CCE Letter to USDOE Released - Claims Committee Decision was Unfair

News Analysis
CCE Letter to USDOE Released - Claims Committee Decision was Unfair


At the end of the December 2011 Hearing held by the National Advisory Committee on Institutional Quality and Integrity (NACIQI) to consider the Council on Chiropractic’s petition for continued recognition by the Federal Government, NACIQI added one final recommendation that created serious concerns at the CCE.

That recommendation was that the CCE demonstrate compliance with section 602.13 dealing with the wide acceptance of its standards, policies, procedures and decisions.  

Just eight days after the hearing, David Wickes MA, DC Chair of the CCE sent a letter to the Assistant Secretary of Education, Eduardo M. Ochoa, asking him to remove this language.

In a move that shocked the conservative faction of the chiropractic profession, the Assistant Secretary honored the CCE’s request stating:

"I disagree with NACIQI’s concern about lack of wide acceptance of the agency’s standards in the field. The dissenting voices in my judgment are a small minority within the profession. Generally, I agree with the arguments presented by the agency in this regard. Accordingly, I am not requiring that CCE address 34 C.F.R. 602.13, or how the agency’s standards advance quality in chiropractic education, in its compliance report.”

Ochoa noted that the recommendations of the Department staff and of NACIQI differed and that he had received written comments from the CCE that opposed NACIQI’s additional recommendation. Ochoa told the CCE:

“I disagree with NACIQI’s concern about lack of wide acceptance of the agency’s standards in the field. The dissenting voices in my judgment are a small minority within the profession. Generally, I agree with the arguments presented by the agency in this regard. Accordingly, I am not requiring that CCE address 34 C.F.R 602.13, or how the agency’s standards advance quality in chiropractic education, in its compliance report.”

Wickes alleged in his letter to Ochoa that much of the third party testimony provided during the hearing was not supported by the record, that the committee was unfairly influenced and that the Committee did not put the evidence into perspective. There has been no public response from NACIQI about these accusations. They may not even be aware of the outrageous charges leveled against them by the CCE.

Wickes went on in his letter to state that they received strong endorsements from the Association of Chiropractic Colleges (ACC), the Federation of Chiropractic Licensing Boards (FCLB), the American Chiropractic Association (ACA) and D’Youville College.

Wickes additionally asserted to the Assistant Secretary that the International Chiropractors Association (ICA) made “outlandish claims” in its testimony and that leadership from the ICA provided testimony “under the guise of other organizations”.

Seeking to draw a distinction for Ochoa based on size and membership numbers, Wickes alleges in his letter to the Assistant Secretary that the ACA has 15,000 members, is 3-4 times the size of the International Chiropractors Association and is the largest professional association representing chiropractors.

According to Wickes’ letter, the CCE maintains that the ICA’s Chief Counsel, James Turner provided “false information” about the ICA’s membership. Wickes made a distinction between the number of doctors the ICA represents versus the actual number of voting members (8500 versus 4000). Referring to it as a “false claim” the CCE further states that Turner revised his statement following the hearing in a brief to ICA membership.

What Wickes fails to mention to the Assistant Secretary is that the FCLB and the ACA are considered to be part of the Chiropractic Cartel - a characterization which was made by NACIQI itself during the 2006 Hearing to consider renewal of CCE’s recognition. The Chiropractic Cartel is felt to have seized control of the educational and regulatory aspects of the profession through calculated moves in an effort to expand chiropractic's diagnostic and treatment scope, including the addition of pharmaceuticals.

Wickes also fails to mention that the ACA ’s claimed membership numbers are in doubt and that many believe that the ACA provided false testimony on this to NACIQI. While the ACA stated, and Wickes parroted, that the ACA has 15,000 members - according to calculations derived from IRS 990 forms the ACA may have only an estimated 6000 full dues paying members. Further evidence for this are reports by Dr. Gerry Clum, Past President of the World Federation of Chiropractic that the membership dues in the WFC are based on membership numbers and that this is consistent with 6000 members in the ACA.

There is also discussion occurring amongst the conservative faction of the profession regarding reports that some chiropractic institutions provide automatic membership in the ACA for their students which leads to inflated membership numbers. Beyond the ethical issues such practices raise, others have further questioned the legality of this if Federal student loan money is being used for this purpose.  

Regarding the support demonstrated by the Association of Chiropractic Colleges that Wickes alleges as an endorsement of the CCE, he fails to inform Ochoa that despite public attestations of support by the ACC, there is actually reported dissension among the Presidents who make up the ACC in regards to their support of the CCE. Some of them have reportedly expressed fear at speaking out against the CCE given the amount of control the CCE has over the schools and licensure in the states. It is widely believed that the ACC has an unwritten “rule” that does not allow individuals to publicly express their own personal views if they are contrary to the majority view on issues where the ACC has voted. This speaks to the power wielded by the CCE through the Chiropractic Cartel and it is exactly this power and intimidation that NACIQI was referring to when they first commissioned the Cartel label.       

Wickes also fails to reveal to Ochoa that the Congress of Chiropractic State Associations (COCSA) publicly and formally expressed concerns regarding CCE’s lack of acceptance by the profession and requested a dialogue with the CCE about these issues. In a letter to the CCE, COCSA President, Dr. Kate ChoidaRufolo-Dreher told the CCE that: "This is of particular interest to our membership as those added charges speak specifically to the concerns of many in the profession". COCSA actually represents the largest number of chiropractors of any trade organization in the profession. It will be interesting to see if COCSA maintains their concern or jumps in lockstep with the rest of the Cartel.

In terms of testimony provided under the guise of other organizations - while Wickes suggests some sinister motives on the part of the ICA, he ignores the fact that in addition to the ACA Vice President providing testimony in support of the CCE, two other individuals who are members of the ACA also provided testimony supporting the CCE. One of those individuals was presented as speaking on behalf of a very small chiropractic program at D’Youville College and the other gave no affiliation. Once has to wonder why Wickes did not make an issue regarding the testimony of these individuals.

Seeking to highlight testimony in support of their agency, the CCE characterized the testimony of ACA’s Executive Vice President as demonstrating that he was “unequivocal in his support” of the CCE. As evidence for this, Wickes provided one quote from O’Connell: “CCE’s standards prepare our students for their future responsibilities”.

Further on in his letter to Ochoa, Wickes pushed aside allegations of testimony that indicated the CCE was a “self perpetuating organization” by simply stating that these allegations “are simply not true”.     

Wickes portrayed the CCE’s efforts to work with its constituents as tireless including the most recent revision of its Standards that they allege included wide representation of educators, practitioners and administrators - including the ICA’s most recent past president. It was stated that the CCE incorporated many of the suggestions for changes during their two public comment periods and two dozen meetings to engage their constituents. No mention was made of the refusal of the CCE to address the most significant issues of contention held by its stakeholders – the issues revolving around language related to drugs and surgery as well as subluxation and primary care.

No mention was made by Wickes of the over 4000 letters received by the USDE from organizations, individual chiropractors and other stakeholders that detailed specific violations of Federal Recognition Criteria by the CCE and that evidenced the indisputable fact that the CCE does not enjoy widespread acceptance by the profession.   

Wickes pushed the notion that not a single accreditation decision since 2002 has been appealed by any of CCE’s accredited programs and, without providing evidence, stated that anonymous survey’s of accredited programs have not yielded any evidence of substantial dissatisfaction with the CCE.

While Wickes admits the substandard performance of the CCE in his letter he also contends that they could debate some of the concerns if they wanted to, but since they will be able to come into compliance in a very short time – this does not seem necessary.

Wickes closes the letter to the Assistant Secretary by stating: "We believe the language added by the Committee is not only unfair, but will be exploited by the same vocal opposition group to further create a division in the profession. We respectfully ask that this language be removed and that the original USDE staff recommendation be adopted."

The letter to Ochoa and his subsequent decision to override the recommendation of NACIQI raises several important concerns and questions. The most obvious is how did the Assistant Secretary simply accept what the CCE told him and become convinced of an alternate reality in which the concerns expressed by so many within the profession represent only a minority view?

Further, does the USDOE only recognize membership organizations within a profession as stakeholders? If so, this becomes problematic since the majority of chiropractors are not members of any organization. And what of the students? Are they not considered stakeholders?  There are approximately 10,000 students currently enrolled in chiropractic colleges and evidence suggests that they have been brushed aside by the CCE. The World Congress of Chiropractic Students (WCCS) sent a letter to the CCE requesting to participate in the recent stakeholders meeting but never received a response from the CCE.

The comments by the Assistant Secretary seem to indicate that the USDOE does not support curricular and academic freedom, but instead is only concerned about the views expressed by a majority.

Perhaps most shocking, the Assistant Secretary’s letter seems to indicate that the USDOE excludes minority interests. Is this the view of the Obama Administration?

Finally, through what process or criteria does the USDOE determine minority versus majority concerns other than the “judgment” of the Assistant Secretary?

These are all questions for which the conservative faction of the profession will be anxiously awaiting answers.