National Board of Chiropractic Examiners (NBCE) politics are reaching an all-time high, as evidenced by the following:
This is just a sample of the kind of communication that has taken place in the past two weeks. Based on all reports, the politics have been intense since the beginning of the year. One has to wonder: Why are those in power working so hard to stay in power of a nonprofit organization? The issues at hand have to do with control and open reporting.
Proposed Bylaws Changes
1. Adding two more directors? As unbelievable as it may sound, this year's proposed amendments to the NBCE bylaws initially included a provision to increase the number of at-large directors from four to six: one for a public member and one for a representative of the Association of Chiropractic Colleges. This would cause an estimated increase of approximately $130,000 in travel and per diem expenses. Assuming that about 3,000 students take the Part I exam each year, this would effectively add an estimated $40 in additional cost for the Part I exam per student, if the students were required to make up the additional costs. It also would increase the number of at-large directors elected solely by the board to six, as opposed to the current four. Right now, for a group to control the 11-member board, it needs two elected directors and all four at-large directors for a 6-5 majority. If the board is expanded to 13 by adding two at-large directors, the control group would only need one elected director and all six at-large directors to control the NBCE by a 7-6 majority.
Why not just expand the NBCE board to 15 by adding four more at-large director positions, so that the control group need never be influenced by the state board delegates at all?
Interestingly enough, when asked, some college presidents suggested that they neither asked for nor wanted a representative on the NBCE board. Fortunately, this bylaws provision was removed due to lack of support.
2. Director per diem and travel expenses. In his March 28 letter, Dr. Ferguson stated that "Board of Director and Committee meeting payments and travel expenses make up less than 8.5% of the total budget." Assuming that the 2005 budget is close to the 2004 budget, that works out to about $710,000. If correct, this is over $100,000 more than the 1999 figures, when the profession initially became concerned about the expenditures of the board of directors. If these excessive expenditures could be eliminated, it would shave an estimated $220 off the amount each student has to pay for one of their NBCE exams.
3. Elimination of election by the delegate body. One of the safeguards for the NBCE district director elections is that the district nominates the director, but the full body of delegates actually elects the director. This is designed to prevent a small group from controlling who is elected for a particular district director position, particularly if the entire group of district delegates recognizes a problem or conflict with that nomination. The current bylaws proposal includes an amendment that would take away the ability for the delgate body to elect the delegate directors.
4. District director term limits. Believe it or not, there are no term limits for the district directors. This has resulted in one district director spending almost 30 years on the NBCE. Sadly, the proposed 12-year term limit amendment has a provision that prevents it from being applicable to any district director until they are next re-elected.
5. Open reporting. In the two weeks before we went to press with this issue, Dynamic Chiropractic made four requests for copies of the NBCE's 2004 and 2005 financial statements. In addition, we requested information on the per diem and travel expenses for all board members. While there were a numbers of promises made, no financial data was ever provided.
As a nonprofit corporation, the NBCE's IRS Form 990 report is public information. (It can be viewed with a free account at www.guidestar.org.) But the form doesn't require the kind of specific information the profession deserves. For example, the per diem and travel expenses for the individual directors are not listed in "Part V List of Officers, Directors, Trustees and Key Employees." Instead, a notation is made that the information is part of an attachment that isn't included in the Form 990, and therefore doesn't appear on the filing. And while there is $652,877 worth of travel expenses, the form isn't clear as to whether this is just for the directors (in addition to their per diem, which is estimated at well over $300,000). Even the directors themselves aren't allowed to know what the other directors were paid.
At the end of the day, the decisions about how the NBCE is run, who runs it, and how the organization spends the $8 million it receives annually from the chiropractic students is in the hands of the state board delegates. They have the power to get the information, make it public and make the reforms needed.
References
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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