War is being waged among chiropractors in Utah, and the state licensing process is the battleground.
The profession split into two factions several years ago - the old guard represented by the longstanding Utah Chiropractors Association and the breakaway young turks belonging to the Utah Association of Chiropractic Physicians.UACP's version of the battle has the old guard complaining there are too many chiropractors cutting in on the UCA members' business, while the younger chiropractors contend there is plenty of business but not enough chiropractors to handle it. The UCA's version has the UACP desperate for members who support a philosophy of making money by charging for as many tests as possible, while the veterans of the UCA want to cut costs for patients and keep professional standards high.
At times the confrontation has turned nasty. Last year a newsletter purportedly published by a group of UCA members practicing together, trumpeted their dominance of the licensing board giving them "leverage" over licensing regulators. The UCA members, saying the newsletter was a fraudulent replica written and mailed by a member of the opposition, contemplated filing criminal mail-fraud charges against the suspected forgers, but they couldn't find witnesses.
Caught in the middle is the state Division of Occupational and Professional Licensing, which licenses and regulates the 300 chiropractors in Utah.
"This is the only profession that has this division," said DOPL director David Robinson, who regulates more than 50 occupations. "We are listening but trying not to get embroiled in the controversy."
UACP contends the state-appointed licensing board and the committee that conducts the licensing exam are top heavy with UCA members, who are using the test as a way to control the number of chiropractors in Utah. The licensing board chairman and the majority of committee members do belong to the UCA, some are related and some are also stockholders in a private chiropractic corporation called CHP that contracts work with insurance companies.
The result is "gatekeeping," the UACP charges, basing its claim by the abnormally low percentage of chiropractors passing the exam on the first try.
In 1992, five of the 27 people taking the exam for the first time passed, for a dismal 18 percent passing rate, according to DOPL records. The UACP's August newsletter said passing rates in other western states range from 76 percent to 95 percent.
State records show that 10 of the 11 candidates who protested their test results to the licensing board lost their appeals. Four of those people have requested a special appeals board, and two hearings have been scheduled.
A California chiropractor, who failed the exam and was denied a special appeals hearing, filed suit in 3rd District Court in October. In his complaint he requests the court review his board appeals, order access to his exam results, order the licensing board to explain why he failed, and order he receive a Utah license.
"Something is wrong, wrong, wrong," the UACP newsletter declared, requesting the state examine its chiropractor exam.
But the state claims that has already taken place. "The complaints have been going on for years and we have listened to them all. We have done everything we can to make the exam fair and competent," Robinson said.
Bruce Egbert, chairman of the state's Chiropractor's Licensing Board, acknowledged UACP members were appointed to the examination committee after the association complained. Outside experts were also asked to evaluate the exam and their recommendations were implemented, he said.
"This still does not please the UACP. They won't be happy until they have complete control . . . . They don't want unification, they want annihilation," said Egbert, a member of UCA and CHP.
He explained the board doesn't want a high passage rate of the licensing exam. Instead it is concerned with conducting a fair exam that tests an individual's competence.
"We are there to protect the public not the profession," Egbert said. "I would hate to have someone treating me who couldn't answer the questions."
He explained that a candidate can retake the failed sections of the exam, and those that do usually pass. Of the 15 retakes in 1992, 12 passed.
UACP president Jeff Hanks said his organization advocates "expanding the profession" in Utah not shutting people out. He added that there are efforts to iron out differences and unite the two groups.
UCA president Tom Malin, who also sits on the state's examination committee, said he hopes the two sides that represent about one-third of the state's chiropractors can make peace before their differences tear the entire profession apart. Malin noted that chiropractors can't expect to protect their interests if they aren't unified.
Egbert is tired of the controversy, but he's determined not to let it get in the way of his regulating responsibilities. "I'll be damned if I give up. I have four more years (as chairman of the licensing board) and I won't let a group of people scare me out."