New York chiropractor Frank J. Amato stands accused for recommending x-rays for a patient with a family history and physical examination suggestive of scoliosis

During my 14 years of practice in Bellport, NY, I have only had one complaint lodged against me—a charge of placing “undue influence on a patient for financial gain,” brought in July 1998, because I recommended x-rays on a 9-year-old boy with a family history of scoliosis and physical examination results that were strongly suggestive of scoliosis. His mother, who was a patient of mine, had 45° scoliosis, which was discovered when she was 12, and now caused her pain and breathing problems everyday of her life.

The mother refused the x-rays for her son—the examination was part of our patient appreciation day and cost $25, which included any necessary x-rays. She continued to visit the office for adjustments for the next 6 weeks, during which I continued to educate her on the necessity of early detection. Also, during those 6 weeks, as she had done twice previously in the 9 months she was under my care, she responded in writing to the question, do you have any comments or complaints about the office?, with: “The office is thorough, professional, and clean.”

One month after she terminated care, a bill for $262 was sent, along with a letter urging her to have her son checked elsewhere for scoliosis. She then filed a complaint with the Office of Professional Discipline (OPD) to avoid paying the money. The New York Chiropractic Board accused me of saying, “If you do not have your son treated by me, I cannot treat you anymore.” The mother also testified that “the doctor told me he would not treat my son without first x-raying him,” and that she was the one who cancelled her remaining visits, not me.

Despite the fact that she wrote down on three separate occasions how much she loved the office and her results, the chiropractic board chose to disregard this and believe her complaint after the fact.

The board should have questioned this woman’s motivation for filing the complaint when she had written compliments during the previous 9 months. Her motivation was obvious—money. Since the board cannot be involved in financial disputes, the case should have been dropped. The mother, after realizing that OPD could not help her with the bill, paid me 1 week later.

At the chiropractic board hearing in November 2000, which consisted of two chiropractors and a layperson, I was subjected to a lecture by then Chairperson Margaret Verhagen, DC. One topic she mentioned was a family posture card I distribute to my patients. According to the transcript of the hearing, Verhagen said, “This is a real beauty. Family posture evaluation. [Reading from the card] ‘Use this card to observe and regard postural conditions of each member of your family. Families that stand up straight together, stay healthy together.’” She continued, “How dare you allow someone that is not a chiropractor to evaluate her family as to their spinal condition! It took me 4 years of chiropractic school to learn that, and 15 years of practice to feel confident. How dare you let a layperson do that!”

If women can do self-breast examinations, and people can take their own blood pressure, administer their own insulin, and so on, why can’t they look to see whether one shoulder or hip is higher than the other?

Eventually, I was found guilty of the charge, along with the charge of providing raffle tickets for a television each time a patient referred someone, to which I pleaded guilty because I did it once. According to the law, I should have only received a letter of administrative warning. Instead, I was sentenced to a 24-month suspension, with 22 months stayed, 36 hours of college level ethics and jurisprudence courses, 100 hours of community service outside the chiropractic profession, and a $7,000 fine ($2,000 for the television charge).

The NY Chiropractic Board is only an advisory board. They advise the Board of Regents, which oversees all professions—health and non-health related—in New York (except for medical doctors) of their findings and proposed punishment.

I then appealed to the Board of Regents in April 2001. In January 2002, I was told that not only were they not changing the findings, but I was to be suspended for the entire 2-year term, as opposed to the 2 months recommended by the board. The reason given for this was that I allegedly “attempted to treat a symptomless person, unnecessarily scared a child, and recommended knowingly unnecessary care.”

Both the mother and I testified that I would not treat the son without x-rays. Even if I did, does this mean that chiropractors can no longer adjust wellness or maintenance patients, or cannot treat other conditions until the last stages? And are we the only profession prohibited from treating symptomless persons?

Also, how could I recommend care when I had not even completed the examination? Everything stopped after she refused to have her son properly evaluated. Interestingly, according to testimony, the child was never evaluated anywhere after the visit to my office. Therefore, my reasons for recommending the x-rays were never questioned.

On the New York OPD website (www.op.nysed.gov), you will not see a full 2-year suspension for any misconduct cases. There are doctors who have committed felonies, federal offenses, molested patients, and treated under the influence of drugs and alcohol—all of whom received less severe penalties. And all this is because I thought it proper to recommend further testing on a 9-year-old with a significant family history of scoliosis and a physical examination strongly suggestive of it.

I have not practiced since January 15, 2002, and I am appealing the decision in the New York Appellate Division. The New York Chiropractic Board, due to the attention this matter has received, has issued its own press release which, in effect, attempts to distance itself from the final decision, and shift the responsibility to the Board of Regents, which increased the penalty. On the other hand, in at least two separate letters I have seen, the Board of Regents, in essence, stated that I was found guilty by the chiropractic board, and that it was the board’s responsibility. Nobody wants to be held accountable. If Verhagen and the rest of the hearing panel had acted appropriately, this matter would have never appeared before the Board of Regents.

As far as the Board of Regents is concerned, it has to be either clear bias against chiropractic or lack of education as to what we do. In the Board of Regent’s letter to my state legislator, who is acting on my behalf, it cites that I was wrong to tell this patient that “everyone needs chiropractic care.” This comes after the president of the chiropractic board, in his remarks to the New York Chiropractic Council on February 2002 (a meeting in which I spoke before him), clearly stated that it is proper to say everyone needs to be under “chiropractic care,” but it is not proper to say that everyone needs to be “adjusted.” So, the Board of Regents continues to be ambiguous in its guidelines.

Legislation is needed in New York that would give the chiropractic board the final decision in misconduct cases. This would eliminate the situation where laypersons who are not fully educated about the chiropractic profession make ignorant or biased decisions.

Since my fate is completely in the hands of the courts, my mission outside that realm is for the profession. I will not stop until some good comes out of this gross injustice. The fight has definitely found me; I did not go looking for it, but I will see it through. For the first time in my career, I am finding out about the politics in our profession.

I am extremely thankful for the world-wide support I have received. The chiropractic profession needs to band together to prevent a devastating precedent to be set, and I have made it my mission to make sure this does not happen to another chiropractor. CP

Frank J. Amato, DC, can be reached at 631-286-2300 or via email: drfrankamato@att.ent.