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Foreman based his statements on an unpublished retrospective study of disciplinary actions of chiropractors and medical doctors in California.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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