State Audit Vindicates Push for California Chiropractic Board Reform

There is a long history of animosity between the medical profession and the chiropractic profession. The chiropractic community often mentions a lawsuit a chiropractor initiated against the American Medical Association in 1976 (Wilk vs. AMA) in which federal court found that the AMA was guilty of conspiracy and restraint of trade of the chiropractic profession. What they don’t mention is how times have changed since then. In 1992 the AMA stated that it is ethical for physicians to refer patients to chiropractors and a further acceptance came in 1997 when an AMA report states that “manipulation has a …reasonably good degree of efficacy in ameliorating back pain, headache…”

It’s time to put the consumers need for board protection before their fear of bias. Their withdrawal from Consumer Affairs left the board without oversight, and left the consumer without any recourse if they experienced a problem with the board. As I detail in an earlier article, I was told by the (then) executive director, Kim Smith, that the only authority to appeal to regarding my complaint was the Governor. With any other consumer board the public can file a complaint with DCA. At the Chiropractic Board meeting on March 27, 2008, board member, Jim Conran, said that he believed that this board started unraveling when they withdrew from DCA. I wholeheartedly agree with him.

The audit details many serious problems with the Chiropractic Board but my primary focus is their inadequacy of enforcement and their complaint process. This board has long failed to protect the people of California. The most glaring example of this failure was shown when an investigation found that a chiropractor accused of rape, was not investigated by the board and continued to practice. “A follow-up described the case of a Los Angeles chiropractor who continued to practice for two years after the board first learned that a woman had accused him of rape. He was later convicted of sexually assaulting five women -- including the initial accuser and four later victims.” (Sacramento Bee) It’s inexcusable for the board not to investigate a sexual misconduct allegation let alone rape. With this negligence how can a patient know if their chiropractor is not a criminal let alone competent or ethical?

The audit showed that the board members have not even been properly trained in consumer protection. The audit states they saw no evidence that the board members had received training in ethics, sexual harassment or even basic orientation within prescribed timelines of assuming office (audit p. 22). Also alarming is that the audit found there was no verification the enforcement staff or investigators were qualified for the positions they held (p. 42 audit). At the meeting on March 27, 2008, executive director, Brian Stiger, mentioned that he had found that two of the four investigators were not even licensed and took the appropriate steps in firing them.

There are no established guidelines for processing complaints, referring serious cases to the attorney general, or insuring that the appropriate staff makes final decisions on complaints (p. 43 audit). Therefore there is no guarantee for a patient that their complaint has been handled competently, referred to the appropriate people or that the information given to them is even truthful. In one case the audit details a patient given false information regarding the closure of her complaint on sexual misconduct. “The board’s enforcement analyst reviewed the investigation report and, without a manager’s review and approval, made the decision to close the case because of insufficient evidence. …. The analyst sent closure letters to the complainant and licensee stating that the chiropractic consultant had reviewed all the available documentation and determined that the evidence was insufficient to support the allegations. In this case staff closed the complaint when the chiropractic consultant was on an extended leave of absence…” (Audit p.50).

The audit contrasts the complaint process of the physical therapy with that of the chiropractic board, “the physical therapy board told us that of the urgent complaints, it handles those alleging sexual misconduct or negligence resulting in injury to a patient on an expedited basis and forwards the cases to the Division of Investigation of Consumer Affairs, usually within one week of receipt.” (Audit p. 67) The Chiropractic Board was found to have allegations of sexual misconduct and fraud that went unresolved between one year to more than three years leading to the potential of repeat offenses and harm to the public. Oddly enough, until May 2007 the Chiropractic Board considered the practicing of chiropractic medicine without a license to be outside their authority to investigate! (Audit p. 54)

The audit details many more inadequacies of the board and I’m thankful that Senator Ridley-Thomas has cared enough to investigate and make this information available to the public. It’s dismaying that our Governor cared more about protecting both his friends and the status quo of the board than giving the people of California a chance to vote for any lasting board reform.

On April 8, 2008 Assembly Bill 450 was approved which would restore the board’s full funding. Most important is that this restoration of funding is contingent of the board’s agreeing to continued oversight by the Department of Consumer Affairs. At the board meeting on March 27, 2008, executive director Brian Stiger sought and received board permission to contract with DCA for services through 2010.

I am impressed with both Mr. Stiger and board member, Jim Conrad, incidentally both former employees of the Dept. of Consumer Affairs. Both gentlemen show genuine interest in restoring this board’s mission to protect the public.

I also trust that Senator Ridley-Thomas will keep monitoring this board... “Though the Governor did not sign my legislative proposal to reform the seven-member Board, I continue to monitor the Board’s actions and at every opportunity, look for appropriate avenues to ensure the Board abides by its governing laws and operates in the most effective and efficient manner to protect the public.” (Ridley-Thomas’ website). The Senator is requesting another audit in six months to follow up the board’s progress in correcting problems and says he will push to cut the board’s budget again if necessary. “I’m still very concerned that the board has stringent oversight, he said. It has to.” (Sacramento Bee April 8th).

When I attended the March 27th board meeting, Richard Tyler, close friend of the Governor and often at the center of controversy, said “I’ve seen our law from 1922 beat around by different administrations, by different lawyers and legal opinions. We won’t always have the same board members or the same governor.” Unlike Mr. Tyler, I see that as a hope that someday an initiative will be enacted that will give the chiropractic board permanent reform.

Deborah Snow was born and raised in California. Deborah received her BA degree from California Baptist University in Riverside, CA. majoring in both English and Behavioral Science. She is currently employed at University of California, Riverside as a Library Assistant. Deborah is married and has one daughter. She also volunteers in her spare time at Riverside City and County Animal Shelter.