Chiropractic board regroups

The state board that polices chiropractors says it wants to patch holes in its disciplinary process identified in a Sacramento Bee investigation this month.

Among the possible improvements are hiring a sworn peace officer with the power to make arrests and actively inspecting chiropractic offices instead of waiting for complaints to come in.

But first, the Board of Chiropractic Examiners must persuade the Legislature to restore its budget, which was slashed in half by lawmakers unhappy with the board's recent conduct.

Legislators, however, say that The Bee's investigation underscores that the board needs outside oversight before its budget should be restored.

"Chiropractic professionals are wonderful, decent, hard-working health care professionals," said Assemblyman Mike Eng, D-Monterey Park, chairman of the committee that oversees the state licensing board. "Like every other health care profession, they need to be put under a system of accountability."

The state's biggest chiropractic association, meanwhile, mobilized to counter what it saw as a slam on the profession. Among other measures, it sent out "talking points" about the newspaper's investigation and a subsequent editorial for chiropractors to use with their patients.

For instance, if patients ask about enforcement, the California Chiropractic Association advises its members to inform them that, "At its most recent meeting, the board announced it was developing new enforcement procedures to make sure that enforcement cases don't fall through the cracks."

It added that the association "has asked local doctors and patients to write letters to the editor that directly respond to the false information in The Bee. These letters will also serve to demonstrate to lawmakers reading The Bee that there is a strong chiropractic constituency that they will face if they try to introduce legislation that limits access to care in these or other areas."

The Bee's two-part investigation found that the board over the past decade has taken a passive approach to discipline. By law, it receives reports about malpractice claims of more than $3,000.

But civil cases involving sexual transgressions or fraud may not come to the board's attention, because that kind of misconduct is not considered malpractice and does not trigger the reporting requirement.

Even when the board does get notifications, it doesn't always do a thorough investigation. The Bee found malpractice cases in which the board never contacted the plaintiff's attorney before dismissing the case – usually the first step in an investigation.

Since March, when chairman Richard Tyler took over a board stocked with new appointees of Gov. Arnold Schwarzenegger, it has taken a more lenient approach to discipline. It is revoking licenses at less than half the rate of the prior nine years, and choosing probation in a higher percentage of cases.

"Clearly, this is not a board that has been operating in the best interest of the public and has instead been trying to advance their own agenda regarding the practice of chiropractors," Sen. Mark Ridley-Thomas said in written comments responding to The Bee's investigation.

Ridley-Thomas, D-Los Angeles, was the author of Senate Bill 801, which would have stripped the board of some of the autonomy it got when voters approved a 1922 initiative regulating the profession. The bill would have asked voters to approve putting the board under the control of the same consumer affairs department that oversees other licensed professionals.

The bill also would have restored the board's $3 million budget, which the Legislature had slashed in half. But when Schwarzenegger vetoed SB 801, the board was left with a half-year's budget. As a result, it is cutting its staff from 15 to 6, and has lost key people in the enforcement program.

The board's executive director, Brian Stiger, said that since he was appointed last spring, he has recognized shortcomings in the board's enforcement program.

In response, the board is revamping the training of the outside experts it hires to assess disciplinary cases, Stiger said.

It would like to hire a peace officer with arrest powers who "can respond very, very quickly" to chiropractors who may be endangering the public.

It wants to do more to prevent problems by meeting with chiropractors and inspecting clinics, he said.

Stiger said he has also talked to the board member who heads the enforcement committee about the possibility of closing the loophole that allows civil settlements in cases of sexual improprieties or fraud to avoid reporting requirements.

"We are looking to increase enforcement," Stiger said. "We have lots of ideas and lots of proposals.

He added, however, that, "It's difficult to do that without our budget."

While not disputing the newspaper's figures on the board's increased leniency, Stiger said, "I don't recognize it as a shift." He said each case is decided on a wide variety of factors, and that the staff and the board have considerable flexibility in meting out discipline.

"The answer is not always revocations," Stiger said.

The California Chiropractic Association also took issue with the newspaper's conclusion that the board was taking a softer approach.

"It could be that (chiropractors) were given probation because the complaints seemed to be less severe," said Kassie Donoghue, a Sacramento chiropractor and past president of the association.

While the board may be considering a more active approach to discipline, she said, "I don't know if it's possible in any health profession for every single doctor to be scrutinized to determine if what they're doing is actionable by the licensing board."

Still, she said, the association has no tolerance for misconduct and supports anything that strengthens enforcement.

"These people should be dealt with firmly," she said.

Grass Valley chiropractor Jay Patt called it "pitiful" that practitioners might not be disciplined for serious transgressions.

"I think those things should be investigated," he said. "I think it's an error in their vision."

About the writer:

• Call John Hill, Bee Capitol Bureau, (916) 326-5543.