presentation to the fclb may 2, 2003
DESCRIPTION
Presentation to the FCLB May 2, 2003. Educating the Licentiate, a State licensing Board’s duty. Massachusetts Board of Registration of Chiropractors. Massachusetts Board of Registration of Chiropractors. Edward J. Barowsky, D.C. Thomas R. De Vita, D.C. Wayne A. Comeau. D.C. - PowerPoint PPT PresentationTRANSCRIPT
Presentation to the FCLBMay 2, 2003
Educating the Licentiate,a State licensing Board’s duty
Massachusetts Board of Registration of Chiropractors
Massachusetts Board of Registration of Chiropractors
Edward J. Barowsky, D.C.
Thomas R. De Vita, D.C.
Wayne A. Comeau. D.C.
Joseph M. Boyle, D.C.
David N. Taylor, D.C.
Kirk J. Shilts, D.C.
Lisa A. Grant, Esq.
Why education?
State licensing Boards
• Set the requirements for state licensure
• Set the rules for proper practice
• Set the terms for regulatory compliance
What issues did our Board frequently encounter?
New doctors not understanding their responsibilities, both administrative (ex: license renewal) & clinical
New doctors taking associateships in practices where they failed to use due diligence in learning about the owner’s prior disciplinary or complaint history
New doctors hired into these unscrupulous practices engaged in similar fraudulent billing, because they failed to learn what was being billed under their name
What issues did our Board frequently encounter?
Epidemic poor clinical recordkeeping habits by most chiropractors (pervasive within our profession because of our wide array of practice methods)
Relative scarcity of postgraduate seminars on clinical recordkeeping within our profession
Chronic coding and billing mistakes
Missing or grossly unsubstantiated treatment plans
Improper substitution of an “implied” consent for an “informed” consent
What problems did our Board commonly encounter?
High recidivism of non-corrective action within previously documented deficient practices
Failure to establish and maintain appropriate boundaries in patient-practitioner relationships
Critical need to place problem doctors within a corrective program that has ONE-on-ONE supervision
3 target groups of doctors:
• New licentiates
• Licentiates in practice• Licentiates under disciplinary action
3 educational programs:
• New licentiate Presentation
• Practice Compliance and Recordkeeping Seminar
• Disciplinary Mentors– Clinical Monitors
– Compliance Auditors
New licentiate Presentation
Educational goals:• Instill duty, responsibility and professionalism
• Proactive (preventative) approach
• Highlight vital clinical practice issues
• Discuss patient sensitivity issues
• Explain renewal requirements
• Enlightenment about associate positions
Practice Compliance and Recordkeeping Seminar
Educational goals:• Review state laws, rules and regulations
• Outline basic clinical practice issues– Clinical recordkeeping procedures– Federal recordkeeping issues– Outcome measures– Insurance/ coding issues
• Promote practice compliance planning
Disciplinary Action (consent decree)Practice Monitors
Educational goals:• Instruction for the deficient practitioner on
proper practice procedures
• Provide the doctor with a personal mentor
• Monitor progression through periodic reports
• Focused corrective actions– Clinical recordkeeping assistance (monitors)– Practice compliance oversight (auditors)
Results: Complaint history 1990-2002
020406080
100120140160180200
1990
1992
1994
1996
1998
1999
2001
Totalcomplaintsissued
Complaint history for newly licensed doctors
Year licensed # complaints issued through 2003
1995 21
1996 33
1997 (initial* program) 9
1998 3
(formal program started)
1999 0
2000 15
2001 4
2002 0
Results: # new doctors, time in practice
1995-1998
Doctors: 393
Months practice: 120
Complaints: 66
1999-2002
Doctors: 464
Months practice: 114
Anticipated complaints:
74
Results: Anticipated vs. Actual Complaints
1995-1998
Doctors: 393
Months practice: 120
Complaints: 66
1999-2002
Doctors: 464Months practice: 114Anticipated complaints:
74Actual Complaints: 19
Results: New Licentiate Program
0
10
20
30
40
50
60
70
80
1995-1998 1999-2002
Doctors (10's)
Months inpractice (10's)
Complaints
Complaints(actual 99-02)
Results: New Licentiate Program
• Since implementing our New Licentiate Program, there has been a 74.4% reduction in complaints lodged against our new doctors compared to the statistically expected norm!
Results: Compliance/ Recordkeeping Seminar
• Recognition of a recommended higher standard of recordkeeping (regulations address only those minimal standards)
• Exposure to compliance programs and practice compliance plans
• Awareness of proper coding issues
• Diminished recidivism rates among disciplined doctors (antidotal)
For additional information:
MA Board of Registration. of Chiropractors239 Causeway St.Boston, MA 0114
www.ma.state.us/reg/boards/ch(617) 727-3033, or 3093
Thank you