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May
2003
Study
suggests ethics a problem for the profession
ORLANDO, FLA — The chiropractic profession is experiencing
a true crisis in ethics, Dr. Stephen Foreman, a California
researcher and author, told attendees at the annual FCLB
conference. “The incidence rate for disciplinary
actions in chiropractic is double that for medical profession,
especially with fraud actions and sexual violations.”
Foreman based his statements on an unpublished retrospective
study of disciplinary actions of chiropractors and medical
doctors in California. He said he selected California
for his analysis not only because he practices in that
state, but also because California publishes disciplinary
actions on its Web site, www.chiro.ca.gov.
The statistics were easily accessible, he said.
Also, he said that California has the largest number of
chiropractic schools, the greatest number of licensed
chiropractors and the largest number of licensed medical
doctors in the nation.
Foreman plans to publish the results from his study.
Foreman’s study took into account differences in
numbers of California-licensed chiropractors (11,095)
vs. medical doctors (104,000). He also noted that he studied
disciplinary actions given by the board in a five-year
period for chiropractors, compared to 18 months for MDs,
but his final analysis also accounted for these differences.
“Two-thirds of all the complaints were in fraud and
sex,” said Foreman. “What this says is that
we have major problems in ethics,” he said. “The
majority of actions are true ethical problems, compared
to drugs, alcohol and clinical competency.”
Foreman guessed at the causes of ethical problems within
chiropractic, stressing that he had no data to substantiate
his opinions. He said he believes:
• An excessive number of non-serious people are allowed
into chiropractic because of standards. “Serious
students work hard, get good grades and get degrees,”
he said.
• There is a failure to remove questionable students
from programs. "These are people who cheat on tests,”
he explained.
• Economic environment caused by changes in reimbursement
and the cost of education contribute to the cause. “It’s
harder to make money today and cost of education is high.
This causes desperation,” Foreman speculated.
• We have a propensity to allow too many disciplined
doctors to return to practice. “Practice is not a
right; it is a privilege. It should be hard to get back
into the profession,” he observed.
Foreman challenged board members to improve the ethical
climate. He urged boards to increase their diligence in
investigating and handling complaints and to demand higher
education and admission standards for license status.
“Higher standards will bring in more serious people,”
said Foreman.
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