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.
Good Old Boys Board
As a veteran of many meetings of the National Board of Chiropractic Examiners (NBCE), I've seen a lot. Over the past 18 years, I've witnessed two "reforms" of the NBCE, each one led by the delegates in an effort to change the people leading the board and the process by which it's governed.
The first reform began at the 1999 annual meeting, with the delegates attempting to pass a motion to enact term limits on the board of directors.1 At that time, directors were elected to three-year terms, but they could serve as many terms as they wanted. (As a point of reference, directors for the Federation of Chiropractic Licensing Boards are limited to a maximum of two three-year terms.) Unfortunately for the state delegates, they discovered that according to the NBCE bylaws, they had no power to make motions to amend the bylaws.
A long list of chiropractic organizations expressed their concern over how the NBCE was operating.2-6 The 2000 annual meeting began with a debate between the directors and the delegates regarding the directors' bylaws amendments to limit the decision-making power of their own state delegates.7,8 This was the beginning of the first reform.
Efforts to reform the NBCE continued for the next few years, with some important improvements in fiscal responsibility and sensitivity to the needs of the chiropractic profession. The second effort began early in 2006 when NBCE delegates were encouraged to "Do the Right Thing: Keep Your Paddle Down!"9 This statement reminded the delegates they still held the power to approve any nomination of the district directors and could withhold the necessary votes. For the first time in NBCE history, the delegates did just that: They refused to elect an old-guard nominee and instead elected the reform candidate.10
At that same meeting, the delegates refused to approve every bylaws change presented by the board (in the past, they had been presented a "take it or leave it" scenario with no ability to amend or vote on proposed bylaws changes separately). The "NO" vote by the delegates was unanimous.
A third historic event took place the next day when the delegates insisted on being present at the first meeting of the newly elected board of directors. This was the meeting at which at-large directors were to be elected. The delegates refused to leave, virtually daring the directors to throw them out. Better judgment prevailed, and delegates have been free to attend the board meetings ever since.
When reform efforts began almost 10 years ago, the delegates were prohibited from receiving all but the most basic financial information regarding how the directors spent millions of dollars each year. As a group, the directors themselves received hundreds of thousands of dollars in per-diem and travel expenses. It wasn't until the second reform in 2006 that this information was made completely available to the delegates.
This year's NBCE annual meeting was the embodiment of what the delegates worked so hard to make possible over the past decade. Complete financial information was available to anyone who wanted to see it. Term limits were enacted for the directors. (All the current directors have served for seven years or less. Compare this to some of the "old-guard" directors who held their positions for 20 or 30 years.) The delegates were allowed to vote on individual bylaws amendments, rather than having to vote "take it or leave it" on the entire package of proposed bylaws changes. And every question asked by the delegates was answered - no more secrecy.
Best of all, the delegates were part of an interactive process of electing directors, passing bylaws and serving the profession. They are now participants with the directors rather than in opposition of what the board is trying to do.
The NBCE is critical to the future of the chiropractic profession. It serves to qualify every doctor of chiropractic whoever touches a patient in the United States. It is involved in testing doctors in other countries as well. The delegates have worked hard to make the NBCE the organization it should have been years ago. They have stood up and made their voices heard. In the future, NBCE delegates will need to continue this effort. They will need to be ever-vigilant to keep the board making the right decisions and operating the way it should.
References
- "Nat'l Board Delegates Seek Greater Authority." Dynamic Chiropractic, May 31, 1999. www.chiroweb.com/archives/17/12/20.html.
- "ICA Calls for 'Immediate, Profound Reforms' of the NBCE." Dynamic Chiropractic, Feb. 7, 2000. www.chiroweb.com/archives/18/04/09.html.
- "ACA Weighs in on Nat'l Board Debate." Dynamic Chiropractic, Feb. 21, 2000. www.chiroweb.com/archives/18/05/12.html.
- "What Does the FCLB Have to Do With the NBCE?" Dynamic Chiropractic, March 20, 2000. www.chiroweb.com/archives/18/07/16.html.
- "Chiropractic Students Weigh in on NBCE Controversy." Dynamic Chiropractic, April 3, 2000. www.chiroweb.com/archives/18/08/19.html.
- "College Presidents Call for 'Consolidation of NBCE Parts II and III.'" Dynamic Chiropractic, April 17, 2000. www.chiroweb.com/archives/18/09/01.html.
- "NBCE Bylaws: Directors vs. Delegates." Dynamic Chiropractic, May 1, 2000. www.chiroweb.com/archives/18/10/19.html.
- "NBCE Embraces Change." Dynamic Chiropractic May 29, 2000. www.chiroweb.com/archives/18/12/10.html.
- "Do the Right Thing: Keep Your Paddle Down!" Dynamic Chiropractic, April 24, 2006. www.chiroweb.com/archives/24/09/07.html.
- "NBCE Meeting Results in Reform." Dynamic Chiropractic, June 6, 2006. www.chiroweb.com/archives/24/12/12.html.