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Protecting the public and serving our member boards
by promoting excellence in chiropractic regulation.

Evolution or Revolution:
FCLB pushes the boundaries on
professional regulation of doctors of chiropractic

"Look to your left, and to your right - in a few years, none of you may be here." The 9th Annual Joseph Janse lecture was delivered by Louis Sportelli, D.C., president of NCMIC and the World Federation of Chiropractic. Entitled "Licensing - Does it Have a Future?", Sportelli challenged the regulatory boards to step up to the challenges posed by current and pending legislation to remodel professional regulation.

The 73rd Annual Congress of the Federation of Chiropractic Licensing Boards was held April 14 - 18, 1999 in Philadelphia, Pennsylvania - a city noted for its revolutionary history. The conference theme, "Evolution or Revolution: The Future of Chiropractic Regulation" hammered hard on the critical challenges facing chiropractic to regulate the profession better or lose the privilege.

The keynote address was delivered by attorney Randolph P. Reaves, a leading legal authority on professional regulation and executive director of the Federation of Associations of Regulatory Boards. He traced the history of professional regulation (dating back 5,000 years) and outlined the current legislative pressure to turn professional licensing and discipline over to state agencies and consumers.

"Chiropractic is not alone in facing this challenge," observed Dr. David E. Brown, FCLB's newly elected president. "Every regulated vocation is under siege today. The right of professionals to regulate ourselves is threatened.

"We have strengths that other professions may not have, however. Our boards are constantly evolving in their role of protecting the public. The FCLB's educational programs are designed to give boards the tools they need to meet the challenges of the new millennium."

The FCLB conference program offered a number of educational sessions designed to push the concept of chiropractic self-regulation to the highest levels of respect by legislators, the public, and the field doctors.

Continuing Education

Canadian Memorial Chiropractic College's "Virtual Viewboxes" provided an impressive demonstration of the technology available today for on-line learning.

Bringing access to quality education for rural chiropractors and upgrading learning to interactive from the current passive "talking heads at the podium" model are two major reasons boards should add these tools to their CE options.

Participants agreed that some in-person CE is critical to maintain a sense of connection between otherwise isolated practitioners.

Conference attendees and speakers strongly encouraged the FCLB to explore hosting a central registry for approving core CE programs.

If developed, individual boards would maintain the right to approve additional CE programs which meet their particular regulatory requirements.

However, programs which would clearly qualify in all jurisdictions would no longer need to apply individually to multiple jurisdictions for approval.

Databanking

Final regulations have not yet been distributed governing the federal Healthcare Integrity and Protection Databank (HIP Databank) to which chiropractic will be required to report.

If immunity is extended to reporting agents, the Federation may be able to serve in this capacity for member boards. The federal program is not scheduled to go on-line until at least fall 1999, and possibly later.

Although information included is all public record, the public will not have access to the HIP Databank, and fees will be assessed for boards to access the information they have put into the system.

The FCLB stressed the importance of continuing to report to CIN-BAD, the chiropractic profession's own databank, where access is available free to member boards.

The Federation also presented a demonstration of the prototype ALLDoCS database, which already has 39,000 licenses in it. "All Legally Licensed Doctors of Chiropractic" will eventually offer on-line primary source level verification of all the licenses held by each chiropractor.

The Federation envisions this as a highly efficient way for managed care to expedite approval of chiropractors to participate in health plans, as well as helping the regulatory boards to verify licensure for faster relocation or travel-to-treat options where permitted by law.

The FCLB was surprised and pleased to receive the announcement from Dr. Louis Sportelli that the NCMIC Board of Directors has approved a two year grant totaling $120,000 to support the development of the ALLDoCS database to assist the field practitioners and licensing boards.

With previous support from NCMIC, CIN-BAD's Official Actions Database with both public board actions and Department of Health and Human Services Sanctions shifted to Internet access last year.

Accreditation

Representatives of the US Council on Chiropractic Education described the CCE's plans for a streamlined governance structure and new admissions standards.

Disciplinary Tools

Several models for Alternative Dispute Resolution were presented, adding to boards' options for professional discipline. It was pointed out that some jurisdictions have only limited, severe sanction options, where ADR may offer higher levels of both practitioner and consumer satisfaction in cases which meet pre-existing guidelines.

Media

Representatives from the Pennsylvania Department of State and Virginia Board of Medicine presented "offense and defense" models for working with the media to ensure appropriate coverage of board issues, including hearings, legislative proposals, and consumer involvement.

Rebuilding the Regulatory Board

The California Board shared its experiences in candid assessment of the board's strengths and weaknesses and implementing an improvement program. Consumer responsiveness was a key focal issue.

Professional Standards

In a team discussion program prior to the main conference, board members explored professional standards issues and made recommendations to the Council on Chiropractic Guidelines and Practice Parameters about future directions in this area. The CCGPP leadership presented an update to the general session.

ADA

Appropriate accommodations in both testing and discipline were described by representatives of the national testing bodies for both chiropractic and allopathic medicine.

A World View

World Federation of Chiropractic Secretary-General David Chapman-Smith, LL.B., closed the conference by urging boards to look at expanding the borders of regulation to a world-wide understanding. The fact that there are now more chiropractic colleges outside the US than within its borders was surprising to many in the audience.

So what was learned?

The "take-home" lessons of the conference varied according to the needs the attendees brought with them.

Some were empowered to go home and energize their visions for change, knowing the broad directions that health care and chiropractic regulation are taking.

Some were challenged to see that their legislative options for continuing education, mobility, and discipline need updating to handle the demands of new regulatory models.

And still others were pleased to see that chiropractic regulation is clearly in the mainstream with other health care professions - and at the cutting edge of board action databanking. "It's nice to be at the head of the pack in this important consumer protection area," Dr. Brown observed.

Annual Business Meeting

The member boards voted to approve two documents for voluntary adoption or adaptation by chiropractic regulatory agencies.

"Guidelines for the Development of a Model Disciplinary Code" and "Model Code of Ethics for Members of Regulatory boards for the Licensed Professions" were both accepted as official Federation publications, with the understanding that both will be evolving documents as worthwhile ideas and changes in regulation are brought to the attention of the FCLB.

Annual member dues were increased for the first time in five years, effective in 2000.

Leadership Changes

With elections, appointments to fill vacancies, and the seating of district directors elected at the fall regional meetings, the leadership slate is complete for 1999-2000:

President: Dr. David E. Brown (VA)
Vice President: Dr. Wayne C. Wolfson (FL)
Treasurer: Dr. Richard L. Cole (TN)
Immediate Past President: Dr. Lawrence M. Gerstein (MO)

Executive Board Chair and District II Director: Dr. Vernon R. Temple (VT)

District I Director: Dr. Patricia G. Conners-Allen (AK)
District II Director: Dr. James P. Powell (OH)
District IV Director: Dr. Ronald J. Zoeller (KS)
District V Director: Dr. Linda Steele Denham

Retiring members Drs. Robert M. Vaughn (NC), Jan A. Harbour (WV) and George R. Phillips (WY) were recognized for their service to the FCLB Board of Directors.

Drs. William Swanson (ND) and Linda Steele Denham (GA) were approved by the membership to serve on the 1999-2000 nominating committee.

Dr. Glenn Moldenhauer (ID) was approved by the membership to serve a four-year term on the Long Range Planning Committee.

Regional meetings take place August - October and next year's annual conference is scheduled for May 3 - 7, 2000 in Seattle, Washington.

For more information about the Philadelphia meeting, please contact the FCLB at (970) 356-3500 or by e-mail: fclb@fclb.org. Readers may also click on the FCLB website at www.fclb.org to obtain copies of major lectures and handouts.


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