As president of the California Chiropractic Association, I am very disturbed about one of the items published in "We Get Letters" in the April 17, 2000 issue of Dynamic Chiropractic. In the letter, Sherwin Kahn,DC, referring to your interview with Mr.
It is troubling that one of your readers would make such a defamatory and unfounded allegation. It is disappointing that you would lend these allegations credibility by publishing them in your newspaper.
Some officers and directors of CCA are providers under a variety of managed care contracts, including ASHP. However, to state that corruption or other impropriety exists is offensive and completely unsubstantiated. The men and women who volunteer their time, money and energy as leaders of the California Chiropractic Association do so to further the chiropractic profession, not for self-aggrandizement. Baseless accusations such as Dr Kahn's are insulting and unjust, and perhaps actionable at law.
The facts are that CCA has left no stone unturned with respect to seeking ways to tame the managed care beast. A few of CCA's actions include:
- In 1999, CCA filed complaints against the major chiropractic HMOs with the Department of Corporations.
- In 1998, 1999 and continuing today, CCA investigated a wide variety of potential legal theories against chiropractic HMOs, including antitrust theories.
- CCA has repeatedly sponsored and/or supported legislation to open panels to all willing doctors, known as "any willing provider" legislation.
- CCA sponsored legislation to remove onerous contract provisions of certain managed care plans.
- CCA provides a member resource line where members can get all kinds of information concerning managed care, workers' compensation, personal injury and other types of practice.
- CCA's managed care committee helps individual doctors with problems, and advocates on behalf of members with ASHP.
- CCA has been an advocate for the major players in managed care, such as Blue Cross and Blue Shield, to improve the environment for all providers.
- CCA protects all other avenues of practice - cash, Medicare, workers' compensation, and Medi-Cal.
We have spent a great deal of time and money researching legal avenues and taking steps to counter the incursions of managed care into the practices of all DCs. As you know, CCA is not responsible for the existence of managed care, and it is naive to think we are in a position to eliminate it.
Unfounded accusations such as those made by Dr. Kahn, against the only organization in the state with the will and resources to address the problems of managed care, merely serve to perpetuate the problem by weakening our collective voice. Such puerile condemnations may be easily made, but they do nothing to correct the real problems.
The chiropractic profession faces serious problems as a result of managed care, and CCA is forced to address them in an environment comprised of an unsympathetic Legislature, antitrust laws that favor managed care entities over doctors and which severely limit our legal options, and disaffected colleagues who vent their frustrations at managed care by blaming their state association. We are acutely aware of the pain, frustration and fear our members feel, and are doing everything legally available to us to help resolve these dilemmas.
On behalf of CCA and its present and former officers, I would respectfully ask that you publish this letter as a rebuttal to Dr. Kahn's letter. In addition, I would ask that you clarify for your readers that it was not your intent to imply in your published interview with Mr. DeVries that CCA officers have been involved in corruption in connection with ASHP.
Thank you in advance for your attention to these very serious concerns.
California Chiropractic Association
"How many persons can look at these accomplishments and still choose to attack the NBCE?"
I am the widow of Dr. Louis P. Latimer, who at the time of his death on March 7, 1999, was a member and president of the National Board of Chiropractic Examiners.
It has been an extremely difficult 13 months for myself and my family trying to adjust to the loss of someone so vital and important in our lives. However, as we once again become more aware of what is going on the world around us, I feel obligated to write this letter. I have always read my late husband's DC Magazine and now I take time to read my son's. To say I am appalled by the attack on the NBCE is an understatement. I am, in fact, angry.
My husband was a man of unquestionable integrity. As a member of the NBCE, he was dedicated and motivated by the love of the profession and his desire to help chiropractic in its continuous growth to gain the respect it so rightfully deserves.
All the nonsense I have read regarding meetings, per diems, food allowances, travel, meeting places, etc., I will not address, as they need no defense.
My husband spent over 30 years of his life dedicated to serving chiropractic. He first started as a member of the Pennsylvania State Board of Chiropractic Examiners, then the Federation of Chiropractic Licensing Boards and then on to the NBCE. I can assure you that this did not make him a rich man. These years were spent with great sacrifice to his practice, his family, and his health. I feel safe in saying that any other board member, past or present, would say the same thing. I know for Louis, it was a labor of love for his profession.
I think perhaps the focus should be on the situation the NBCE was in prior to the likes of Dr. Paul Tullio, Dr. Frank Hideg, Dr. Titus Plomaritis, and yes, Dr. Louis Latimer, along with the numerous other past and present board members.
Prior to the work and sacrifice of these dedicated doctors, there was not a Part III, Part IV Exam, or Practical Exam enabling young doctors to practice in the majority of states without having to involve individual state boards. There was no beautiful, debt-free building in Greeley, CO, which is a wonderful tribute to chiropractic. There was no official office for the FCLB and no financial support for it. There was not a number of students each year who were able to take the exams gratis, an exam "scholarship," if you will. There was not the pride in the NBCE as we see now, and may I add, the integrity. I know there must be many more accomplishments under the leadership of these gentlemen, but not being a member of the board, I only know the obvious ones.
How many people can look at these accomplishments and still choose to attack the NBCE? I can only think of one thing that these self-serving people have in mind. I know what it is, do you?
"... the NBCE has overcome the pervasive poverty complex to which some still subscribe"
Regarding your recent tirade on the National Board of Chiropractic Examiners, I propose a change in perspective. I am not sure of your motivation, but it certainly appears to me, and many colleagues with whom I have spoken, that a few frustrated individuals may be responsible. Of course, the facade is concern over financial burden and convenience of the students. However, reading between the lines of your editorial in the February 7 issue, and particularly considering your prediction of the formation of a competitor organization, I have suspicions that you may be part of a small group of power seekers that will sacrifice unity for self gain.
That is hard for me to say, considering the longstanding admiration I have for you and had for your father, as editor of Dynamic Chiropractic. I have often been inspired by your "call for unity," your personal messages and your motivational insights. Certainly, your vituperative flavor has united us on many occasions when certain individuals outside (and inside) our profession have acted antagonistically or selfishly.
But now you are attacking the NBCE, which in my opinion is the finest organization ever to serve the chiropractic profession in this capacity. Perhaps your "eight-month investigation" should have been nine or 10 months. Then you might have taken the time to survey the consumers (the student/candidates and practicing doctors who are fully satisfied with their investment). First of all, it is important, as Dr. Temple of the FCLB pointed out in your March 20 issue, that readers realize that the testing products and services are not an issue. The surveys I have seen, and the direct feedback I have received as a chief examiner, are overwhelmingly favorable. In fact, many of the Part IV candidates with whom I have spoken told me that the practical exam was the most impressing experience of their entire chiropractic education.
As far as the cost of the exam is concerned, let's put that in perspective. Parts I, II, III and IV can be taken for $1,450, with successful completion allowing the doctor to obtain licensure through reciprocity in most of the 50 states. Ask the several thousand DCs around the nation who obtained (and maintain) more than one state license before the Part IV concept. Which is more expensive? The NBCE Part IV exam is a gold standard among all health professions, and I understand it is being used as a model for a similar medical exam. As far as I know, at this time there really is no comparable product that benefits the recipient so greatly with such acceptance. Certainly, the graduating student DC is faced with financial hardship. A typical debt for chiropractic education is probably $100,000. Your cost savings recommendations might save the student 1/2 of 1% of total debt. Considering the marginal significance and the increased odds of full repayment and practice success with NBCE certificates in hand, the investment turns out to be quite a bargain. Considering that your recommendations may save each student a total of only $350 for all four exams, and the potential organizational trauma some of your recommendations could cause, those recommendations appear less reasonable.
There may very well be some room for cost containment within the NBCE. I would not know because I am not on the board of directors, and as a chief examiner for Part IV, I only travel to my Dallas test site and to the headquarters in Greeley for workshop participation. I am amused, however, with your editorial opinion that three country club memberships constitute "the most flagrant and insulting item on the budget."
Mr. Petersen, I just returned from a workshop meeting in Greeley, and we were provided with dinner at the country club. While grateful for the nourishment, I was hardly impressed by the facility and was told that the memberships do not even have golfing privileges. There surfaced no "country club attitudes" at the dinner, just friendly and professional hospitality. It was very nice but very average, yet consistent with a successful organization. Fortunately for us all, the NBCE has overcome the overcome the pervasive poverty complex to which some still subscribe.
I remain very proud to have the privilege of serving my profession through administration of the NBCE Part IV exam. As a third-generation chiropractor, I am sure that if my grandfather and grandmother were alive today, they would enthusiastically praise our accomplishments. Having read many of your father's editorials, I think he would join them.
I do regret having to write to you in disagreement, as I have been inspired many times to write you in praise of your positive influence and leadership through your publication.
NBCE Chief Examiner
Fort Worth, Texas