As modern medicine recognizes the benefits of chiropractic care as an alternative or complementary treatment, demand for chiropractors has increased. Although this is an advantage, the prevalence of this holistic approach has brought significant scrutiny to the practice. The increased attention and scrutiny of the safety and quality of chiropractic care have led to practitioners being accused of incompetence or negligence.
If you face an accusation or complaint from the California Board of Chiropractic Examiners (BCE), you risk losing the permit you have worked so hard to earn. Fortunately, at the San Jose License Attorney, we understand the regulatory authority’s rules and regulations, as well as the administrative process for defending your license against disciplinary action. Our attorney will mount a strong defense to help you retain the ability to practice or negotiate a favorable disciplinary action that will not harm your reputation or career in the future.
A Quick Glance at Modern Chiropractic Care
Chiropractors are licensed and trained to diagnose and treat spine alignment issues, alleviate pain, and enhance nervous system functionality. These practitioners understand the link between the nervous and the musculoskeletal systems and are trained to use their hands to manually manipulate or adjust the spine to restore harmony and relieve pain or conditions affecting the spinal cord and associated muscles. Patients rely on chiropractic care as an alternative to modern medicine or as a complement to modern medical procedures. Most of those who seek the services of chiropractors suffer from lower back pain, followed by headaches, and then neck pain.
Modern chiropractors adopt a holistic approach to various conditions. In addition to offering hand therapy, these experts advise patients on proper nutrition, stress management, exercise, and sleep techniques. They are trained to review patient records, diagnose medical conditions, and use advanced medical equipment, such as MRI machines and X-ray machines. As a chiropractic practitioner, as much as you are trained to diagnose and treat conditions, you must understand your bounds and know when a case is outside of your practice to refer it to a surgeon or physician to avoid overstepping. Apart from training and certification, some practitioners undergo residency programs that enable them to specialize in a specific practice area.
Being a chiropractor is challenging and demanding; you must work long hours, and your practice is constantly scrutinized. Despite the hard work you put into obtaining the license and building a career, a single complaint can be career-threatening.
Even the most experienced practitioners make honest mistakes. Unfortunately, because of the industry’s high standards, even a minor mistake or accusation could trigger a board investigation, putting your ability to practice at risk. If you find yourself in this position, you need the help of an experienced license defense attorney to protect your permit, which is the source of your livelihood and the reason you are allowed to put your skills into use.
California BCE Mission
BCE has licensed approximately 14,000 chiropractic practitioners in California. Apart from issuing licenses to eligible applicants, the regulatory authority sets rules and professional standards that licensees must comply with to maintain their practice. With that said, one can easily assume that the board exists for practitioners. However, this is false. The purpose of BCE is to keep the public safe and healthy by controlling the licensing process to ensure only qualified chiropractors can apply their skills and imposing disciplinary measures to enforce the rules of this healthcare field. Furthermore, the board ensures that licensees participate in training and continuing education programs to promote high standards in patient care. All this is done to protect consumers, which is why, if you engage in misconduct and the case is reported to the BCE, they will initiate an investigation and, if you are found guilty, impose the relevant punishment.
Common Violations that Can Result in BCE Investigation and Punishment
BCE groups violations into four classes. Category I is for minor violations, including:
- Failing to inform the board of a change in business address if you run a chiropractic care clinic
- Failure to properly display your permit
- Not furnishing patients with their records upon request
The least punishment you can face for the minor violations is 12 to 24 months of license probation. However, if aggravating circumstances are present in your case, you risk maximum disciplinary action, which is license cancellation or revocation.
Category II outlines more serious violations than Category I. Allegations that fall under this group are those that show a greater disregard for the law, professional ethics, or the safety and health of the general public. They include:
- Misleading or false advertising, such as advertising to cure sexual disorders
- Failing to maintain patient confidentiality
- Skipping an administrative proceeding for another violation
When you engage in a violation under this group, and the accusation is validated by evidence, you risk a lenient punishment of at most 36 months of license probation. During the probationary term, you will sustain your license and continue practicing, although under supervision and strict probationary conditions.
BCE categorizes serious violations under Category III. The allegations that fall under this group include:
- Overstepping your mandate by practicing outside the bounds of chiropractic care or your license
- Engaging in sexual misconduct with a patient
- Gross negligence
- A guilty verdict for a crime of moral turpitude
- Failure to refer a patient to a physician or surgeon when it is necessary
- Substance or alcohol abuse or addiction on the job
- Providing excessive treatment or prescription
The least punishment you will face when found guilty of a formal disciplinary charge based on these accusations is 30 days to 60 months of license probation.
Category IV violations are the most severe, and when found guilty, you risk permanent cancelation of your permit. BCE cannot impose an alternative disciplinary action for this violation. These allegations are the same as those in Category III, only they involve aggravating circumstances that warrant more stringent disciplinary action. Examples of Category IV violations include:
- Excessive treatment
- Using your professional permit to accomplish a sexual act
- Physical violence
- A criminal conviction for a heinous crime
- Engaging in fraudulent activities
BCE will revoke your professional permit if you fail to file a defense notice within 15 days of receiving the formal accusation notice or fail to attend the administrative proceeding after it has been scheduled. A violation of probationary conditions after the board has stayed a revocation can also attract a revocation. The punishment you will face depends on the type of violation and factors that aggravate or mitigate it. You will require a dedicated legal representative to protect your rights and interests in the disciplinary process.
Regardless of the category of your violation, a competent license defense attorney can defend against the allegation for a fair verdict. Your attorney will evaluate the BCE’s case to identify weaknesses in their evidence and testimony. Additionally, a seasoned attorney will present expert testimony and gather exculpatory evidence to compel the ALJ to issue a favorable verdict, which could include dropping the formal accusation before the administrative hearing or dismissing the charge at the hearing.
If a charge dismissal is not possible, your attorney will present the circumstances in mitigation to convince the ALJ to recommend a lenient or less stringent disciplinary measure. The common mitigating circumstances the ALJ considers to decide on the most appropriate proposed punishment include:
- Whether the public or the patient was injured
- The possible harm your patients or the public could have suffered because of the violation
- Whether you have prior discipline in your healthcare professional record
- Whether you have an active complaint against you
- The nature and gravity of the accusation
- Proof of rehabilitation, such as a rehabilitation certificate
- The years that have passed after a criminal conviction for a crime with a significant relationship to your chiropractic practice, and whether you adhered to court-imposed probationary conditions.
- Whether there was a monetary gain or profit from the alleged violation
- Whether you acted with intent or the violation was accidental
- The degree of incompetence or negligence displayed in the violation
An experienced legal representative will know how to submit the mitigating circumstances during the hearing to lower the professional discipline provided in the BCE’s guidelines for your violation. An attorney with knowledge of evidentiary rules and the nuances of the administrative proceeding is your best chance for securing a fair settlement or ruling.
California BCE’s Disciplinary Process
The disciplinary process starts when the board informs you of a pending investigation. Do not wait until it is too late to hire an attorney. You should engage a competent attorney immediately after you receive a complaint notice to protect your rights. BCE investigators will want to interview you after they send the notice. Being ignorant of the fact that the board or its investigators are not on your side can jeopardize the entire defense, as you could end up disclosing information that can be used against you. BCE is a consumer protection agency, and its interest is protecting the public, not you, a licensee. Having an attorney on your side when engaging the investigators is the best way to protect your interests and license.
Most accusations come from patients, their loved ones, other licensees, professional bodies, or government entities who have a problem with your practice. A criminal conviction can also trigger a disciplinary proceeding.
After BCE receives the complaint, it assigns it to an enforcement analyst who examines the allegation and supporting evidence. Some allegations fall outside of BCE’s jurisdiction or lack merit. In such cases, the board closes the case even without notifying you. Allegations outside BCE’s mandate that will be closed include:
- Personal conflict
- Billing disputes, or
- General business practices
The violations that give BCE the authority to investigate and enforce professional discipline include the following:
- Breach of the Chiropractic Initiative Act
- The Health and Safety Code (HS)
- Subsections of the California Regulations Code that apply to chiropractic care
- The Business and Professions Code (BPC)
If the accusation against you is within BCE’s jurisdiction and can be substantiated, the board will commence investigations. However, before the official investigations, the complaints must be categorized by priority. The most egregious violations, such as fraud, sexual misconduct, or negligence, are given priority for investigation. The less serious violations are set aside, but the regulatory agency eventually hears them.
When you receive a notice of a pending investigation, you must consult a skilled license defense attorney immediately, because after the notice, investigators will be interested in interviewing you to get your side of the story or for more information regarding the case. An attorney will be helpful during the interview because they will protect your interests.
Your attorney’s main responsibility before the administrative hearing is to fight an interim suspension if the board issues one. Investigations and the entire disciplinary process can be lengthy. An interim suspension prevents you from using your license until the case ends. You cannot afford to stop practicing for months or years awaiting the case’s determination. An attorney will be helpful at this stage because they can challenge the suspension and have it lifted.
Complaints that lack validity or sufficient evidence, or those where defense attorneys put up a spirited fight, are often dropped. BCE only continues with accusations that are substantiated and supported by sufficient evidence of wrongdoing.
If you have a case to answer after investigations, you will receive a statement of issues and a formal disciplinary charge from BCE. When you receive the notice, you must submit a defense notice within fifteen days or risk relinquishing the right to defend yourself. Your attorney will help you file the response on time to contest the accusation. Additionally, your attorney will negotiate with the other party for a settlement before the scheduled administrative hearing.
In the hearing, BCE is the accuser, and you are the defendant. You will have the chance to review the evidence against you and formulate defenses to contest the charges. These are the defenses your attorney will use in the hearing to obtain a fair outcome.
The ALJ will deliberate on the case and issue a proposed decision within 30 days of the conclusion of the hearing. If the board accepts the recommendations, they become a final, enforceable verdict.
Find a Skilled Chiropractic Care License Defense Attorney Near Me
An investigation or formal accusation notice from BCE is a threat to your chiropractic license, and you must take it seriously by hiring a license defense attorney. At San Jose License Attorney, we pride ourselves on skilled chiropractic license defense attorneys who will help you navigate the disciplinary process and defend your license in the administrative hearing to prevent any damage to your career or reputation. Call us at 669-330-4517 to schedule a no-obligation consultation.
