Edward J. Barowsky, D.C.,
Chairman
The
Massachusetts Board of Registration of Chiropractors (Board) believes that we have
accomplished a variety of practical measures, which have made a significant
impact in how chiropractic services are delivered, utilized and accessed for
the betterment of our states health care consumer. At this past October’s FCLB regional meeting, we outlined a
number of initiatives that our Board found tremendously helpful as well as
goals for new projects that we were working to achieve. We are pleased to be given the opportunity
to briefly report on three of our successes over this past year. We hope these programs may serve as
potential models to build upon for other licensing Boards who may be grappling
with many of these same issues.
Consent
Agreement Supervisor Program:
We developed this innovative program to provide a
framework where problem doctors can resolve their former deficient practices
during the probationary period within an environment of oversight and
support. At the conclusion of their
suspension period, the disciplined doctor under a consent agreement, is asked
to select a Board approved supervising monitor who will provide predetermined
periodic reports on that doctor’s progress.
The questions that these reports will cover have been outlined by the
Board and relate directly to those problem areas previously demonstrated. The problem doctor personally selects their
own supervisor as they wish or we provide them with a list of potential
supervisors, many of which are former Board members. The one-on-one personal
oversight allows for the development of trust and serves to break the
atmosphere of secrecy that may have in the past clouded the integrity of the
problem doctor. At the conclusion of
the monitor period the disciplined doctor and at times their supervisor, review
the reports/progress with the Board and bring a positive finality to what could
be an unpleasant situation. In addition to the benefits from a team approach,
the Board is able to outsource this time consuming rehabilitation through the
use of non-Board member supervisors.
Rules,
Regulations and Recordkeeping Seminar:
Our Board
recognizes that recordkeeping errors are commonly encountered in most
accusations of health-care fraud, overutilization, negligent practice, and
improper charges. Proper records are
the basis of better quality care. Therefore, we committed our collective talent
and resources to develop and present a recordkeeping
seminar that is comprehensive, accurate and stimulating. Topics include: Standards of Chiropractic
practice within Massachusetts, Recordkeeping in clinical practice, Outcome
measures, Federal recordkeeping requirements, CPT coding definitions for
chiropractors, and Federal healthcare compliance guidelines. Our first 6-hour seminar was held this past
December and was overwhelmingly successful. We utilized a PowerPoint presentation
where each Board member covered a certain section. By the time this report is printed, we would have completed our
second expanded (12-hour) seminar this April.
Our intent is to have this seminar available biannually. We trust that our efforts will eventually
lead to better standards of chiropractic care within our state.
Board Policy Guidelines:
From time to time, licensing boards are confronted with an important issue that pertains to clinical practice but does not require the issuance of a legal rule or regulation to narrowly define an acceptable behavior or evolving element of clinical practice. These are instances were a Policy Guideline can better serve both the public and profession. We describe Policy Guidelines as a recommended protocol for the profession to follow. Guidelines do not have the force or effect of law, as would a Massachusetts law or a Board rule/regulation. We utilize these policy guidelines as internal management tools in formulating decisions that relate to issues of chiropractic practice. Along with our rules and regulations, we post these guidelines on the State’s public web site so that both the profession and public may be clearly informed about the Board’s opinions on situations that are often multi-facetted. Over the past year, our Board developed a number of new as well as upgrading all of our existing guidelines. Examples of these guidelines include: The use of Advanced Technology in a Chiropractic Office, Chiropractic practice protocol for the Treatment of Non-human Vertebrates, Timely Release of Patient Records, a Peer Review guideline, Protocol for Investigative Chiropractic Techniques, and a guideline on Informed Consent. These guidelines can be found at our website at: www.state.ma.us/reg/boards/ch.
Current challenges:
The Massachusetts Board has been plagued with insufficient state funding for numerous years. This has resulted in a lack of appropriate administrative, investigative, and legal staffing. Although our Board is up to date on all complaints presented to us, the backlog of unresolved complaints within our legal department remains unacceptably high. The investigative unit is also backlogged which slows the complaint process brought before our Board. Fortunately, we have just recently entered into a new statutory “Trust Fund” revenue program that we are optimistic will be helpful in meeting this challenge.
FCLB assistance:
Our Board is very appreciative of the FCLB’s guidance and assistance in formulating a goal for national inter-jurisdictional mobility. Since initially learning about this type of licensing option at the 2001 FCLB national meeting and witnessing other states efforts toward this effort at last fall’s district meeting, we have been provided a large step-up on how to best accomplish such a provision in our state.
Chiropractic consumers, as well as our entire profession, are far better off from the cooperative wisdom afforded by the FCLB. We believe that in Massachusetts our current Board of Registration of Chiropractors with, the help of the FCLB, is meeting the challenge of serving, protecting and ensuring the health and welfare of our Commonwealth’s citizens.