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Chiro Board Fines PT $10,000
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Chiro Board Fines PT $10,000 - August 28, 2003 7:57:00 PM
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teston
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The Arkansas Chiropractic Board accused a physical therapist of practicing chiropractic without a license, found him guilty and fined him $10,000. The Arkansas legislators let a law pass that gave the Chiropractic board the authority to levy fines up to $5,000 per treatment, with the power to enforce the fines in curcuit court. All they needed was a PT to bring before their board and boom they have limited the scope of practice for all PTs in Arkansas. Check it out at [URL=http://www.defendphysicaltherapy.com]http://www.defendphysicaltherapy.com[/URL]
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 6:14:00 AM
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teston
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The physical therapist wasn't practicing chiropractic. The Arkansas State Board of Physical Therapy supplied the Chiropractic board with a Declaratory order that stated that the physical therapist was not at any time practicing outside the scope of physical therapy as defined by the Arkansas Physical Therapy Practice Act... He went to physical therapy school and was practicing physical therapy.
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 7:26:00 AM
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Bournephysio
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Did you manipulate and is this specifically allowed under the PT practice act? Is the APTA/FAAOMT going to bat for you? Here in Canada this would be rigorously defended by (and funded by) the CPA and CAMT. Doesn't your malpractice insurance cover this?
We had a similar case in Quebec where chiropractors sued a PT for performing a manipulation. We won this case. I would contact the canadian physiotherapy association, the orthopaedic division of the cpa and the canadian academy of manipulative therapy and see if they can give you any advice on what strategies worked for them. Of course that may not be helpful as the PT climate in this country is completely different.
Doug
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 7:35:00 AM
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teston
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Thanks for the information. I will look at finding the case you are talking about.
You can read the transcript (chiro.pdf) and see how the chiropractic board defined manipulation. (http://www.defendphysicaltherapy.com) Basically if a procedure produces an audible noise than it is a manipulation, according to the chiropractic board's expert witness. The PT performed a joint mobilization on the patient in question. Joint mobilization is well within the scope of practice for a physical therapist in the state of Arkansas.
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 8:31:00 AM
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teston
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The PT or physiotherapist in Canada is named Philippe Thomas. He has gone through the same thing that the PT in Arkansas is going through right now. Do you have any way for me to get ahold of Philippe?
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 10:03:00 AM
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Bournephysio
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I wouldn't know. If the CPA won't help or he isn't a member, you could check the regulatory board. Do a google search on college and physiotherapeute. I'm not 100% sure the spelling is correct.
One more question, was the technique performed a grade V technique, or a grade IV or lower that just happened to click?
As I recall, in the Quebec case the therapist purposefully did a grade V mobilization (a manipulation). No one was trying to hide under symantics i.e. no one was suggesting that a grade V mob was different from a manip.
If the therapist was using a grade IV or lower technique the case is a complete joke. You can get an audible sound with active or passive range or just by setting up a patient for a mob.
I believe Jim Meadows site site has a review on the case (search swodeam).
Doug
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 10:06:00 AM
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Wisecracker
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Frankly after reading your links and the definition of manipulation, I think you're getting the short end of the deal. Sorry you are in the midst of this quagmire. I am writing a letter to the Ark board to discuss the error of their thinking (though I doubt that it will have any affect). Good luck.
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Re: Chiro Board Fines PT $10,000 - August 29, 2003 10:18:00 AM
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teston
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The techniques are described in the hearing transcript. I can't really say much more because of pending appeal. I am not the PT. I am the PT's wife. I am trying to get the word out about what is going on in Arkansas with the web site and with letters. We need all the support we can get. Thanks for your interest.
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Re: Chiro Board Fines PT $10,000 - August 31, 2003 7:52:00 PM
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coloradojulie
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How disturbing. I just sent a letter to the Arkansas Chiro board critisizing their paranoid and deceptive tactics and siting some legal quotations from an article called "The overlap between the practice of medicine and the practice of nursing" found on [URL=http://www.aana.com/legal/legbrfs/1998/021b98.asp]www.aana.com/legal/legbrfs/1998/021b98.asp[/URL]
"State legislatures, through licensing laws, determine what is and what is not the practice of medicine. However, licensing laws do not create monopolies for professions."
"Courts, attorneys general, and, on occasion, even organized medicine have acknowledged that practice areas overlap and are not exclusive."
I also wrote the ARPT board showing support and stating that the APTA and the ARPT support this therapist fully. Anyone who reads this post, this is an example of the prevalent defeat of physical therapy practice act laws based on professional passivity as a whole. ACT!! Contact your local reps, your attorney generals etc. It takes 10 minutes to find the website and send an email! DO IT! DO IT OFTEN!
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Re: Chiro Board Fines PT $10,000 - August 31, 2003 9:40:00 PM
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goodlooks58
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This represents in war-the first blow. If the PTs do not see what is in store for them for being passive, then the Arkansas story will be repeated in every state, unless ACTION is
taken!! I think the APTA should set aside x number of dollars just to fight this kind of nastiness! However, I am loosing faith in APTA when I hear news of a fellow PT being beaten down like this.
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Re: Chiro Board Fines PT $10,000 - September 1, 2003 2:12:00 PM
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Bournephysio
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Sorry its an ordre not a college in Quebec. The link: [URL=http://www.oppq.qc.ca]www.oppq.qc.ca[/URL]
To find a physio it looks like you have to email or phone: physio@oppq.qc.ca (it may help to know French)
Jim's link: [URL=http://swodeam.com/mto.html]http://swodeam.com/mto.html[/URL]
check under current column.
I would also contact COMTA, they seem to be representing us in manual therapy related court cases: [URL=http://orthopractic.org/contact.html]http://orthopractic.org/contact.html[/URL]
I looked over parts of the transcript. It is not 100% clear if a thrust (a thus a manip) is being performed but it sounds highly probably. The question then becomes is manipulation specifically excluded from the PT practice act. If it is not what the PT did is perfectly fine, a manipulation is a grade V mobilization.
This is a very important case and should be fully supported by the APTA and FAAOMT.
Doug
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Re: Chiro Board Fines PT $10,000 - September 1, 2003 7:51:00 PM
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coloradojulie
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I checked the Arkansas practice act...manipulation is not included in scope of practice in this state.
However....throughout the US there is very little collective policy for the practice of PT and that is disturbing. In one state you can say this or do that while in another you cannot. Granted it is related to individual state legislature, but I think the issue is deeper than that. As a profession there is inconsistent public and governmental understanding of the role of PT, training, scope and diversity of practice etc. People make laws, and these people from state to state are not informed. The APTA and state organizations need to interconnect and lobby together to create a more standardized view of the PT profession.
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Re: Chiro Board Fines PT $10,000 - September 2, 2003 4:59:00 AM
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teston
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If you read the Appeal that is linked on the website [URL=http://www.defendphysicaltherapy.com]http://www.defendphysicaltherapy.com[/URL] you can see how the appal is being argued. Arkansas physical therapists are allowed to perform mobilizations on any part of the body. Manipulations of the spine is excluded in the PT scope of practice, but spinal mobilizations are not excluded. The only place spinal manipultions is defined is in the chiropractic practice act and it is defined as something physical therapist do not do nor are they taught how to do in school. The chiropractic board brought in a man from Maryland that is a PT and a DC to explain the difference between manipulation and mobilization. This man admitted in the hearing that he had not even read the Arkansas State Law. He was defining these terms as he knew them not how they were defined by our legislators. (this is where he stated that if an audible noise is heard than the procedure is not a mobilization but a manipulation) According to past cases, law can not be defined in board hearings. This is the argument our lawyers are making. Not to mention in the Chiropractic Practice act there are 2 sections that clearly state that the Chiropractic Practice Act Can not limit the scope of practice of a Physical Therapist by anything written in their act. What they did was wrong.
Goodlooks 58 you are right about other states following the Arkansas example. The Congress of Chiropractic lists on their web site which states have passed laws that are similar to the ones that are in place here in Arkansas. Other states are lining up to do what is being done here and the PTs are not paying attention. That is why it is so important that this decision be overturned.
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Re: Chiro Board Fines PT $10,000 - September 4, 2003 8:23:00 PM
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hmgross
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I forwarded this info to the MN APTA office and they were happy to get it--the other day I was working on someone's low back (mobilizing) and I felt a "pop" in my own back, hmmm do I report myself? (Sorry, had one of those crazy days at work).
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Re: Chiro Board Fines PT $10,000 - September 5, 2003 8:24:00 AM
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teston
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Thanks for the help. We are about to get a $19,000 bill from the lawyer and we only have about $5,000 to pay for it. Does anyone reading this have any great ideas on how to raise money to pay these lawyer costs?
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Re: Chiro Board Fines PT $10,000 - September 8, 2003 2:52:00 PM
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smarshall
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From: havre, MT, USA
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how in the world does the chiro board legally have the power to levy a fine????
how is this not a conflict of interest, given the known "competition" between DC's and PT's???? Should the arkansas PT board be given the legal authority (deputized, in effect)to go through the phone book and fine every chiro that has the words "physical therapy" in their advertisement $5000???
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Re: Chiro Board Fines PT $10,000 - September 8, 2003 5:35:00 PM
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Andrew M. Ball PT PhD
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If the term is protected in that state, as it is in North Carolina, then the PT board does in fact have that authority over non-physical therapists including chiropractors.
Drew
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Re: Chiro Board Fines PT $10,000 - September 8, 2003 5:50:00 PM
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teston
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It could happen in many states the way the laws are written. You can go to the Congress of Chiropractic State Association's web site and see where the different states are passing laws to allow this same thing to happen in other states.
After they fined Michael the physical therapists worked to have a bill passed that prevented one board of the healing arts in Arkansas from disciplining a liscensee of another board of the healing arts. The Arkansas chiropractic board didn't like the new law but quickly noted that they could still take physical therapists to circuit court. Especially if they have Michael's case as a precedent.
There is a news article in the Arkansas Business that tells about the case. [URL=http://www.arkansasbusiness.com]www.arkansasbusiness.com[/URL] It is pretty accurate except for the mention that the patient that filed the complaint quit coming to therapy because she was worse. In reality the patient asked for more therapy because she was getting better. It also doesn't mention the fact that she started seeing a chiropractor after her physical therapy. She started her chiropractic visits in July 2001 and is still seeing her chiropractor. She isn't any better.
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Re: Chiro Board Fines PT $10,000 - September 8, 2003 7:27:00 PM
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Sam B
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The transcipt for this trial is quite bizarre. Regarding repeated "mistakes" of one interviewer saying "Dr... I mean Mr. Teston"; was that a geniune mistake on the part of the interviewer, or part of interview tactic to dicredit him as a "non-physician?"
The patient sounds as though she has drug problems, to the extent that one family Dr. actually refused her further treatment. The patient's character did not seem to enter the conversation too much, although it would be a major factor in a court of law. It is hard to ascertain her character on paper. At one point, the board member complimented the witness on her excellent memory and recollection of the facts. That does not seem a very reasonable/ neutral comment, given her obvious distorsion of facts early in the transcript regarding headaches caused by Mr Teston. One interviewer asked the patient.." did Mr. Teston ever tell you that you had a hypermobile segment in your spine?" In a court of law that would be stricken, or at least objected on grounds of speculation from the witness, and even the current treating Chiropractor.
I am VERY glad that North Carolina has protection over the term Physical Therapy. I disagree with a governing board of only PT's. It is the scenario of the cat watching the canary in the cage, just as shown here in Arkansas. We can't assume that Chiropractors would operate under less ethics that we do. Although, reading this transcript..... Professional bias affects judgment, regardless of how neutral the judges may be. Neutral PT's should have input to clarify professional isuues, but not have the power to make the final decision. The fact that manipulation is not a legal issue, but only a political issue could be another thread.
I totally oppose Chiropractors preventing PT's from manipulating the spine, but until it is legal, I personally won't be doing it on patients. It seems clear here that we can say we only mobilize all we like and document clearly, but if a patient describes the position of treatment and that they heard a pop, thats all that probably matters in a court room. Given that no-one even KNOWS what a pop IS, the trial outcome being based on a "pop" is ludicrous.
My heart goes out to Mr Teston and his family. Clearly law and politics are firmly joined here and the scales of legal process were tipped against him before even starting the trial. Is this Arkansas board liable for their actions to another external body within the legal system? The trial seems completely flawed and should be acted upon legally by the APTA. I can't see how they cannot.
Best regards,
Sam B
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