While most DCs don't think much about the National Board of Chiropractic Examiners (NBCE) after they pass their last exam, it is probably the wealthiest "nonprofit corporation" in chiropractic, with almost $16 million in assets (almost $5 million of which is in cash or equivalent).
And while everyone knows that most of the NBCE's money comes from the four tests it administers to graduating chiropractic students each year, it is almost impossible to find out specifically how the board spends that money. The NBCE takes in almost $8 million in "examination fees/other services" and spends almost $7 million of it - but on what?
Just as secretive is the annual per diem and reimbursement to NBCE board members. A relevant question to ask is: How much of a factor does the director's fee income play in each board member's decisions?
Want to know what the president of any chiropractic college makes each year? Call the college or go to its Web site; that's public information. Want to know how much the board members of the Federation of Chiropractic Licensing Boards (FCLB) are reimbursed each year? That too is public information. Want to know how much each of the 11 board members of the NBCE is paid? Better hire an attorney. The board has historically refused to provide that information, even to some of its own board members.
The NBCE board members generally comprise two groups. Four board members could be considered "reform" board members: Vern Temple, DC (District III representative), Ted Scott, DC (District IV representative), Ed Weathersby, DC (FCLB president) and Bud Smith, DC (FCLB vice president). All four of these board members have been working hard to make changes within the NBCE. The top three changes they hope to make are:
- implementing term limits;
- reducing the expenditures of the NBCE and thereby reducing the cost of the tests; and
- reforming the reporting of the NBCE to a level of "transparency" that makes public how the board spends its $7 million each year and what each board member gets paid.
Unfortunately for the reform group, they are outnumbered. The NBCE board of directors has four "at large" positions that are "elected" by whomever is in power on the board, not the state delegates. (The at-large members even get to vote to elect themselves.) This means that once a group has control of the NBCE, they only need to keep two positions elected by the state delegates (along with their four at-large positions) to have 6-5 voting control.
Term Limits - What Really Happened?
The reason for term limits is simple. It forces changes that allow fresh ideas to enter an organization and breaks up control so the board has a better chance of representing its constituents. From the date of its inception, the NBCE has never been a fan of term limits. Oddly enough, when it adopted term limits for the at-large members a few years ago, the board chose not to apply them to the district directors. Once you were elected, you only needed to side with the controlling group to keep your position. (For example, Frank Hideg, DC, has been on the board for almost 30 years.)
The most recent attempt by the reform group to encourage term limits took place at a NBCE board of directors meeting in November of last year. As expected, they were voted down (7-4)
But then something new happened. Don Miner, DC, a member of the Nevada state licensing board, began to make noise about term limits and the duty of the state licensing boards to ensure the fiscal responsibility of the NBCE. On Jan. 28, 2006, the Nevada board passed its own resolution (No. 06-01), calling for NBCE district director term limits and encouraging other chiropractic state licensing boards to do the same.
The control group apparently became very concerned. They realized quickly that if Nevada had decided to no longer accept the NBCE tests for licensure, other states licensing boards, equally frustrated, might follow suit. Almost magically, the issue of district director term limits was considered on a NBCE board conference call on March 3, 2006. This time, the proposal received a unanimous 11-0 vote, just a week after the NBCE President Peter Ferguson had publicly opposed term limits at a test committee meeting at NBCE headquarters.
Unfortunately, the nine-year proposed term limits are not retroactive. They begin in 2006, regardless of how long a member has been on the board. This means that by the time the term limits affect the control group, they could have served an average of more than 17 years each - if not replaced sooner.
Reducing Test Costs - Avoiding Further Embarrassment
In 2004 (the last year that any financial statements were released), the assets of the NBCE grew an incredible $1,476,694, mostly at the expense of chiropractic students. As the pressure for reform increased, the control group responded. Still refusing to reveal how it was spending the money, the control group did vote to reduce the fees for Parts I, II and III by $25 and reduce the fees for Part IV by $100. While this was a step in the right direction, it still leaves chiropractic graduates paying $425 for each of the first three tests and $1,025 for Part IV, a total of $2,300.
Based upon the 2004 numbers, the NBCE assets will probably increase another $1.5 million in 2005. This will bring the total assets to about $17 million, assuming that the board doesn't dramatically increase its expenditures. When the test cost reductions become effective in 2006, that could drop the increase in the NBCE assets to a mere $1 million dollars per year - not too bad for a "nonprofit corporation."
Transparency - How Liable Are the State Licensing Boards?
By accepting the NBCE tests, the chiropractic state licensing boards have effectively relinquished their right to test potential licensed chiropractors for their state. As such, the chiropractic state licensing boards have a certain amount of liability for how the NBCE is spending the money the state boards require their prospective licensees to pay the NBCE for that testing. Without the acceptance of the NBCE tests by the chiropractic state licensing boards, the NBCE would cease to exist.
Sadly, the state delegates and even some of the elected board members don't know how the students' testing fees are being spent. They don't know if they are supporting a well-run organization or one in which the board members are spending money inappropriately.
In talking to some of the NBCE state delegates, it's apparent that they are questioning their state's delegation of testing authority to the national board. Their concern over not being able to obtain adequate financial reports is apparently overshadowing the value of the NBCE tests.
Reference
- National Board of Chiropractic Examiners Annual Report 2004 www.nbce.org/pdfs/report_2004.pdf.
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