I-III, PT, and most ridiculously, airfare to fly across the country to take Part IV. By the time I added a motel stay and auto rental to the tab, I was absolutely broke. How do you begin a life like this?

Gary Boyd, DC

Dear Editor:

The NBCE article would appear to have several breakdowns in reasoning as well as several non-sequiturs. For example, how does one reach the conclusion that a relationship of professional trust exists simply because an organization is nonprofit? I would imagine that the issue of professional trust does not exist anywhere in the incorporation documents establishing the NBCE. If it does, then that should have been mentioned in the article, i.e., that the NBCE was established specifically with some sort of "professional trust" in mind, and exactly the nature of that trust.

The issue of professional trust does not exist simply because an organization is nonprofit, any more than it exists simply because it is the only such organization providing a particular service. The NBCE is neither a utility company nor a business providing some sort of public or civic service. It is a nonprofit corporation providing a specific professional service. The fact that it does so extremely well and that no one else has sought to enter the same arena is not its fault nor does it imply restrictions on its conduct. It may well be that NBCE's very success may have to do with the lack of competition. Remember that chiropractors won their class-action lawsuit with the AMA on the RICO Act, which has to do with restraint of trade, i.e. business activity.

The NBCE seems to be doing the kinds of activities that a wildly successful business does. It spends money on perks and travel, the very frills that make hard work and insight somewhat rewarding and fun when all goes well, and it has put substantial reserves aside for the proverbial "rainy day." Pretty admirable, I'd say.

Just because a group of people had the foresight to establish this organization (and business) and no one has demonstrated the resourcefulness to challenge it in the marketplace, does not mean that they should be faulted for their success. After all, I thought wild success was the purpose of all our enterprise.

As for the students, I would hope that this NBCE example would serve as encouragement that they too could be successful with similar foresight and enterprise in our profession, and as such would enjoy the fruits of their labor. At least they will not have to suffer the vagaries of a multitude of independent state boards, as has existed in the past. Every seemingly inane National Board question can be matched by an even greater state board horror story, not to mention the considerable financial and emotional expenses of those experiences.

No, NBCE seems to be establishing a unifying presence in the confusing wilderness of professional standards, and doing so successfully. We are continuing to establish a sense of national standardization, which will benefit us professionally more than we can imagine. One only needs to look no further than the ICA and the ACA when any aspect of unification rears its head in our profession.

This certainly does not mean that the NBCE should be exempt from an examination of its mission and purpose. It just seems to be lacking in this article. But the one service that you do provide is to remind us that competition always serves some purpose. Just ask the ICA and ACA or any state that has two or more professional associations. Oh yes, and ask how they have benefited from a public display of their procedures by their own colleagues.

Name withheld by request