SEATTLE, Washington - In delivering the 10th Annual Joseph Janse Lecture during the 74th annual congress of the Federation of Chiropractic Licensing Boards (FCLB) May 3-7, Toronto attorney David Chapman-Smith, secretary general of the World Federation of Chiropractic, challenged the FCLB leadership to define "minimum standards of education for all professionals who seek the privilege and responsibility of practicing spinal manipulation in the United States."
Chapman-Smith noted that spinal manipulation is being practiced by the medical, osteopathic, and physical therapy professions, but with many of those professionals "practicing manipulation inadequately on the basis of educational and clinical skills far below those of the foremost licensed professionals in the field - doctors of chiropractic."
He expressed concern that those who regulate other professions are not defining the standards to ensure that practitioners have sufficient educational and clinical expertise. He encouraged the FCLB to lead the development of a national, interdisciplinary process.
The conference theme, "Charting Your Course: Navigation through Contemporary Issues in Chiropractic Regulation," provided a forum for the increasingly international aspects of licensure and regulation. To underscore that reality, a fourth flag was added to the podium as the Federation welcomed Mexico to its membership, joining Australia, Canada and the United States.
Fitting the expanding emphasis of the FCLB on worldwide regulatory issues, Dr. Daniel Saint-Germain of Quebec, Canada was elected to the FCLB Board of Directors, the first non-U.S. director to be seated on the board.
Dr. David Brown of Virginia, elected for his second one-year term, also spoke to the international scope of licensing:
Clearly, the Federation has an important and growing role in assisting chiropractic boards worldwide to fulfill their mandate of public protection. The world is increasingly interconnected and chiropractic is exploding as vital to health care internationally. Patients expect and deserve quality care delivered by competent, ethical practitioners.
The conference offered a number of educational sessions designed to push the concept of chiropractic self-regulation to the highest levels of respect by legislators, the public, and the field doctors.
Continuing Education:
A pre-conference workshop on credentialing models for CE programs and presenters offered colleges and regulatory boards a look at more streamlined options for qualifying CE for relicensure credit. A central registry through FCLB would be guided by standards developed cooperatively between education and regulation.
Education and Regulation
Palmer College President Guy Riekeman,DC, discussed regulation from an educational viewpoint. He offered to create a new partnership with the licensing boards to ensure that chiropractic college graduates meet both the spirit and letter of regulatory law. "Let's not concentrate on fixing the past, but rather creating the future," he advised. Databanking
An update on the Healthcare Integrity and Protection (HIP) Databank revealed that most boards are in the process of complying with the federal laws that require chiropractic to report its public board actions. Twenty-eight boards have designated the FCLB as their reporting agent via the FCLB's Chiropractic Information Network/Board Action Databank (CIN-BAD), which simplifies compliance and lowers costs for the state boards. CIN-BAD is free to member boards.
The Federation also presented a demonstration of the ALLDOC database (All Legally Licensed Doctors of Chiropractic), scheduled to go on line later this summer. The database will eventually offer on line primary source-level verification of all the licenses held by every chiropractor. The developmental costs for this project ($120,000) is supported by NCMIC Insurance Company. The Federation envisions ALLDOC as a highly efficient way for managed care to expedite approval of chiropractors to participate in health plans, and to help the regulatory boards verify licensure for faster relocation or travel-to-treat options.
Mandatory Malpractice Insurance
Do patients expect boards to require practitioners to carry malpractice insurance? Should boards have more detailed requirements for record keeping? Can malpractice carriers reveal investigative reports to boards? NCMIC Insurance Company president Dr. Louis Sportelli challenged boards to address those issues.
Guidelines for Standards of Care
Representatives of the Oregon board presented some of the draft practice guidelines under development, which prompted the question: Which standards should boards use to determine deviation from appropriate practice?
Military Demonstration Project
Appointees to the Department of Defense Congressional Oversight Committee, Drs. Peter Ferguson, Rick McMichael, and George Goodman, offered insights into their final report, an effort with the goal to provide credentialed chiropractic care in the military.
Fraud in Multidisciplinary Practices
Ohio attorney Michael Moran pointed out some of the pitfalls in the emerging new trend toward multidisciplinary practices.
Additional breakout sessions focused on NBCE testing; the public nature of disciplinary actions; ethical conflicts for board members; regulating chiropractic assistants; impaired practitioners/recovery programs; practitioner mobility; and accreditation and regulation.
"Take-Home" Lessons
For some, the conference energized their visions for change, knowing the broad direction that health care and chiropractic regulation are taking. Some were challenged to see that their legislative options for continuing education, mobility, and discipline needed updating to handle the demands of new regulatory models. Others were pleased to see that chiropractic regulation was clearly in the mainstream with other health care professions, and on the cutting edge of board action data banking. "It's nice to be at the head of the pack in this important consumer protection area," Dr. Brown observed.
Annual Business Meeting
Just one resolution was presented and subsequently adopted during the conference: to endorse the ACA's "Policy Statement on Spinal Manipulation." No bylaws changes were presented this year.
Leadership Changes
With elections and the seating of district directors elected at the fall regional meetings, the leadership slate is complete for 2000-2001:
President
Dr. David Brown (Virginia)
Vice President
Dr. Wayne Wolfson (Florida)
Treasurer
Dr. Richard Cole (Tennessee)
Imm. Past President
Dr. Lawrence Gerstein (Missouri)
Executive Board Chair and District I Director:
Dr. Patricia Conners-Allen (Alaska)
District II Director:
Dr. James Powell (Ohio)
District III Director:
Dr. Daniel Saint-Germain (Quebec, Canada)
District IV Director:
Dr. Oliver "Bud" Smith Jr. (Texas)
District V Director:
Dr. Linda Steele Denham (Georgia)
Retiring member Dr. Vernon Temple (Vermont) was recognized for his six years of service as district III director and executive board chair.
Dr. Davis Kinney (Georgia) and Patricia Conners-Allen (Alaska) were approved by the membership to serve on the 2000-2001 nominating committee.
Dr. Elizabeth Kressin (Iowa) was approved by the membership to serve a four-year term on the long-range planning committee.
FCLB Awards Crown Annual Conference
Citing a lifetime of contributions to protecting the public, the FCLB presented its highest honor, the "George W. Arvidson Award," to Dr. Kenneth Padgett, president of New York Chiropractic College.
Distinguished by a professional career that has included service in regulation, legislation, national politics, and education, Padgett has been recognized for "Meritorious Service to Humanity and Chiropractic" from the American Chiropractic Association four different times.
In presenting the award to Dr. Padgett, FCLB President Dr. David Brown commented: "He continues to lay the issues on the table with the same passion and compassion that have marked his service to regulation, association, and education."
This marks the 8th year the award has been presented. It recognizes individual sacrifice and contribution to chiropractic regulation. Past recipients include: Edwin Devereaux; Peter Ferguson; Daniel Saint-Germain; co-winners Frank Hideg Jr. and Paul Tullio; D. Brent Owens; Rex Wright; and Donald Petersen Jr., the initial recipient
The award for "Outstanding Chiropractic Regulatory Board" went to the Maine Board of Chiropractic Licensure. The Main Board served as a model to other boards, acting with professionalism in the face of a three-year challenge to its authority.
In a surprise presentation, FCLB executive director Donna Liewer was honored for 10 years of service to chiropractic regulation. In presenting the award, FCLB President Dr. David Brown was joined at the podium by his four predecessors: Drs. Larry Gerstein (Missouri), Robert M. Vaughn (North Carolina), Carroll Winkler (North Dakota), and D. Brent Owens (Florida). With the exception of Dr. George Arvidson, who is deceased, this represented all the presidents for which she served.
Other awards included:
Regional FCLB meetings take place in October, and next year's annual conference is scheduled for April 4-8, 2001 in San Antonio, Texas.
Editor's note: To obtain copies of major lectures and handouts of the Seattle meeting, click on the FCLB website at http://www.fclb.org. The FCLB can be contacted at (970) 356-3500 or via e-mail at fclb@fclb.org.
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