May 2006

NBCE reformers gather support

Once again, questions are being raised about the activities and policies of the National Board of Chiropractic Examiners (NBCE), the non‑profit organization that provides testing programs for state licensing authorities.

The latest in a long history of controversies centers on two issues: fiscal accountability and unethical election activity.

According to Salvatore LaRusso, DC, the NCBE delegate from Florida, the NBCE Board, under the direction of NCBE President Peter Ferguson, DC, has been lobbying behind the scenes to gather support and votes for Rick Murphree, DC, NCBE vice president, and Kenneth Padgett, NBCE director‑at‑large and treasurer, in spite of the obvious conflict of interest this lobbying represents.

"Ideally, the NBCE Board should not try to influence anyone who is in line for election to their Board and their actions are clearly inappropriate," Dr. LaRusso stated. "I think this is unethical behavior on the part of the NBCE officers; their actions are obvious maneuvers to maintain their power on the Board." He added that such lobbying on the part of the NBCE Board members "calls into question the impartiality and credibility of the entire NBCE process."

Concerns about overt electioneering were also raised last year, as reported in the July issue of The Chiropractic Journal. The Journal article revealed the simmering discontent evident during the NBCE's Annual Board and State Delegates' Meeting in Montreal, Quebec, Canada, on May 7.

During that meeting, James Badge, DC, of Arizona, was unseated as District IV director and, in his place, members of the organization chose Theodore J. Scott, DC, of Kaysville, Utah, who had called for a reform of many questionable NBCE policies and procedures. Dr. Scott had voiced concerns over the lack of financial responsibility on the part of the NBCE in the past, noting that the organization has steadfastly refused to provide records of its financial dealings, including payments made to Board members.

In a keynote speech given during the meeting, David Brown, DC, the mayor of Charlottesville, Va., who has served as president of the Federation of Chiropractic Licensing Boards (FCLB) and on the NBCE Board, shocked the audience by noting that, "the dirtiest, the most underhanded politics I have ever experienced have occurred here, at the annual FCLB and NBCE meeting."

He added: "I am talking about misinformation, untruths and back room deal making that have regularly occurred in our elections, especially national board elections." Dr. Brown noted that the tactics used during the two organizations' elections are "unethical" and asked "why do the best and brightest of our profession who oversee the ethics of the profession become so cutthroat at times when it comes to winning a National Board election?"

Financial accountability

Like Dr. Scott, Brown alluded to financial irregularities, including "excessive spending on the board, especially on travel by the leadership of the board," and revealed that the NBCE's travel budget in the year 2000 was more than a half million dollars. "I have been told that travel by the current leadership of the National Board is as great or greater than it has ever been," he noted.

In addition, he stated that each NBCE Board member received more than $3,000 in per diem payments for the meeting and urged state board representatives to "ask the NBCE leadership what their 1099s from the National Board were this year."

The 2005 NCBE Annual Report indicates that, in 2004, the NCBE generated $7,652,854 in income from examination fees, with another $56,691 coming in from interest and $407,291 from "net assets released from temporary restrictions," giving the organization a total revenue of $8,116,836.

On the other side of the ledger, the NCBE listed operating expenses of $6,895,653 but failed to specify what items went into this category, how much was paid to Board members or for per diems and travel expenses.

This was not the first time that the NBCE's financial dealings have been called into question.

As far back as 1997, the World Congress of Chiropractic Students (WCCS), expressed disapproval over a controversial funding arrangement between the NBCE and the FCLB.

NBCE‑FCLB relationship

In an article published in the Feb. 1998 issue of The Chiropractic Journal, Dana Kind, 1997 chairperson of the WCCS was quoted as stating: "We as students find it unjust for the NBCE, a not for profit testing organization, to financially support the FCLB."

The relationship between the NBCE and FCLB often deemed 'incestuous' by critics has also been the subject of much discussion within the profession.

At the 2005 NBCE meeting, Dr. Badge in one of his final official acts as president presented a check for $250,000 to the FCLB for 2005 operating expenses. The students opposed using testing fees to fund the FCLB, which would be financially insolvent without the outside money. "Testing fees derived from the administration of National Board exams should only be used for NBCE related operating costs, i.e., recuperation of expenses of test preparation and administration," noted Kind. "It is unacceptable for the NBCE to give $500,000 to the FCLB and claim to be a not for profit organization."

Kind added that, "It is a further conflict of interest for NBCE to be giving money to FCLB, which has influence over state boards accepting National Board Examinations, which NBCE administers... NBCE gets more test money from the increase of students taking exams, and shares a portion with FCLB the very organization that favors state boards to have students take these exams. For NBCE to be an effective testing agency, they must be independent of outside influence."

In 1997, the International Chiropractors Association (ICA) called for an investigation of the NBCE's ties with the FCLB. In an "Open Letter to the NBCE," it stated that it "calls for the complete severance of financial relations between the National Board of Chiropractic Examiners and the Federation of Chiropractic Licensing Boards. The blatant conflict of interest inherent in this relationship has troubled a broad segment of the chiropractic profession, including the ICA, for many years. For a vendor marketing testing services to dominate and fund an organization comprised of the consumers of those testing services is, on its face, inappropriate. That the FCLB has worked so aggressively to promote the power, reach and revenue of the National Board is clear evidence of the need to separate those organizations for the greater good of the chiropractic profession."

The ICA also reviewed NBCE's public financial records and revealed that the organization had grown into a huge entity, with millions of dollars in assets and more than $1 million in annual profits. "ICA estimates that the National Board has added over $50 million to the student debt burden over the past 12 to 14 years," stated then ICA President Dr. Robert Hoffman. "In light of what we know about the financial strength of the National Board, the fees they charge and the delays they cause in obtaining licensure are indefensible and must be reformed."

In an 2002 article titled, "Is There an Alliance Between the FCLB & the NBCE?" for the ICA's "Chiropractic Choice" newsletter, Maxine McMullen, DC, then ICA vice president, warned that FCLB supported by the NBCE was "indeed engaged in serious discussions regarding the accreditation of a program that would evaluate all hours of continuing education that would be deemed 'acceptable' to qualify for your re licensure credits."

Ideas for reform

The next annual meeting of the NCBE Board state delegates promises to be another debate‑filled event, with the reform contingent gathering support from within the organization as well as from the profession as a whole. Already, a campaign is underway to demand that all Board members disclose the amounts they have been paid by the NCBE and to change several key policies and procedures.

In a letter to those who support the reform of the NBCE, Ron Tripp, DC, FCLB District IV director and chairman of the Okalahoma Board of Chiropractic Examiners reviewed the situation.

"Over the past year the call for reform of the structure and operation of the National Board has been forefront with many of you," he stated. "The outcry for democratic participation in the matters of the organization is at an all time high. It truly saddens me to see aggressive battle lines drawn in the leadership when the delegates only ask for what is reasonable. They are asking for the right to participate in the decisions of an organization of which they are members, and they have supported for years. So when does the oppression stop?"

He listed several ideas that he felt should be embraced by the organization, including:

***  Having at‑large members elected by the state delegates at the annual meeting

***  Electing alternate district directors

***  Limiting district directors to two consecutive three‑year terms

***  Barring district directors from holding officer positions

***  Filling one at‑large position with a public member

***  Requiring a 2/3 majority of the state delegates to change by laws.

"The participating members of the organization (state delegates) should decide who should be seated on the Executive Committee," he elaborated. "The term for At Large Members should expire at the close of the annual meeting of state delegates and the new members elected from the state delegates should be seated. The At Large Members should know they are supported by the membership before they serve, and the best and most efficient way to determine that level of support is by election from the state delegates."

Dr. Tripp also noted that since "transparency of the organization in the past has been drawn into question, the seating of an independent public member is a positive move for the NBCE."

In addition, Tripp explained that "the most pressing issue I am hearing from the state delegates is the blockade created by the existing NBCE bylaws to allow change from the membership. I for one believe and trust that any amendment of the bylaws supported by two‑thirds of the state delegates is a change supported by the body and a change for the betterment of the organization."

He closed by encouraging "our leadership of the NBCE to look at 'what makes sense' and bring to the table a reorganization of the business practices of the organization that allows for a democratic participation and governance from those who have supported you."

The annual meeting of the NBCE will be held May 5 in Portland, Ore.