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Chiropractor Disciplined for Inappropriate Solicitation
Stephen Barrett, M.D.
Frank J. Amato, D.C., of Bellport, New York, has been disciplined
for promoting unnecessary treatment to symptom-free patients.
In December 2001, he was judged guilty of "unprofessional
misconduct." His license was suspended for two months; and
he was fined $7,000 and placed on probation for two years. He
was also ordered to perform 100 hours of community service amd
complete 36 hours of an approved college-level course in ethics
and jurisprudence. The licensing
board's summary states:
Licensee was found guilty of exerting undue influence on a
patient for his own financial gain by placing pressure on the
patient to bring family members into the office for examination,
evaluation and treatment by him. Respondent was also found guilty
of holding a "Patient of the Month" contest in which
the patient who recommended the most new patients to the Respondent
would win a color television set .
Public documents in the case provide a vivid account of what
took place in Amato's office. Here's what the New York State
Regents Review Committee concluded about what happened :
FINDINGS OF FACT
- Respondent was authorized by the New York State Education
Department to practice as a chiropractor in the State of New
- Respondent was duly served in this matter.
- At all times relevant in this matter, respondent was in private
practice and maintained an office as a chiropractor in New York
- Patient S.M. sought chiropractic treatment from respondent
- After November 10, 1997, respondent informed patient S.M.
about the fees that he would charge her if she entered into treatment
with him. Respondent stated that S.M. could sign a contract for
approximately 72 visits over a one-year period.
- In discussing the amount of his fee, respondent offered S.M.
to take 15 percent off his fee. Respondent also offered her a
50 percent discount if her husband would enter into treatment
with him. In addition, the total fee to S.M. would be reduced
by 25 percent for each of her two children if they would also
enter into treatment with respondent.
- S.M.'s husband and S.M.'s two children were all not experiencing
back or neck problems. S.M. informed respondent that she was
not interested in a fee plan involving the treatment of her husband
- In November 1997, respondent began treating Patient S.M.
for scoliosis. During the course of treating S.M., respondent
gave a validation card to take home to screen her husband and
sons for back problems. S.M. completed and returned the card
and told respondent that none of her family members had any chiropractic
problems. Nevertheless, respondent told S.M. that he wanted her
to make appointments for her husband and sons to be evaluated
by respondent. On different occasions, respondent told S.M. to
bring her husband and sons in for examination by him. PS.M. declined
to make appointments for her husband and sons to be seen by respondent.
- On various occasions when S.M. went for her appointments
with respondent, she did not hire a babysitter for her nine year-old
son, P.M. On these occasions when P.M. accompanied P.M. to respondent's
office for S.M.'s visit, S.M. did not bring P.M. to respondent's
office for the purpose of his being examined or evaluated by
- Although P.M. was not. respondent's patient and was not seeking
to become a chiropractic patient, respondent asked P.M. various
questions. Respondent specifically asked P.M., in the presence
of his mother, "Do you play baseball?" "Do you
want to hit a ball further?" "Do you want to jump higher?"
"Do you want to run faster?" P.M. very active in sports.
When P.M. responded yes to respondent's questions, respondent
then said: "You talk to your mom about coming to see me
and you can do these things." Respondent admits that he
told P.M. that his performance in these areas would increase
if he received chiropractic treatment by him.
- Respondent's secretary told S.M. that respondent "would
like to know when" S.M. will be making an appointment for
the children. Respondent's secretary also told S.M. that she
had to ask S.M. when she will be making an appointment for P.M.
- Respondent told S.M. that everyone needed chiropractic care.
Even though S.M. had not told respondent that she would bring
her family in to his office or that she would make an appointment
for any of them to see him, respondent kept pressuring S.M. to
bring her family in for treatment by him. Respondent constantly
asked S.M. when could she bring her children in to see him and
when would she make an appointment for them.
- Respondent's efforts to get S.M. to bring her husband and
children in to his office for treatment by him became more frequent
over time. S.M. became very uncomfortable with these efforts
to influence her and told respondent that she did not. feel it
was necessary for her children or husband to be treated by a
- As a result of respondent's constant efforts, S.M. agreed
for P.M. to be examined by respondent on July 1, 1998. Based
upon his examination of P.M., respondent recommended that P.M.
be x-rayed. Respondent did not make any diagnosis for P.M. at
the time respondent recommended an x-ray.
- S.M. decided that x-rays were not to be taken for P.M. In
view of S.M.'s.decision, respondent did not take any x-rays of
P.M. Due to the absence of x-rays, respondent did not know if
P.M. should be considered a chiropractic case.
- After examining P.M., respondent stated, in P.M.'s presence,
that he saw certain particular problems in P.M.'s case, but did
not indicate that P.M. had scoliosis. When P.M. went home from
this examination and report by respondent, P.M. threw himself
on a bed and cried because he felt he was deformed and that something
was wrong with him.
- After he was convinced that S.M. would not agree to have
her family be treated by him, respondent sent S.M. a letter dated
September 21, 1998. In this letter signed by respondent, respondent
indicated that his philosophy was to "educate and adjust
as many families as possible toward optimal health using natural
- In his letter, respondent asked S.M "how can we continue
to have a truly healing Doctor-Patient relationship when you
have no confidence in me or my healing philosophy". Respondent
wrote, in view of his philosophy, that he "can't" continue
adjusting S.M. "anymore."
- Respondent exercised undue influence on S.M, for his financial
gain, by advising S.M. that he could not continue to treat her
if he was not also treating her children.
- Respondent exercised undue influence on S,M., for his financial
gain, by further advising S.M. that if P.M. did not receive chiropractic
treatment, his health would be at risk.
- During the course of treating S.M., respondent had a "Patient
of the Month" contest n which the patient who recommended
the most new patients to the respondent would win a color television
- Respondent offered an inducement in a form other than a discount
or reduction in an established fee or price for a professional
service or product. Respondent's conduct constituted advertising
or soliciting for patronage that is not in the public interest
in violation of S. N.Y.C.R.R. §29.1(b) (12) (i) (e).
We unanimously determine that the first and second specifications
of the charges have both been proven, by a preponderance of the
evidence, and that respondent is guilty of both the first and
second specifications of professional misconduct.
. . . The hearing panel finds Patient S,M, to be credible.
Her testimony accurately described the key relevant events. Respondent
is found to have exerted undue influence on this patient for
his own financial gain. He exercised undue influence on S.M,
by advising her that he could not continue to treat her without
his also treating her family; and by further advising her that
without chiropractic treatment her son's health would be at risk.
This hearing panel finds respondent's testimony to be incredible.
Respondent was acting for his own financial benefit in placing
pressure on S.M. to bring her son into the office for examination
by him. He sought to gain financially by bringing P.M. into the
practice as a new patient and by maximizing the number of patients
he could bring into this practice.
Respondent attempted to overcome S.M. and her family's choice
regarding whether they would seek professional services from
him. The record demonstrates that respondent became obsessed
with financial considerations beyond those appropriate in treating
patient S.M. Contrary to his clams, respondent was not focusing
solely upon his patient's interests. Respondent persisted in
pressing his concerns on S.M., even though, as he testified,
he had not determined, in the absence of x-rays and a full examination
of P.M., whether P.M. should be treated as a chiropractic patient
in his office. It was unprofessional for respondent to constantly
apply pressure on S.M. against her wishes in order to pursue
his gaining new patients.
Moreover, respondent acted inappropriately in suggesting to
P.M. that he could run faster, jump higher, and hit a ball further
if he would talk to his mother about his receiving chiropractic
treatment from respondent. The questions respondent deliberately
directed to this nine year-old boy needlessly upset him and caused
Many chiropractors still cling to the belief that most health
problems are caused by misaligned spinal bones ("subluxations")
that can be corrected by spinal "adjustments." Although
the disciplinary documents do not mention the word "subluxation,"
Amato appears to advocate that every spine should be checked
and "adjusted" throughout life. The World
Chiropractic Alliance (WCA), which is "dedicated to
promoting a subluxation-free world," has sharply criticized
the New York licensing authorities and issued a position paper
Chiropractic care to detect and correct vertebral subluxations
offers benefits for all people, including those who do not demonstrate
symptoms of a disease or health condition. Therefore, the presence
of symptoms and/or a medical diagnosis should not be a factor
in determining the need for or appropriateness of chiropractic
adjustments, nor should the presence of symptoms be required
by any chiropractic board, insurance company or court of law
to justify the rendering of chiropractic care to any patient
The paper claims that checking for "subluxations"
is analogous to periodic dental and blood-pressure check-ups.
However, blood pressure and tooth decay can be objectively demonstrated,
but the subluxations to which WCA refers can not .
According to a WCA report, Amato is appealing the action in
court . Do you think he will succeed?
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This article was posted on June 19,
- New York State Education Department Office of the Professions.
Summaries of Regents
Actions on Professional Misconduct and Discipline, December 20,
- Cohen SB and others. Report of the Regents Review Committee
in the matter of the disciplinary proceeding against Frank J.
Amato. No. 18075, Nov 8, 2001.
paper on chiropractic for asymptomatic patients. World Chiropractic
Alliance, May 15, 2002.
- Barrett S. Chiropractic's
elusive "subluxation." Chirobase, Dec 25, 2001.
doctor censured for pushing family care. The Chiropractic
Journal, April 2002.