by Carol J. Winkler, DC •
President, Federation of Chiropractic Licensing Boards •
When it comes to living “green,” one usually assumes a natural lifestyle, organic food, climate change awareness, recycling, and efficient energy consumption. When it comes to chiropractic, living green should embody a different concept of freedom and practice without barriers, restrictions, or regrets.
Life has a way of issuing warning signals, usually before impending disaster or harm. When practitioners choose to reside or practice surrounded by warning signs, refusing to take measures and move toward the “green,” preventable, and unnecessary stressors can complicate practice and life. Think stoplight. Green means go, yellow means caution, and red is STOP. Regarding chiropractic, STOP is designed to protect the public and maintain ethical, legislatively enacted practice parameters upheld by professional licensees.
The National Practitioner Data Bank reports that in 2022, 343 adverse actions were reported nationally in the field of chiropractic. In 2021 that number was 425. Malpractice settlements were 155 and 134, respectively. Many ongoing investigations, settlement agreements, and less-than-reportable actions are occurring throughout the country as regulators provide due process to the complaints that come before them. In the world of public protection, each of these complaints, especially those resulting in a reportable action, represents a chiropractic patient and their family. These complaints allege a violation of state statute or rule and may lead to a malpractice claim, depending on the nature of the incident.
Living green, for an ethical chiropractic practice, equates to a lifetime of treating patients free from the stress imposed when a formal complaint is filed and the subsequent adjudication process ensues. Complaints are avoidable in many instances and the statute and rules that protect the public often protect the practicing doctor of chiropractic. The first rule to live by is knowing and understanding the jurisdictional statute and regulations that pertain to licensure. The statutes and rules governing chiropractic practice and the jurisprudence portion of receiving a license vary throughout jurisdictions nationwide. Some jurisdictions require a formal jurisprudence exam, and some require an affidavit affirming understanding and a willingness to abide by these regulations.
Yet frequently, when coming before a regulatory board with a complaint in process, the respondent to the complaint admits they did not know the rules. Are you able to advertise as a specialist? Can one practice functional medicine, and is it permissible through telehealth? Is it appropriate to delegate authority to staff? Is there a standard of documentation and financial disclosure that your jurisdiction requires, and what constitutes unprofessional conduct? These are rhetorical questions that beg an answer. While most practitioners consider the information provided by state or jurisdictional licensing boards as punitive, it can be one of the greatest assets in practice. Adopting regulatory language into a practice and business model allows one to live in the green.
Part of living an authentic practice life is realizing and then admitting what sections of practice regulation remain challenging and then doing something about it. A lack of knowledge or pervasive soft spots in the defensive section of a practice’s business plan can be disastrous.
The good news is that disasters can be avoided. The Federation of Chiropractic Licensing Boards is an association of chiropractic regulatory boards throughout the United States, its territories, and Canada. Its mission is to protect the public by promoting excellence in chiropractic regulation through service to our member boards. In addition, the FCLB serves as an information service organization, promoting the safe and ethical practice of chiropractic to licensees through several programs.
The Providers of Approved Continuing Education program recognizes Continuing Education providers who have undergone a rigorous application and vetting process. This assures the licensee of obtaining scientifically sound, professional post-licensure education. Forty-two jurisdictions accept PACE-approved courses for license renewal. More importantly, there are many courses to educate and refresh licensees on problematic regulatory issues such as ethics, boundaries, documentation, and compliance.
If delegation is a problem, the Certified Clinical Chiropractic Assistant (CCCA) Program provides an avenue for staff to be certified in providing clinical assistance to patient care.
Lastly, living green and free must not be lost on those seeking employment within the practice. The Chiropractic Information Network-Board Action Databank (CIN-BAD) is a data bank or repository of jurisdictional licensing board actions. It is important to evaluate potential employees’ licensure standing and previous actions taken against that license when considering adding individuals to the team of professionals serving the needs of the public.
Living green and free of the fear of licensing board complaints is attainable. Utilizing jurisdictional regulatory requirements as part of a defensive practice plan is prudent, wise, and life-giving when counting the cost and emotional strain of the complaint process. The FCLB tools available for the defensive toolbox include PACE-approved courses, CCCA certification, and CIN-BAD information on completed board actions. Invest in your future now so that your legacy will be an impactful career with service to humanity that reflects the profession’s ethical standards, provides the service that the patient public requires, and produces the joy of living in the “green.”
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Why is the Discount Challenge prize amount $15,024? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $15,024 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.