On Jan. 24 1978, the New Zealand governor-general referred to a Commission of Inquiry an investigation to determine the desirability of providing for reimbursement of chiropractic benefits under the New Zealand Social Security Act and the New Zealand Accident Compensation Act. The commision's findings would impact chiropractic worldwide for decades to come.
NCMIC -- How Far We've Come! How Far We Need To Go!
Unquestionably NCMIC has undergone some radical changes in one year. Changes which were necessary to insure the fact that policyholders would have a voice in at least determining who would be the officers and directors of their "mutual" malpractice insurance company. For years the policyholders were afforded the opportunity to cast a vote for presidentially-appointed, hand-picked candidates. If the policyholders voted the candidates won, if the policyholders did not vote, the candidates won, the elections did not invite participation or input from the policyholders. Last year the policyholders revolted against the NCMIC president and voted two candidates into office on a write in ballot. This singular action by the policyholders, has resulted in some dramatic changes in the company. For example:
- All NCMIC directors are now limited to three terms of office.
- Policyholders now have an opportunity to secure a position on the ballot for directorship, even if not nominated by the nominating committee.
- Chiropractors who engage in sports now have some provision in their NCMIC coverage, which was not previously available.
- Attorneys are now being more carefully evaluated and selected by NCMIC to represent DC's who have been sued.
- The executive vice president of NCMIC, who had guided the company for many years, was retained following the election of the policyholders write-in candidates.
- Policyholders received a "dividend" this year following some re-evaluation by the new NCMIC board.
- The high cost Risk Management Programs, were immediately stopped, following the election of the policyholders candidates. This had a positive significant economic impact on NCMIC.
- The responsiveness of NCMIC to the policyholders has generally been markedly improved following last year's election.
- Officer's salaries were reduced to a more realistic level.
There is more to be done
The NCMIC board has not significantly changed for many years and that is precisely the reason they were not "responsive" to the "needs" and "concerns" of the policyholders. One election, in which only two of the seven candidates were changed is not enough to make the major changes needed in NCMIC. This year and next year the policyholders must again exercise the only power available to them, the power to vote for NCMIC directors. The NCMIC board must be changed in order for the board to function in a harmonious and positive fashion.
What changes could be made?
Many policyholders have asked what changes still need to be made in NCMIC, and I will respond with just a few:
- I recommend that NCMIC form a "legal swat team", a group of top notch attorneys who will be dispatched to meet with the local attorney selected by NCMIC to represent the doctor who is sued. Many doctors have called me with fears that the attorneys did not understand chiropractic, or did not appear interested in the case. The "swat" team would brief the attorney on the chiropractic/legal issues and provide the local counsel with information which is relevant to the case. In this fashion, the local attorney does not have to re-invent the wheel by doing "costly legal research" in each and every case. While costly up front, this will save NCMIC, and ultimately the mutual policyholders, significant dollars once the team and research is in place.
- There needs to be an improved review process on how legal counsel is performing. NCMIC, and Dr. Cianciulli are currently working on this project at the moment.
- Doctors should be contacted several times during the course of any malpractice litigation to determine if everything is going well and if there are any problems with the case that he/she would like to discuss with NCMIC. A program like this would greatly alleviate fears and anxiety on the part of the doctor during these troubled times.
- NCMIC should begin to support research projects designed to validate or disprove certain contentions made in the top ten categories of malpractice litigation. For example, if disc herniation is one of the major reasons for a doctor being sued, NCMIC should consider funding research to obtain all the data necessary to defend the amount of force used, torque necessary, and probability or impossibility of disc herniations under certain conditions. It will only take one NCMIC victory in a case which would otherwise be won by the plaintiff, for this benefit to be more than offset by any costs to NCMIC for the research.
- There have been many requests by policyholders to the board in areas of malpractice insurance for "preceptorships", "short term" policies for vacationing doctors, etc. A new and more responsive attitude on the part of the directors, while not guaranteeing every request will be granted, will at least insure a "fair and interested" review by the board.
These are some of the possible directions that NCMIC can and will attempt to strive toward, provided the policyholders continue to maintain a high level of interest in what happens at NCMIC, who is elected to the board, and how they respond to a positive forward direction, in order to keep NCMIC the premier malpractice company in chiropractic.
There are many companies now entering the malpractice field because the ground is fertile and the possibility of profits remains high. The question that should concern all DCs is whether or not these companies will be around when another malpractice crisis appears? It is my firm belief that every DC should carry his/her malpractice coverage with NCMIC in order to insure not only the availability of malpractice coverage today, but to guarantee that we will have a company which will provide coverage to chiropractic physicians tomorrow!
Louis Sportelli. D.C.
Palmerton, Pennsylvania