By Darren Barbee - Star-Telegram staff writer - Tue, Jun. 12, 2007
Third in a four-part series examining state regulation of health professionals
Some of the worst charges hurled against chiropractors involve sexual assault, theft and fraud. Year after year, the state's response to consumer complaints has been unwavering: sluggishness for all.
But the Texas Board of Chiropractic Examiners, the agency responsible for investigating, has its reasons for the delays.
Consider first quarter, 2004: A backlog of complaints, including a court case 1,500 days old, skewed response times.
Or fourth quarter, 2005: The agency's sole investigator quit. No cases were closed.
Or third quarter, 2006: Officials complained that the state's 125-day deadline for resolving complaints wasn't enough time. And the latest investigator quit.
Plagued by high employee turnover, limited staff and a tight budget, the board has seen its ability to protect patients deteriorate in recent years. Consumers seeking information about a chiropractor must consult Web sites that offer enforcement data nearly 15 months old and rely on licensing information that Executive Director Glenn Parker cautions isn't dependable.
But Parker, who took the job last summer, said his top priority is enforcement.
"The real reason that most of these licensing agencies exist, at least in theory, is to ensure that the people out there practicing are competent," he said.
The board failed to meet one measure of that goal in recent years. In fiscal 2006, the board disciplined seven chiropractors. But the state had projected that 21 chiropractors would be penalized.
This fiscal year got off to a better start: From September through November, the board disciplined 34 licensees, which Parker cited as evidence of the board's commitment to consumer protection.
Yet most of those cases were old, near completion, and penalties were easier to negotiate with licensees.
Most of the discipline consisted of reprimands or fines; one license was revoked and eight licenses were suspended.
"Simply stated, we took the opportunity to close some of the easier disciplinary cases," Parker said.
Parker said the board stands a better chance of protecting patients with an additional $149,000 approved by the Legislature last month. The money will pay for a second investigator for the 200 or more complaints the board receives each year and will also help clear old complaints.
Fifteen are more than three years old, including one from 1999.
Performance suffers
Since June 2005, the board has employed four different investigators. The latest left this year, and the board spent a month finding a replacement. That meant most significant cases again came to a halt.
Turnover is a problem in all positions, officials said. In October, for instance, a state report found that six of the board's then eight workers, Parker among them, had been at their jobs for less than a year.
"On a smaller board, it's magnified because if you've only got one person doing one type of job, as soon as that person is gone there's going to be some lag time" as new employees are trained, said Dr. Scott Isdale, a Killeen chiropractor who serves on the board's enforcement committee.
In 2004, the Sunset Advisory Commission cited the board's ineffectiveness due to limited resources.
The commission reported that the board had one of the worst ratios of enforcement staff to licensees in the state -- one enforcement position for 4,700 chiropractors. The ratio is about the same today.
The report also noted that from 2001 to 2003, chiropractors fraudulently acquired workers' compensation claims totaling about $15.8 million.
Parker said the board has stepped up cooperation with other agencies, such as the Texas Department of Insurance, to combat fraud.
Public access criticism
D. Vincent Baugher, a Denton chiropractor, says consumers should have access to disciplinary records when choosing a chiropractor.
"I hate to say it, because it does reflect on me," he said.
In early 2001, Baugher was treating a female patient who was in the midst of some emotional difficulties, he said. To Baugher, the woman seemed to be reaching out for someone to show her affection. In what he said was a moment of weakness, Baugher crossed a line.
"I was under the impression that she wanted me to touch her breasts. I did, through her clothing," Baugher said.
The woman later confronted him, and Baugher said he immediately apologized. She reported the incident to the board in 2001, and Baugher took a course on ethics and boundaries and was placed on a two-year probated suspension -- almost four years later.
"I'm still very caring about my patients, male and female, and yet there's no question about whether that caring could ever overstep those bounds again," he said.
If patients knew which archived newsletter to look in, they could find details about Baugher's case on the board's Web site. But the newsletters are hit and miss, and the site otherwise provides little information about why chiropractors were disciplined and is out of date.
"There is virtually no information that would help a patient make an informed decision," said Alex Winslow, executive director of Texas Watch, a consumer advocacy group.
For example, a former Austin chiropractor, Hartwin Peterson, is listed on the site as having his license revoked in 1999. No other details about his case are provided. State Office of Administrative Hearings records show that he was accused of sexual misconduct with a patient.
Though he is listed on some Web sites as a chiropractor, he offers what Parker described as natural methods of healing that are not regulated by the board. He apparently shares a receptionist with his brother, a licensed chiropractor.
Peterson, who denied the allegations in court documents, did not return calls seeking comment.
The board uses the Texas Online Professional Profiling System, an Internet database, to provide limited information on chiropractors, including whether an individual has been disciplined.
The Star-Telegram found that some chiropractors do not appear to be in the database. Parker said that's because the list isn't always up to date. "That's why I caution people not to depend on that as an absolute," he said.
He plans to add a searchable database to the agency's own Web site sometime this year.
Online.
Financial snapshot
Officials at the Texas Board of Chiropractic Examiners say the agency has been underfunded for several years while making a profit for the state. In 2006, the board's revenue topped $2 million, but expenses were $428,000, according to the State of Texas 2006 Annual Cash Report. Excess revenue of about $1.6 million was transferred to the state's general fund.
ILLUSTRATION: Consumer Report Card: Chiropractors
About the Consumer Report Card series
Evaluating healthcare professionals
This report is part of the first installment in a periodic series examining how well Texas is fulfilling its consumer protection role. Findings are based on documents and data compiled by the state, and the Consumer Report Card criteria include some of the measures the state has devised to judge performance. Evaluations were made by weighing a variety of factors and reflect the state's overall performance.
Coming up
Wednesday: nurses
If you missed a part of the series, you can find the reports at www.star-telegram.com.
Tell us about your problems
What happened when you had a problem with a medical professional? Comment on your experience or to suggest other topics for future consumer report cards.
For information on filing a complaint about a licensed healthcare professional, call the state's toll-free hot line: 800-821-3205.
Read more in the Fort Worth Star Telegram.
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