August 2005
DCs warned about high cost of board complaints
by Timothy Feuling, CBS President
Insurance coverage vital but missing from many policies
It used to be that the
worst thing that could happen to a chiropractor was a malpractice lawsuit.
Today, a complaint from a state Board of Chiropractic Examiners can be
nearly as bad ‑‑ or, sometimes, even worse. As one lawyer put it in an
article for Medical Economics: "Few doctors realize that a patient's
complaint to the state medical board could pose an even greater threat to
their careers and livelihoods."
While the majority of
board actions come from patient complaints, board actions can be spurred by
complaints from other DCs (frequently motivated by professional jealousy or
political animosity) or from insurance providers alleging inappropriate or
unnecessary care.
"You can't know the
terrible feeling you get from learning that you are the subject of a
licensing board investigation until you've experienced it," one doctor
stated in an article by John H. McCord, DPM for The Center for Peer Review
Justice. "It felt like a lynch mob was after me."
What makes things worse
is that, unlike a lawsuit, you have few rights when it comes to board
complaints. Attorney Mary Nester explained that, "because a license
investigation is not a criminal action, you are afforded no constitutional
rights to confront your accuser or have an attorney appointed to represent
you. Further, because a license investigation is not a civil action, you may
not be entitled to discovery of evidence that the agency may have to support
its case. Some agencies may withhold evidence indicating that you did
nothing wrong... Most licensing boards have the authority to subpoena
records without being obligated to notify you of this action. The board may
obtain and review your personnel file, including any disciplinary records,
your school records, patient records and, depending on the source of the
complaint, quite possibly your own medical records."
Her final warning is
the most ominous: "Take every board investigation seriously. Do not presume
that because you are innocent, you will ultimately prevail." Remember:
completed license complaints that result in letters of concern, stipulations
or board disciplinary action are part of the PUBLIC RECORD. They are
available (usually via the internet) for anyone to see, including preferred
providers, managed care companies, and your patients. Board complaints and
discipline actions must be disclosed to insurers, other state licensing
agencies and credentialing firms. An adverse action will remain on your
record for the life of your license.
Obviously, board
complaints have gone from being minor and rare irritations to serious
threats that could put your license ‑ and your entire career ‑ in jeopardy.
In addition, they can
cost you huge sums of money. "The cost of defending yourself in a
disciplinary case is not cheap," said McCord. "Most attorneys with expertise
in disciplinary issues charge between $150 and $300 per hour and the
eventual total can run into six figures, depending on the complexity of your
case."
That isn't an
exaggeration. Although one source puts the average cost for defending a
chiropractic board dispute at $15,000, it's likely that they will become as
expensive as those filed against other types of practitioners. In one
extreme case, a psychologist spent more than $400,000 battling an accusation
from his board. Although he was ultimately allowed to remain in practice,
the process took several years.
Until recently,
professional liability insurance policies didn't cover the cost of defending
board complaints or disputes, but today, these actions post a greater threat
to chiropractors and such coverage is vital. Margaret A. Bogie, a property
and casualty insurance consultant and executive administrator of the
American Psychological Association Insurance Trust, emphasizes that
"Licensing board coverage is a major difference between insurance policies
because it provides unique coverage for a previously uninsurable risk."
When comparing
malpractice insurance policies, be sure to look specifically for board
dispute defense coverage. Without it, you could be faced with a devastating
financial burden of defending yourself against a board complaint that could
be far more damaging that any lawsuit.
(Timothy J. Feuling is
president of Chiropractic Benefit Services (CBS) and a member of the Board
of Directors of the World Chiropractic Alliance. He assists doctors in
maximizing their practices through the proper choice of insurance and
related services. Doctors may contact him with questions, comments, and
requests for insurance quotes at 2950 N. Dobson Rd. Ste. 1, Chandler,
AZ 85224, by phone at 800‑883‑0412 or
by e‑mail: feuling@cbsmalpractice.com).
