Timothy Francis, D.C. Disciplined for
Stephen Barrett, M.D.
Timothy Francis, D.C. practices chiropractic in Las Vegas Nevada and conducts applied kinesiology seminars throughout the country. In March 2015, the Chiropractic Physicians' Board of Nevada charged him with acting improperly toward a student whom he met at one of his seminars and later became a patient. The notice of charges stated:
- In 2012, Dr. Francis and the student began a relationship that included diagnosis, treatment, and sexual relations.
- Using applied kinesiology muscle testing, Francis diagnosed venereal diseases, a pregnancy, and other problems that the woman did not have.
- Francis made no medical records regarding any of his diagnoses or treatment.
In August 2015, as noted below, the board upheld the charges and placed Francis on probation for three years, during which he must (a) take remedial courses, (b) pass tests related to boundary violations and jurisprudence, (c) provide a corrective plan to the board, (d) cooperate with any board requests to monitor his practice, and (e) pay 60,484.16 to cover the cost of the board's investigation and prosecution.
Applied kinesiology is an unscientific method of diagnosis and treatment that includes muscle-testing to detect the alleged presence of disease, vitamin deficiency, and other problems. During the proceedings, the woman testified Francis had muscle-tested himself and determined that they were perfectly compatible (99 out of 100), that they had been married 33 previous times over the 155 lifetimes that they had known each other, and that she would not be happy until she broke up with her then boyfriend and married Dr. Francis. Despite the bizarre nature of Francis's concepts of diagnosis and treatment, the board's order does not (a) prohibit him from continuing to practice applied kinesiology or (b) consider whether his misguided beliefs about diagnosis and treatment are as dangerous to patients as his boundary violations.
In addition to complaining to the board, the woman has filed a civil suit alleging sexual battery, sexual harassment, slander, lack of informed consent, and negligence. The suit also names two seminar sponsors as defendants.
BEFORE THE CHIROPRACTIC PHYSICIANS' BOARD OF NEVADA
IN THE MATTER OF
TIMOTHY FRANCIS, D.C.
Case Nos. 14-08S
FINDINGS OF FACT, CONCLUSIONS
The Chiropractic Physicians' Board of Nevada heard this matter on May 29 and 30 and July 17, 18, and 19, 2015 in Las Vegas, Nevada. The Board's staff was represented by and through its Board Counsel, Louis Ling. Timothy Francis, D.C. was represented by Edgar Carranza of Backus, Carranza and Burden as well as Corrine Murphy of Patti, Sgro, Lewis and Roger. At the hearing, the Board presented the testimony of Jennifer Taylor and Dr. Francis (through cross-examination), and Dr. Francis presented the testimony of Jordan Bray, D.C., Darrick Sahara, D.C., and Dr. Francis. The parties stipulated to the admission of various exhibits (1-16 by Board staff and A-UU by Dr. Francis). The Board also heard fifteen voicemail messages left by Dr. Francis on Ms. Taylor's cellular telephone. Based upon the presentations of the parties and the evidence admitted by the Board, the Board finds the following to be the facts of this matter.
FINDINGS OF FACT
1. On January 1, 2003, Dr. Francis became licensed as a chiropractor in Nevada (License No. B309). At all times pertinent to this matter, Dr. Francis' practice was and is located at Chiropractic Kinesiology, 7473 W. Lake Mead Blvd., Suite 100, in Las Vegas, Nevada 89128.
2. Dr. Francis and Ms. Taylor first met in January 2012 when she was a student in a seminar, Applied Kinesiology I, taught by Dr. Francis. At this time, Ms. Taylor was 23 years old and was studying for a degree in naturopathic medicine at National University of Health Sciences in Lombard, Illinois. Dr. Francis was 56 years old, was a practitioner of chiropractic medicine in Las Vegas, Nevada, and was also a nationally renowned lecturer in applied kinesiology as well as other advanced and alternative techniques and methodologies supplemental to traditional chiropractic medicine. Dr. Francis traveled to Chicago, Illinois and taught the Applied Kinesiology I seminar one weekend per month from January through August 2012.
3. According to both Ms. Taylor and Dr. Francis, beginning in March 2012, Dr. Francis and Ms. Taylor began a personal relationship beyond the instructor-pupil association. According to Dr. Francis, by May 2012, he was in love and smitten with Ms. Taylor. According to Ms. Taylor, in May 2012, Dr. Francis began chiropractic treatment on Ms. Taylor utilizing his various techniques. According to Ms. Taylor, during one of the treatment sessions, Dr. Francis told her that he wanted to treat her exclusively and he asked that she terminate any relationship she might have had with other medical professionals.
4. According to Ms. Taylor, Dr. Francis' treatments utilized his "menuing" technique—a technique that was not being taught in the Applied Kinesiology I course in which she was enrolled—by which he would assess, diagnose, and in some cases treat Ms. Taylor. The "menuing" technique would result in a pile of handwritten notes made by Dr. Francis as he was going through his menu while muscle testing Ms. Taylor. According to Ms. Taylor, Dr. Francis would direct Ms. Taylor to hold the notes to her chest to "introduce" the contents of the notes to Ms. Taylor's body so that the body would become "aware" of the contents of the notes while he would manipulate her arms. According to Ms. Taylor, the "introduction" of the contents of the notes would often, of itself, constitute a treatment for the maladies and diagnoses contained on the notes. Ms. Taylor testified that she would gather the notes after each treatment session and keep them because they pertained to her health. At the hearing, Ms. Taylor identified Exhibits 4-15 as notes made by Dr. Francis1 during several of his treatments of Ms. Taylor, and she was able with specificity to correlate most of the note piles with particular treatment sessions. According to Ms. Taylor, the treatments would sometimes include manual, chiropractic manipulations. Additionally, the treatments usually included orders for Ms. Taylor to take various supplements and homeopathic remedies in particular quantities at specified times of the day. Often, Dr. Francis would modify the list of supplements and homeopathic remedies between treatment sessions by means unknown to Ms. Taylor, and he would transmit the modified lists via text messages or voicemail messages left on Ms. Taylor's cellular telephone.
1Exhibit 4 contains some handwriting by Ms. Taylor that she testified she made during the first of such treatments.
5. According to Ms. Taylor, Dr. Francis treated Ms. Taylor similarly to what was described in the preceding paragraph each time Dr. Francis came to Chicago to continue teaching the Applied Kinesiology I seminar. According to Ms. Taylor and Dr. Francis, throughout the period of May 2012 through January 2013, the two regularly spoke on the telephone and corresponded frequently by text and voicemail messages as their personal relationship progressed and deepened.
6. In September 2012, when Dr. Francis was no longer Ms. Taylor's instructor, Ms. Taylor flew to Las Vegas to attend a Total Body Modification conference. Ms. Taylor's testimony and Dr. Francis' testimony regarding the events of the weekend were remarkably similar with two major points of departure. Both agree that the conference was disappointing. Both agree that Dr. Francis took Ms. Taylor out to dinner on the Saturday evening of the conference (September 15, 2012) and that Ms. Taylor consumed enough alcohol to become inebriated while Dr. Francis consumed no alcohol. Both agree that Dr. Francis took Ms. Taylor in her inebriated state to her hotel room. Both agree that once in the hotel room, Dr. Francis and Ms. Taylor kissed. In the first point of departure, Dr. Francis testified that after the kiss, he left the hotel room and returned to his home, whereas Ms. Taylor testified that in the hotel room Dr. Francis provided her with a chiropractic adjustment and that thereafter Dr. Francis made several overt attempts at sexual contact including placing her hand on his erect penis and attempting to touch her vagina. Ms. Taylor testified that she rebuffed Dr. Francis' sexual contact and he subsequently left. Both parties testified that on Monday, September 17, 2012, Dr. Francis took Ms. Taylor to his office in Las Vegas to show her the office, and both parties agree that the visit lasted at least an hour. In the second point of departure, Dr. Francis testified that he took Ms. Taylor to his office in an attempt to impress her and while there, Ms. Taylor took some photographs of the office. Ms. Taylor testified that Dr. Francis treated her at his office using the previously described "menuing" techniques and that the treatment took about one hour to an hour-and-a-half.
7. While at Dr. Francis' office on September 17, 2012, Dr. Francis created two documents that he provided to Ms. Taylor, both of which were accepted into evidence as Exhibit 1. One document was entitled "Authorization for Absence" and the other was entitled "School Physical Exemption Report." Both were stamped by Dr. Francis with an address stamp he maintained in his office, and both were filled out and signed by him. In the "Authorization for Absence" form, Dr. Francis represented:
This is to certify that: Jennifer Ann Taylor is under my care. In order to avoid aggravation of a health condition, I recommend that this patient be excused from: 9-1-12 until 9-18-12. Remarks: Seminar Attendance.
In the "School Physical Exemption Report" form, Dr. Francis represented:
To the principal and teacher of Physical Education: This is to certify that I have examined the above student and found the following abnormal conditions: Ligament Stretch Syndrome / Ligament Laxity Syndrome. I hereby recommend that participation in regular physical education be restricted as checked in space below: COMPLETE. Should take no exercise—MANIPULATIONS [Dr. Francis' handwriting].
Dr. Francis further indicated on the "School Physical Exemption Report" that the duration of the exemption was for the entire school year. Ms. Taylor testified that in addition to the "Authorization for Absence" and "School Physical Exemption Report" documents, Dr. Francis also provided her with a form entitled "Symptom Survey Form" on which Dr. Francis placed the same rubber stamp as the other two documents and wrote his name and facsimile machine number in the upper right-hand corner. The "Symptom Survey Form" was accepted into evidence as Exhibit 2.
8. At hearing, Ms. Taylor explained that Dr. Francis comprised the "Authorization for Absence" form to excuse her absence from a day of class because of her attendance at the Total Body Modification seminar and that he comprised the "School Physical Exemption Report" to further his earlier stated intention that she only treat with him and with no other health care professionals. Ms. Taylor further explained that Dr. Francis provided her with the "Symptom Survey Form" so that if she experienced any of those symptoms while she was in Chicago, she could fax the form to him in his office so that he could develop a list of supplements and homeopathic remedies as treatments for her symptoms. Ms. Taylor testified that she did not need either the "Authorization for Absence" form (because she had sufficient ability to excuse her one day of absence without the form) or the "School Physical Exemption Report" (because she did not need the form to refuse manipulations that might be part of the hands-on curriculum at her school), but that Dr. Francis insisted on creating and providing to her the two forms. The facts bear out that Ms. Taylor did not need either of the two forms because she still had the originals of both in her possession from which the copies that were presented to the Board were made. At hearing, Dr. Francis admitted that he created the "Authorization for Absence" form and the "School Physical Exemption Report" for Ms. Taylor during her visit to his office, and Dr. Francis gave two contradictory explanations about how Ms. Taylor might have come into possession of the "Symptom Survey Form," one of which is that he may have provided it to her during her visit to his office. Dr. Francis did explain at length at hearing that he regularly provides the "Symptom Survey Form" to his out-of-town patients for the very purpose also testified to by Ms. Taylor, namely so that the out-of-town patient who was experiencing symptoms could fax the form to him in his office in Las Vegas. Upon receipt of his patient's fax, he would order supplements and homeopathic remedies appropriate to treat the patient until he or she could visit Dr. Francis in person at his office.
9. Regarding the interaction between Dr. Francis and Ms. Taylor in September 2012 in Las Vegas, Nevada, the Board believes that the preponderance of the reliable, credible, and probative evidence adduced at hearing supports the conclusion that Dr. Francis did treat Ms. Taylor as a patient as part of a then ongoing course of treatment of her by him as her treating chiropractic physician. The "Authorization for Absence" and the "School Physical Exemption Report" forms both expressly certify that Dr. Francis was Ms. Taylor's treating physician, that he had examined her, and that in the case of the "School Physical Exemption Report," he had diagnosed her with two conditions based upon his examination of her. By Dr. Francis' own testimony, the "Symptom Survey Form" was routinely provided by him to his out-of-town patients for the very reason to which both he and Ms. Taylor testified, namely to assist him in treating the out-of-town patient until the patient could be seen by him in person. Furthermore, both parties testified that Ms. Taylor was at the office for at least an hour or more, and Dr. Francis' testimony could not account for the majority of the time spent at the office, making Ms. Taylor's testimony that he treated her as his patient while she was at his office credible and believable while conversely making his testimony incredible and unbelievable.
10. Throughout the period after the weekend in September 2012 and January 2013, Dr. Francis and Ms. Taylor continued to correspond by telephone, text, and voicemail, and included an exchange of gifts and cards appropriate to a burgeoning personal relationship. Ms. Taylor testified that Dr. Francis had muscle tested himself and determined that they were perfectly compatible (99 out of 100), that they had been married 33 previous times over the 155 lifetimes that they had known each other, and that she would not be happy until she broke up with her then boyfriend and married Dr. Francis. Both parties testified that in this period, marriage was discussed, having children was discussed, and certain affirmative acts in furtherance of marriage occurred, including Dr. Francis' arranging for Ms. Taylor to speak with his mother about Dr. Francis' intentions toward Ms. Taylor. According to Ms. Taylor, the course of treatments continued as before, including treatments he rendered to her when he was in Chicago at the end of October 2012.
11. According to Ms. Taylor, in early January 2013, Dr. Francis muscled tested that Ms. Taylor had trichomonous vaginal is, a sexually-transmitted disease. According to Dr. Francis, in early January 2013, Ms. Taylor contacted him (even though he repeatedly denied being her treating chiropractic physician) and informed him that she suspected she had a sexually-transmitted disease. Dr. Francis recommended that Ms. Taylor contact a close friend and colleague of his, Dr. Carlotta Watson, who was a licensed naturopathic physician in Portland, Oregon, because Dr. Watson could prescribe a prescription drug to treat the STD that Dr. Francis could not prescribe. Dr. Watson subsequently contacted Ms. Taylor on January 14, 2013 at 9:32 p.m. Portland time (11 :32 p.m. Ms. Taylor's time) using her personal cellular telephone (not her office telephone), and in the course of a three minute and eight second telephone call determined that Ms. Taylor had trichomoniasis vaginalis. Thereafter, Dr. Watson called in a prescription for Metronidazole, a drug used to treat trichomonous, to a Walgreens pharmacy in Lombard, Illinois that was proximate to Ms. Taylor's apartment. Ms. Taylor did pick up the prescription called in by Dr. Watson, but Ms. Taylor took none of the tablets prescribed to her. According to Ms. Taylor, at the time she spoke with Dr. Watson, Ms. Taylor had no symptoms of an STD and had had no diagnostic testing performed or ordered that would verify whether she had an STD. Subsequently, Ms. Taylor informed her boyfriend of Dr. Francis' muscle-tested conclusion that she had an STD. As a result, both she and her boyfriend had themselves tested and both were negative for any STDs.
12. During the course of the four nights that Dr. Francis was in Chicago to teach a seminar between January 17-21, 2013, he and Ms. Taylor had sexual intercourse three times. Both parties agree that the condom Dr. Francis used was compromised during one of the sexual incidents. According to Ms. Taylor, Dr. Francis muscle tested and "menued" her—a finding of "your gravid uterus" in Dr. Francis' handwriting was in the treatment sheets that are Exhibit 10—and diagnosed that Ms. Taylor was pregnant. According to Dr. Francis, Ms. Taylor expressed to him her concern that she might be pregnant. To address the potential pregnancy, Ms. Taylor purchased and took an over-the-counter emergency contraceptive. According to Ms. Taylor, Dr. Francis also treated her several times over the course of the weekend using the techniques previously discussed.
13. Despite Dr. Francis' claim that Ms. Taylor "broke up" with him at the end of the January 2013 weekend, the preponderance of the evidence demonstrated that the parties continued to have a chiropractor-patient relationship simultaneously with a personal relationship throughout the period of January through October 2013. At hearing, the Board reviewed six text messages and heard fourteen voicemail messages all created by Dr. Francis and left on Ms. Taylor's cellular telephone. The texts and voicemail messages date from February 11, 2013 through July 23, 2013. Though Dr. Francis and Dr. Bray attempted in their testimonies to characterize the texts and voicemail messages as something other than treatment orders from Dr. Francis to Ms. Taylor, their testimony as to this point was not credible. The texts and voicemail messages are clearly and obviously orders by Dr. Francis to Ms. Taylor, including that she wear certain colored glasses for specified periods of time and that she take certain supplements and homeopathic remedies in specific quantities at specific times. In fact, Dr. Francis testified that when he ordered such supplements and homeopathic remedies for patients in his office, he ordered the products in exactly the same way as is seen in the texts and voicemail messages in evidence, except that he provides patients in his office with a piece of paper on which the lists of supplements and homeopathic remedies are placed on a schedule.
14. Dr. Bray's attempt to describe the information in the texts and voicemail messages as recommendations by Dr. Francis for Ms. Taylor's alleged treatment of mock patients or patients she might have seen in a clinic as part of her training—in particular his persistent refusal to acknowledge that the word "you" in the texts and voicemail messages was Ms. Taylor—made Dr. Bray's testimony on this point incredible, unbelievable and evidenced his extreme bias and prejudice in favor of his teacher and mentor, Dr. Francis. Dr. Francis' explanation was equally unbelievable, i.e. that the texts and voicemail messages were for Ms. Taylor, but were not orders by a chiropractor to his patient. Additionally, Dr. Francis tried to persuade the Board that these orders were instead "suggestions" that she might discuss with Dr. Bray in order for Dr. Bray to muscle test them on Ms. Taylor during Dr. Bray's treatment of Ms. Taylor at the NUHS clinic. Dr. Francis' and Dr. Bray's explanations are mutually exclusive and incapable of being reconciled, and both belie the very clear language of the texts and voicemail messages themselves. At hearing, Dr. Francis admitted that some of the texts and voicemail messages were referential to each other, and many of the voicemail messages revealed a clear and continuing course of treatment by Dr. Francis of Ms. Taylor, including sequential therapy modifications in May and June 2013 that clearly evidence a therapeutic relationship. Inasmuch as both Dr. Francis and Dr. Bray were personally close with Ms. Taylor at the time that many of the texts and voicemails were made, their stories should have jibed in order to have any credibility. Dr. Francis presented no evidence to support either his or Dr. Bray's explanations regarding the texts and voicemail messages other than his and Dr. Bray's conflicting testimonies. In fact, Dr. Francis' testimony is the only testimony or evidence provided that Dr. Bray ever treated Ms. Taylor as a patient; neither Dr. Bray nor Ms. Taylor mentioned any such treatment or therapeutic relationship in either of their extensive testimonies.
15. Ms. Taylor, Dr. Francis, and Dr. Bray all testified that by the fall of 2013, Ms. Taylor was estranged from Dr. Francis and Dr. Bray. According to Ms. Taylor, through the fall of 2013 and into the winter of 2014, Ms. Taylor was in a state of unresolved emotional turmoil related to her relationship with Dr. Francis. According to Ms. Taylor, she sought assistance with her emotional issues by speaking with a psychology professor at NUHS, who then referred her to another professor, Dr. Bruce Hodges, who taught ethics and boundary issues at NUHS. When she met with Dr. Hodges, Ms. Taylor discussed with him her circumstances regarding Dr. Francis without using Dr. Francis' name. Dr. Hodges asked Ms. Taylor in what state the chiropractor was licensed. When Ms. Taylor told Dr. Hodges that the chiropractor was licensed in Nevada, he searched the Board's website for a consumer complaint form, which he then printed, gave to Ms. Taylor, and recommended that she fill it out and send it to the Board. Ms. Taylor did as Dr. Hodges recommended and filled out the Board's consumer complaint form on February 25, 2014, which she subsequently sent to the Board.
16. The central factual questions in this matter to determine whether Dr. Francis engaged in unprofessional conduct by simultaneously engaging in a sexual, romantic and/or a dating relationship with Ms. Taylor were: (1) Was Ms. Taylor a patient being treated by Dr. Francis, and (2) If so, when did Ms. Taylor become Dr. Francis' patient? Dr. Francis and his witness, Dr. Bray, repeatedly denied that Ms. Taylor was ever Dr. Francis' patient, and because Ms. Taylor testified that she was treated by Dr. Francis as his patient beginning in May 2012 and through July 2013, the Board must resolve issues of credibility. The preponderance of the probative, reliable, and credible evidence showed that Ms. Taylor was a patient under the treatment of Dr. Francis at least from September 2012 through July 2013. The Board's observation of the demeanor of the various witnesses supported a finding that Ms. Taylor's testimony was credible, Dr. Bray's testimony was mostly incredible, Dr. Sahara's testimony was credible, and Dr. Francis' testimony was mostly incredible with respect to his treatment of Ms. Taylor. Following is a discussion regarding the findings of credibility related to each witness.
17. Ms. Taylor's testimony was credible. It was extremely detailed, accurate, and consistent with the events described and the documentary evidence. Throughout her testimony, Ms. Taylor seemed genuinely concerned that she answered the questions asked to the best of her ability, regardless of whether during direct or cross-examination. Ms. Taylor's demeanor was often nervous, emotional, or tired, and she occasionally exhibited confusion, but the confusion was always related to questions related to her emotional state and was never regarding factual issues. Ms. Taylor's demeanor indicated that she was deeply trusting of, and reliant upon, Dr. Francis to her detriment, and under close questioning by various of the Board members, it was apparent that she still believes in Dr. Francis' techniques. Further, she appeared to be genuinely and sincerely conflicted and damaged by the effect and power she maintains that Dr. Francis exerted over her.
18. Dr. Bray's testimony was almost entirely unbelievable. Dr. Bray persistently evaded answering simple questions. Dr. Bray insisted time and again that documents did not mean what they actually stated. He always dodged the obvious answer by insisting that the real answer lay in texts and voicemails that he imagined to exist though they were not in evidence at the hearing. Dr. Bray's demeanor was evasive, pompous, and condescending. Dr. Bray's admiration of Dr. Francis bordered on the sycophantic, while his occasional character attacks on Ms. Taylor were perceived as calculated, mean spirited, and gratuitous. Dr. Bray's testimony appeared carefully tailored to anticipate the evidence he knew would be presented to the Board. His script avoided use of words such as "patient," "treatment," and "order," that might indicate that Dr. Francis was treating Ms. Taylor as a patient. Moreover, he refused to acknowledge that the word "you" in the various texts and voicemail messages between Dr. Francis and Ms. Taylor could or did refer to Ms. Taylor.
19. Dr. Sahara's testimony was credible but not helpful to Dr. Francis' position on the key questions in the case. Dr. Sahara's testimony established that he was a student of Dr. Francis who then transitioned into becoming a patient of Dr. Francis and thereafter, a personal friend, colleague, and fellow practitioner of the techniques used by Dr. Francis. Dr. Sahara's demeanor was appropriate and seemed intended to be helpful to the Board. Dr. Sahara testified truthfully even when the testimony was not helpful to Dr. Francis' position, most notably when Dr. Sahara testified that he would never have issued the documents contained in Exhibit 1 unless he was, in fact, the treating chiropractor for the patient at issue.
20. Dr. Francis' testimony was mostly incredible when discussing his treatment of Ms. Taylor. As with Dr. Bray, Dr. Francis' testimony seemed tailored to avoid or refute the evidence he knew was before the Board, and in so doing, he persistently and assiduously had to explain how the documents he created did not really mean what they said. Dr. Francis cheerfully admitted that both documents in Exhibit 1 were lies and that he was, therefore, a liar. Oddly, though, the preponderance of the evidence showed that in admitting that he was lying about Exhibit 1, Dr. Francis was lying about lying because the documents in Exhibit 1 were, in fact, true—he was, in fact, Ms. Taylor's treating chiropractic physician, just as Exhibit 1 certified. As another example, Dr. Francis testified that Ms. Taylor had "broken up" with him at the end of the weekend they were together in January 2013, but texts and voicemail messages from him only weeks later were laden with romantic overtures and overtones. As yet another example, Dr. Francis' claim that the personal relationship had ended in January 2013 was belied by his own evidence, namely a letter he introduced (Exhibit BB) that was written by Ms. Taylor's boyfriend in July 2013 in which Ms. Taylor's boyfriend expressed a concern that indicated that Ms. Taylor was still torn personally between her feelings for her boyfriend and her feelings for Dr. Francis. The overall impression of Dr. Francis' testimony was that it presented a telling of the tale that often belied the evidence he had created at the time of the events in the matter, as if the person at hearing disagreed with himself and what he said at the time the events were actually transpiring. It appeared that Dr. Francis was most sincere when he was talking about the twists and turns of his personal relationship with Ms. Taylor and the pain it caused him and when he was describing in considerable and vivid detail his idiosyncratic and esoteric healing systems, knowledge, and techniques. Dr. Francis' demeanor was a mixture of friendliness, professionalism, and self-aggrandizing superiority—simultaneously captivating and repellent—and it seemed to support the view of him that Ms. Taylor described in her testimony. As with Dr. Bray, Dr. Francis' occasional slips into character destruction of Ms. Taylor seemed calculated and gratuitous, and did not serve his credibility well.
CONCLUSIONS OF LAW
1. The Board has jurisdiction over this matter because Timothy Francis, D.C. is licensed by this Board as a chiropractic physician (License No. B309).
2. In engaging in a romantic or dating relationship with Ms. Taylor commencing in at least September 2012, including engaging in sexual relations as part of the relationship in September 2012 and January 2013, while he was her treating chiropractic physician and she was his patient, Dr. Francis violated NRS 634.018(10), NRS 634.018(11), NRS 634.018(17), NRS 634.140(1), NAC 634.430(1)(a) and NAC 634.430(1)(0).
3. In failing to make or maintain any health care records regarding his diagnoses and treatment of his patient, Ms. Taylor, Dr. Francis violated NRS 634.018(10), NRS 634.018(11), NRS 634.018(17), NRS 634.140(1) and NAC 634.435.
4. Because the central legal issue in this matter was if and when did Ms. Taylor become Dr. Francis' patient to determine whether they were simultaneously engaging in a sexual, romantic, and/or dating relationship, the Board will explain its conclusion that Ms. Taylor was Dr. Francis' patient commencing in at least September 2012. The analysis of when a chiropractor-patient relationship arises is a question of substance and function over form and formality. A chiropractor-patient relationship is formed when a patient seeks chiropractic counsel, advice, examination, diagnosis, and/or treatment from a chiropractor for a particular cause or reason and the chiropractor willingly and intentionally provides such counsel, advice, examination, diagnosis, and/or treatment. The extensive deliberation by the Board regarding this issue showed varied approaches and views on the testimony and evidence, but the consensus of the Board was that by September 2012, the preponderance of the reliable, probative, and credible evidence was that Dr. Francis was treating Ms. Taylor as a patient, including examining her and treating her through traditional chiropractic and through his idiosyncratic and esoteric techniques. Thus, when the two kissed in Ms. Taylor's hotel room (regardless of what else may have happened), the kiss was between a chiropractic physician and his patient, which is strictly prohibited by NAC 634.430(1)(a) and (2)(c)(1) and (2). Similarly, when the two engaged in sexual relations during the weekend in January 2013, the sexual relations were between a chiropractic physician and his patient, which was strictly prohibited by NAC 634.430(1)(a) and 2(c)(I).
5. The Board's charge, per NRS 634.019, is that the "practice of chiropractic is hereby declared to be a learned profession, affecting public safety and welfare and charged with the public interest, and therefore subject to protection and regulation by the State." The instant case is a clear exemplar of why, for the promotion of public safety and welfare, the professional boundaries between a chiropractic physician and his patients must stay sharp and clean. The preponderance of the reliable, probative, and credible evidence showed that Dr. Francis did not keep his professional boundaries sharp and clean, and, instead he regularly blurred his professional obligations by being Ms. Taylor's instructor, personal coach, treating chiropractic physician, mentor, suitor, and (eventually) lover. The Board interprets: enforces NAC 634.430(1)(a) and 2(c) as intended to assure a sharp and clean professional boundary a chiropractic physician such that at no time can he or she use her special knowledge and therapeutic relationship with a patient to cajole, coax, influence, persuade, or force a patient to engage in sexual relations. As the final sentence in NAC 634.430(2)( c) makes clear, if a chiropractic physician and patient find themselves in the midst of a mutual attraction, the chiropractic physician—as the professional in the budding relationship—must terminate the therapeutic relationship and allow for passage of a reasonable time before initiating sexual relations with the patient so that when the sexual relationship commences, the chiropractic physician and the patient are free of any taint of undue influence that the therapeutic relationship may have created. Dr. Francis' seemed unaware of his professional boundaries, and, thus, he crossed them all too easily with Ms. Taylor, causing them both considerable pain and harm.
Based upon the foregoing, the Board hereby orders the imposition of the following discipline:
1. Dr. Francis shall pay the Board's fees and costs incurred in the investigation and prosecution of this matter in the total amount of $60,484.16. The fees and costs shall be payable by cashiers or certified check or money order made payable to: "Chiropractic Physicians' Board of Nevada." Dr. Francis shall contact the Executive Director within ten days of the effective date of this Order to make payment arrangements such that the fees and costs are fully paid on or before the expiration of the probationary period in Paragraph 2. The probationary period shall not terminate unless and until the Board has received all fees and costs.
2. Dr. Francis' chiropractic physician's license (License No. B309) shall be placed on probation for a period of three years from the effective date of this Order upon the following terms and conditions:
(a) Dr. Francis shall take and pass all five topic areas of the EBAS Essay Examination within three months of the effective date of this Order. Dr. Francis can obtain information regarding the EBAS Essay Examination and an Application Form from www.ebas.org. Dr. Francis shall pay the costs associated taking and passing the selected portions of the EBAS Essay Examination. Dr. Francis shall provide written documentation of the successful completion of the EBAS Essay Examination to the Board's office within three months of the effective date of this Settlement Agreement and Order.
(b) Dr. Francis shall take and pass the Board's jurisprudence examination within three months of the effective date of this Order.
(c) Within one month from the date of the successful completion of the EBAS Essay Examination, Dr. Francis shall submit to the Investigating Board Member (IBM) a written correction plan addressing what concrete policies, procedures, and steps he intends to take regarding his teaching and chiropractic practices to assure that he maintains proper and distinct professional boundaries between his students, his mentees, his personal friends, his paramours, and his patients. The IBM shall review the correction plan upon his receipt of it. If the IBM determines that the correction plan will, if followed, assure that Dr. Francis understands and respects the boundaries of his various roles, then the IBM will so notify Dr. Francis in writing. If the IBM determines that the correction plan needs changes or additions, the IBM will contact Dr. Francis and the two will work together in good faith to develop a final correction plan that satisfies the IBM. Once the IBM has approved the correction plan, Dr. Francis shall implement and follow the correction plan. The IBM may speak with Dr. Francis, visit Dr. Francis' office, class or seminar announced or unannounced, review any of Dr. Francis' patient charts or other documents used by Dr. Francis in his teaching or practice, or use any other reasonable means to verify that Dr. Francis is following and in compliance with the correction plan. Any violation of the terms of the correction plan shall be deemed a violation of this Order.
(d) Dr. Francis shall obey all laws related to the practice of chiropractic medicine, whether state or federal and whether statutory or by regulation.
(e) Dr. Francis shall meet with the Board or its representatives upon request and shall cooperate with such representatives in their supervision, monitoring, investigation, or auditing to assure compliance with the terms and conditions of this order. Dr. Francis shall pay any and all reasonable and necessary costs incurred by the Board resultant from this paragraph.
3. In the event Dr. Francis fails to materially comply with any term of this Order, the IBM may suspend Dr. Francis' chiropractic physician's license without any action of the Board other than the issuance of an Order of Suspension by the IBM. Upon complying with the term, Dr. Francis' chiropractic physician's license in the State of Nevada will be automatically reinstated, assuming all other provisions of this Order are in compliance. Additionally, Dr. Francis' failure to comply with any term or condition of this Order may result in further discipline by the Board, up to and potentially including revocation of his license. Board staff may take any and all actions it deems necessary to collect any sums ordered that remain unpaid. If Board staff is required to pursue judicial action to effect such collections, it shall be entitled to recover its attorney's fees and costs incurred in pursuing such judicial action.
Signed and effective this 20th day of August, 2015.
SHELL MERCER, J.D., Presiding Officer
This article was posted on October 12, 2015.