IDAHO BOARD OF CHIROPRACTIC PHYSICIANS

Bureau of Occupational Licenses

700 West State Street, P.O. Box 83720

Boise, ID 83720-0063 

 

Minutes of 10/19/2010

 

BOARD MEMBERS PRESENT: Shannon Gaertner-Ewing, D.C. - Chair

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Geffery D. Anderson, D.C.

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Glady Schroeder

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Larry D. Nelson, D.C.

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BOARD MEMBERS ABSENT:††† Robert W. Haug, D.C.

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BUREAU STAFF: ††††††††††††††††††††††††† Tana Cory, Bureau Chief

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Dawn Hall, Administrative Support Manager

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Lori Peel, Investigative Unit Manager

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Karl Klein, Administrative Attorney

††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Marilyn London, Technical Records Specialist I

 

OTHERS PRESENT:†††††††††††††††††††† Ryan Fitzgerald, Principle Strategic Advisors

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The meeting was called to order at 9:00 AM MDT by Shannon Gaertner-Ewing, D.C.

 

AMENDED AGENDA

 

Ms. Peel requested that the Board amend the agenda to include a continuing education settlement order. There was a good faith effort in trying to get it on the agenda, but it was inadvertently missed. It was moved by Dr. Nelson to amend the agenda. Seconded by Ms. Schroeder, motion carried.

 

APPROVAL OF MINUTES

 

The Board reviewed the July 14, 2010 Board meeting minutes. It was moved by Dr. Anderson to approve the July 14, 2010 minutes. Seconded by Dr. Nelson, motion carried.

 

LEGISLATIVE REPORT

 

Ms. Cory informed the Board that the proposed rules are posted on the web. At this time there have been no comments received on the rules.

 

FINANCIALREPORT

 

Ms. Hall presented the financial report, which shows a balance of $119.907.20 as of September 30, 2010.

 

CONTRACT

 

Ms. Hall presented the Fiscal Year 2011 Renewal Contract. It was moved by Dr. Nelson to approve the 2011 Renewal Contract and authorize the Chair to sign on behalf of the Board. Seconded by Ms. Schroeder, motion carried.

 

INVESTIGATIVE REPORT

 

Ms. Peel presented the investigative report:

 

For Board Determination:

 

I-CHI-2010-18C alleged R used inappropriate treatment on Cís back.Investigation revealed that C is 83 years old, has had multiple hip operations, and presented to R with severe left femoral nerve pain, low back pain, and neck stiffness.At the first visit, R conducted a consultation and examination, and X-rays were taken but no treatment took place.At the second visit, R went over the examination and radiographic findings with C and discussed the fact that R would proceed using extremely gentle techniques.R stated that Cís first treatment consisted of light adjustments with the drop table where extra precautions were taken to not adjust his femur, femoral acetabular junction or either ilium.R stated that adjustments were performed as light as possible.R stated that after the adjustment, C was placed on a roller table on the lowest setting for 5 minutes and only on Cís thoracic spine.C stated that at this point, R immediately left the room without explaining the purpose of the roller table or asking R if the machine was hurting his back.†† R stated that she checked with C to make sure he was comfortable and was not in pain, and C told her everything was fine.C stated that 10 minutes after leaving Rís office, pain and numbness radiated from his lower back down his legs.C stated that he called Rís office after getting home and relayed the symptoms.C stated that R offered that C could return for an adjustment, but he declined.C stated that two days later he returned to Rís office to cancel further treatment appointments.†† A pro review was conducted of the file and Rís records for C, and the pro reviewer stated that Cís statement of what happened differs considerably from Rís records.Rís records reflect that R adjusted the table and asked C if the rollers were causing any problem before leaving the room, and C stated no.The pro reviewer stated that Cís medical records reflect that C had considerable low back problems that R was aware of.The pro reviewer stated that the condition of Cís low back could give rise to episodes of pain with any activity.The pro reviewer stated that there did not appear to be any negligence on Rís part with the care she provided.Based on the pro reviewerís opinion, IBOL recommends that the Board authorize closure. It was moved by Dr. Nelson that the Board authorize closure. Seconded by Ms. Schroeder, motion carried.

 

I-CHI-2010-21C alleged R injured C during treatment and failed to take into account prior injuries or obtain a detailed history before performing an adjustment.After reviewing Rís records for C and the investigative file, the pro reviewer stated that Cís records indicate degeneration in the spine and evidence of chronic low back pain.The pro reviewer stated there were also symptoms of sciatica, psoriasis, allergic rhinitis, PTSD, numbness in both hands and possible migraines, and that X-rays verified the degeneration of the spine.The pro reviewer stated that the subjective and objective sections of Rís notes reflect that R reviewed Cís records and performed an exam, which correlates with the information C provided on the patient history, plus obtained in-depth information in the consultation.The pro reviewer stated that the allegation that Rís adjustment caused C pain and discomfort is hard to substantiate.The pro reviewer stated that it appears C experienced similar pain in the past and did receive some relief through chiropractic adjustment, but with the history of her condition, it is possible that C could experience pain after a spinal adjustment.The pro reviewer stated that there is no indication by Rís front desk staff or anything in Rís notes that C had any adverse reactions to the adjustment.The pro reviewer stated that, in his opinion, the information reviewed does not substantiate the allegations against R.Based on the pro reviewerís opinion, IBOL recommends that the Board authorize closure. It was moved by Dr. Anderson that the Board authorize closure. Seconded by Ms. Schroeder, motion carried.

 

I-CHI-2010-27The Idaho Board of Veterinary Medicine (IBVM) alleged that R was providing treatment on animals without required veterinarian supervision and that Rís advertising for Veterinary Orthopedic Manipulation failed to indicate that a veterinarian referral must occur before R could legally provide care to animals.Investigation revealed that R worked with IBVM to correct the advertising.R stated that he now understands that he can only work on animals under the indirect supervision of an Idaho licensed veterinarian.Based on Rís response, IBOL recommends that the Board authorize closure. It was moved by Dr. Anderson that the Board authorize closure. Seconded by Dr. Nelson, motion carried.

 

CONTINUING EDUCATION SETTLEMENT ORDER

 

Ms. Peel presented a continuing Education Settlement Order for case #CHI-2010-11. It was moved by Dr. Anderson that the Board approve the Continuing Education Settlement Order for case #CHI-2010-11 and authorize the Chair to sign on behalf of the Board.

 

NATIONAL PRACTITIONER DATA BANK

 

Ms. Peel presented information on the National Practitioner Data Bank with regard to reporting continuing education disciplinary actions. It was moved by Dr. Anderson that continuing education disciplinary actions are an administrative issue and are not reported to the National Practitioner Data Bank. Seconded by Dr. Nelson, motion carried.

 

NEW BUSINESS

 

CORRESPONDENCE

 

The Board reviewed correspondence from Sherman Chiropractor College on its 100 hours Certification Program in Upper Cervical Care. Their question is regarding whether chiropractors can use the initials, U.C.A. for Upper Cervical Academy upon completion of the program. The Board does not recognize specialties. The Board directed Mr. Klein to respond in writing and reference Rule 450.

 

The Board reviewed correspondence from the Alabama Board of Chiropractic Examiners requesting if Idahoís Chiropractic Practice Act would allow reciprocity with Alabama. The Boardís rules allow for endorsement, not reciprocity. The Board directed Mr. Klein to respond and reference Idahoís Endorsement Rule 100.01(b).

 

The Board reviewed correspondence from an Idaho chiropractor requesting options on using an out of state chiropractic neurologist to examine their patient. Idaho Code allows an Idaho chiropractor to consult with out of state doctors. The Board directed Mr. Klein to respond and reference Idaho Code 54-705.

 

The Board reviewed a letter from Danny Anderson regarding endorsement from another state. The Board directed the Bureau to send a letter referencing the endorsement rule.

 

The Board reviewed a letter from Shauna Brastock requesting to be grandfathered. The Board directed the Bureau to send a letter referencing the endorsement rule.

 

The Board reviewed a letter from Shaun McCrae regarding scope of practice for nerve conduction velocity test and surface EMG testing. The Board indicated that their law does not address this and directed Mr. Klein to respond.

 

The Board reviewed a letter from Gary Montgomery regarding the appropriate use of the anti gravity lumbar trunk cast. The Board is familiar with this technique and it is taught at chiropractor colleges. The Board directed Mr. Klein to respond.

 

CONTINUING EDUCATION COURSES

 

The Board reviewed and approved the following continuing education courses:

 

Hormone Replacement by the Book, The Stress Connection, and Treating Obesity for 7 hours.

 

(805) Reflexogenic Systems for 15 hours.

 

Dyslexia, Dyscalculia and Dysgraphia for 6Ĺ hours.

 

Oppositional Defiant Disorder, Conduct Disorder and Conflict Resolution with Difficult Children for 6 hours.

 

American Heart Association CPR/First Aid for 6 hours.

 

FEDERATION OF CHIROPRACTOR LICENSING BOARDS

 

Dr. Gaertner-Ewing presented highlights of the October 2010 FCLB District meeting.

 

VETERINARIAN PRACTICE WITH CHIROPRACTORS

 

Mr. Fitzgerald asked the Board for clarification regarding Veterinarian Practice with Chiropractors.The Board discussed the subject, and noted that the Veterinary Practice Act specifically discusses this issue.  The Board does not administer the Veterinary Practice Act.  The Board noted, however, that the Veterinary Practice Act states, at Idaho Code ß 54-2104(2)(p), that the Veterinary Practice Act ďshall not be construed to prohibit Ö an allied health professional actively licensed and in good standing in any state from participating in a medical procedure involving an animal provided that such participation is in his licensed field of medicine and under the indirect supervision of an actively licensed veterinarian.Ē  At Idaho Code ß 54-2103(3), the Veterinary Practice Act defines ďallied health professionalĒ to include ďa person holding a current active license, in good standing, in any state to practice one (1) of the healing arts including, but not limited toÖ chiropractic.Ē  At Idaho Code ß 54-2103(24), the Act defines ďindirect supervisionĒ to mean that ďthe supervising veterinarian is not on the premises but is available for immediate contact by telephone, radio or other means, has given either written or oral instructions for the treatment of the animal patient, the animal has been examined by the supervising veterinarian as acceptable veterinary medical practice requires, and the animal, if previously anesthetized, has recovered to the point of being conscious and sternal.Ē  The Board of Chiropractic Physicians has communicated with the Board of Veterinary Medicine and understands, based on the above language, that a chiropractor who complies with the Veterinary Practice Act will not be involved in the unlicensed practice of veterinary medicine.  

 

NEXT MEETING

 

The Board scheduled a conference call meeting for January 25, 2011 at 9:00 AM MST.

 

ADJOURNMENT

 

It was moved by Dr. Anderson that the Board meeting adjourn at 10:40 AM MDT. Seconded by Ms. Schroeder, motion carried.

_________________________________††††† _________________________________

Shannon Gaertner-Ewing, D.C., Chair††††††††††††† Geffery D. Anderson, D.C.

_________________________________††††† _________________________________

Glady Schroeder††††††††††††††††††††††††††††††††††††††††††††† Larry D. Nelson, D.C.

_________________________________††††† _________________________________

Robert W. Haug, D.C.†††††††††††††††††††††††††††††††††††† Tana Cory, Bureau Chief