April 24, 2002

Appearing in The Chiropractic Journal, April 2002

N.Y. doctor censured for pushing family care

As you can imagine, Dr. Amato is in financial trouble. Tell me this 
couldn¼t happen to any one of us? I will be contacting Frank 
tomorrow. My check will be in the mail within 24-hours. At the very 
least, contact Frank and let him know how you feel. Contact info is 
belowä

Frank J. Amato, D.C., of Bellport, New York, makes it clear to all new 
patients that he provides chiropractic care for the entire family, and 
thinks it's important for all members of a family to be examined and 
receive adjustments.

Yet, the New York State Board for Chiropractic slapped Dr. Amato 
with a suspension, a $7,000 fine, and mandatory community service, 
after a former patient complained that he advised her to get 
chiropractic help for her nine-year old son, who showed signs of 
possible scoliosis.

After he appealed the decision, the Board increased the penalty from 
a two-month to a 24-month suspension, accusing him of "treat(ing) 
symptomless patients."

As the chiropractic profession increasingly embraces the concept of 
family practice and wellness care, the potential ramifications of 
this case were felt throughout the nation.

"If our licensing boards begin condemning chiropractors for 
educating the public on the benefits of family care or for caring for 
asymptomatic people, the entire 21st century chiropractic paradigm 
is in jeopardy," stated Terry A. Rondberg, D.C., president of the World 
Chiropractic Alliance (WCA). Dr. Amato is a member of the WCA and 
a long-time advocate of family wellness care.

The case in question involves a patient who had been diagnosed with 
scoliosis when she was 12 and went to Amato with complaints of 
neck pain and weakness, low back pain, leg pain, headaches, 
menstrual problems and other symptoms.

She late credited Dr. Amato's care with a significant reduction in 
her symptoms and consistently praised him and the care she 
received. In routine three-month progress evaluations, the patient 
stated that she had no complaints.

As he did with all patients, Amato repeatedly recommended that she 
bring her husband and son in for checkups as well. Although 
reluctant, she eventually also brought her son in for an examination 
after Amato told her he observed signs of "postural anomalies" 
which could indicate the boy also suffered from scoliosis.

The office examination routinely included x-rays and Amato advised 
the patient he could not care for her son unless he was able to verify 
his suspicions with radiographic evidence. Although Amato told her 
there would be no additional charge for the x-ray, she refused and 
the boy never received chiropractic care.

Amato continued to adjust the woman, and continued to recommend 
that she bring her son in for chiropractic care as well, often 
expressing his concerns about his physical condition. In her regular 
evaluation during this period, she noted that "the office is thorough, 
professional, and clean."

Six weeks after the boy's aborted examination, the mother canceled 
all future appointments, requested copies of her x-rays, and 
terminated her relationship with Amato's office.

Shortly thereafter, Amato sent her a final bill for $252 and a letter 
reminding her that her son should be checked by someone else. In 
appealing the disciplinary findings, Amato's attorney, Steven Legum, 
explained that he had written the letter because "it still weighed on 
his mind that the child had a serious problem."

Although she first attempted to dispute the bill amount, when told 
that the Board does not involve itself in financial disputes, she filed 
a complaint saying the letter was an unethical attempt at pressuring 
her into bringing her son in for treatment. She claimed Amato 
refused to care for her unless she also brought her son in for 
adjustments. The Board charged him with "placing undue influence on 
a patient for financial gain."

Amato's lawyer says the entire case is without merit, particularly 
since the letter was sent after the patient-doctor relationship had 
been severed.

"That letter cannot, under any construction, be viewed as an 
unprofessional act since it was not in the context of his relationship 
with his patient," the Appeal argued. "Rather, as Dr. Amato explained, 
he was trying to prevail upon (the patient) to follow up with the 
diagnosis of her child to obtain an x-ray to confirm whether or not 
he was suffering from scoliosis."

Amato's appeal examines another, potentially more important, issue 
‚ that of possible prejudice by the chairperson of the New York 
Board, Dr. Margaret Verhagen.

According to Amato's attorney, Dr. Verhagen, who chaired the 
hearing panel, "demonstrated overt manifest antagonism and 
prejudice toward the respondent," and the panel's judgment was 
"infected by her prejudicial and biased actions."

Transcripts of the hearing provide evidence that Verhagen 
repeatedly criticized Amato's procedures and patient education 
methods.

At one point, she scolded him for distributing posture evaluation 
cards, a popular patient education tool which encourages patients to 
make observations about family members' posture.

"How dare you allow someone that is not a chiropractor to evaluate 
their family as to their spinal condition," she admonished him. "It 
took me four years of chiropractor school to learn that, and 15 years 
of practice to feel confident. How dare you let a layperson do that?"

Her criticism extended even to his treatment of the mother. "There 
is nothing in your records that talks about any kind of neurological 
testing," Verhagen lectured. "If this woman had paresthesia in her 
legs, she should have been examined in a much more thorough way as 
opposed to a postural scale. So procedure, techniques-wise, you are 
off the mark."

Amato's attorney took exception to her remarks. "This was beyond 
the scope of the charges and the patient never even alluded to any 
issue concerning problems with the nature of the care," he noted. 
"Rather, the only reasonable conclusion is that Dr. Verhagen was 
simply conducting an inquest hoping to find other reasons to 
criticize, castigate, chide and otherwise deride Dr. Amato."

Her animosity toward Amato is evident, too, in the severe penalties 
the Board placed on him, penalties which his attorney labeled as 
"shockingly disproportionate to the offense."

Although admitting that he encouraged referrals by raffling off a 
television set, the sentence was clearly given for the "offense" of 
supposedly trying to influence his patient to bring her son in for 
care.

Yet, his attorney argued, even if he were guilty of such an action, the 
sentence was extreme. "Superimposed upon the loss of income and 
the devastating effect of the suspension to Dr. Amato's professional 
practice, a substantial monetary penalty was also recommended. 
Most appalling and most graphically demonstrating the impropriety 
of the Panel's action both on its findings and on its recommendation 
of punishment, is the direction that Dr. Amato engage in public 
service."

The panel specified that the 100 hours of public service outside the 
chiropractic profession be conducted in a hospital or other medical 
facility. Yet, the appeal pointed out, "Dr. Amato's license as a 
chiropractor does not allow him to provide any services in a medical 
facility or AIDS clinic. What then could Dr. Amato do in such 
facility? Clearly, he could be a delivery boy, he could assist the 
licensed practical nurses, he could clean bed pans. ...This 
recommendation is shocking and appalling and disproportionate to 
any offense. It will serve no purpose either for Dr. Amato or for 
society in general, for this professional man to be so degraded."

In addition, Amato was sentenced to attend 36 hours of an approved 
college level course on Ethics and Jurisprudence.

After the appeal was filed with the New York Board of Regents, 
Amato was faced with another shocking development. "I was 
informed that, upon review, they were increasing the penalty to a 
full 24-month suspension, citing my desire to 'treat symptomless 
patients,' and for recommending 'knowingly unnecessary' treatment 
and for scaring a young child," he explained.

Although the case is now in the New York Appellate Court, Amato 
was forced to go on suspension as of January 20, 2002. His motion to 
stay the Board's decision while the appellate court decides his case 
was denied and he is considering the possibility of selling his 
practice and leaving chiropractic.

For now, he is managing to keep his office open with the help of 
friends. "Dr. Susan DeVito, Dr. Robert McEvoy, and Dr. Gus Cossifos 
are giving up their personal time to cover my practice and help out a 
friend," he told The Chiropractic Journal. "I can never repay them."

Dr. Rondberg stated, "We are going to do whatever we can for Dr. 
Amato. We feel it is important to provide assistance to all our 
members, and to all doctors who are victimized by board members 
who allow personal animosity to cloud their judgement."

The World Chiropractic Alliance has long defended the right of all 
D.C.s to provide chiropractic care to all members of the family, 
including children and those without overt symptoms. "To say that 
chiropractic should only be provided to adults or to those in pain or 
exhibiting other physical symptoms is to deny the benefits of 
chiropractic to a vast portion of the population, including those who 
may need it most. The WCA cannot condone such actions and will not 
sit by while doctors are persecuted for their dedication to 
chiropractic principles."

Doctors wishing to learn more about the case or offer assistance to 
Dr. Amato may contact him at 631/286-2300 or 
drfrankamato@att.net.

A legal fund has been set up for Frank Amato, DC in care of his 
attorney, "Carlucci & Legum" 170 Old Country Rd, Mineola, NY 11501. 
He wants to thank everyone so much and to tell as many of our 
colleagues as possible, about this, so it doesn't have to happen to 
anyone else.