Title: IN THE DISCIPLINARY MATTER OF STUART H. GREENE, D.C., LICENSE NUMBER 366: STUART H.GREENE, D.C., V. STATE OF WYOMING, ex rel. WYOMING BOARD OF CHIROPRACTIC EXAMINERS

State: wyoming

Issuer: Wyoming Supreme Court

Document:

IN THE DISCIPLINARY MATTER OF STUART H. GREENE, D.C., LICENSE NUMBER 366: STUART H.GREENE, D.C., V. STATE OF WYOMING, ex rel. WYOMING BOARD OF CHIROPRACTIC EXAMINERS2009 WY 42204 P.3d 285Case Number: NO. S-08-0137Decided: 03/25/2009
OCTOBER 
TERM, A.D. 2008

 
 

IN 
THE DISCIPLINARY MATTER OF STUART H. GREENE, D.C., LICENSE NUMBER 
366,STUART H. GREENE, 
D.C.,Appellant(Petitioner),v.STATE OF WYOMING, ex 
rel., WYOMING BOARD OF CHIROPRACTIC 
EXAMINERS,Appellee(Respondent).

 
 

Appeal 
from the District Court of Laramie County

The 
Honorable Michael K. Davis, Judge

 
 
Representing 
Appellant:

Bill 
G. Hibbler, Bill G. Hibbler, P.C., Cheyenne, Wyoming.

 
 
Representing 
Appellee:

Bruce 
A. Salzburg, Attorney General; Michael L. Hubbard, Deputy Attorney General; Ryan 
Schelhaas, Senior Assistant Attorney General; Kennard F. Nelson, Senior 
Assistant Attorney General.  
Argument by Mr. Nelson.

 
 
Before 
VOIGT, C.J., and GOLDEN, HILL, KITE, and BURKE, JJ.

 
 

KITE, 
Justice.

 
 
[¶1]  Two patients of licensed chiropractor 
Stuart H. Greene filed complaints against him with the Wyoming Board of 
Chiropractic Examiners (Board).  
Following a contested case hearing, the Board entered an order dismissing 
one of the complaints and indefinitely suspending Dr. Greene's license to 
practice as a chiropractor based on the second complaint.  Dr. Greene sought review in district 
court, which affirmed the order.  On 
appeal to this Court, he claims the Board's order is arbitrary, capricious, an 
abuse of discretion, and not in accordance with the law because of several 
evidentiary errors, and not supported by substantial evidence.  We affirm.  

 
 
ISSUES

 
 
[¶2 
]  The issues for our determination 
are:

 
 
1.         
Whether the Board's order is arbitrary and capricious, an abuse of 
discretion, or otherwise contrary to law because:

 
 

a.       
The 
Board denied Dr. Greene access to SS's mental health records and inquiry into 
her mental health;

 
 

b.      
The 
Board considered evidence and issues of which Dr. Greene received no 
notice;   

 
 

c.       
The 
Board allowed a witness to testify who did not file a complaint against Dr. 
Greene;

 
 

d.      
The 
Board failed to explain its reasoning for rejecting expert witness testimony 
favorable to Dr. Greene; and, 

 
 

e.       
The 
Board violated Dr. Greene's due process rights when it allowed access to and use 
of his expert witnesses' professional licensing records.

 
 
2.         
Whether the Board's order was supported by clear and convincing 
evidence.

 
 
FACTS

 
 
[¶3]   Dr. Greene was licensed in Wyoming 
to practice as a chiropractor.  In 
October of 2002, the Board received a complaint from one of his patients.  Among other claims, she alleged that in 
the course of treating her in 2001 Dr. Greene had made sexual advances toward 
her.  While that complaint was 
pending, the Board received a complaint from another patient of Dr. 
Greene's.  The second complaint, 
filed by SS, alleged that Dr. Greene sexually assaulted her during treatment in 
November of 2003.  The Board 
notified Dr. Greene about the complaints and he denied the 
allegations.

 
 
[¶4]  The Board assigned the complaints to one 
of its members for investigation.  
Following the investigation, in 2006, the Board notified Dr. Greene that 
the investigating Board member together with the Wyoming Attorney General's 
Office (the State) intended to pursue disciplinary action against him as a 
result of the complaints for alleged violations of § 33-10-110 of the 
Chiropractic Practice Act, Wyo. Stat. Ann. §§ 33-10-101 through 33-10-117 
(LexisNexis 2005), and Chapter 6, Section 2 of the State Board of Chiropractic 
Rules and Regulations (Board Rules).    

 
 
[¶5]  Section 33-10-110 provides in pertinent 
part:

 
 
(a)  It shall be unlawful for any holder of a 
license according to this chapter to commit any of the following 
acts:

. 
. . .

        
(vi)  To be guilty of any . . 
. unethical or unprofessional conduct likely to . . . harm the public[.] 

. 
. . .

(b)  . . . [T]he board may revoke the license 
and certificate or suspend the license and certificate of any licensee proved 
guilty of any of the acts stated in section (a).

 
 
[¶6]  Chapter 6, Section 2 of the Board Rules 
gives the Board the authority to suspend or revoke a license or take other 
disciplinary action for the following reasons not set forth in the 
statutes:

. 
. . .

(b)  Immoral, unprofessional or dishonorable 
conduct;

(c)  Practicing chiropractic in such a manner 
as to endanger the welfare of clients or patients; 

. 
. . .

(f)  Engaging in . . . sexual . . . contact 
with a client or patient[.]  

 
 
[¶7]  Dr. Greene reiterated his denial of the 
charges and the Board scheduled the matter for hearing.1  The State filed a petition and 
complaint, asserting the acts complained of 

were 
inappropriate, not valid, necessary or acceptable and outside the scope of 
acceptable standards of chiropractic practice.  The State further alleged that in the 
course of investigating the complaints, another former patient of Dr. Greene's 
had come forward with an allegation that Dr. Greene touched her in an 
inappropriate way during treatment.  
The State sought revocation of Dr. Greene's license. 

 
 
[¶8]  Over the course of four days in March 
and April of 2007, the Board conducted a contested case evidentiary 
hearing.  After the hearing, the 
Board entered findings of fact, conclusions of law and an order finding the 
State had proven by clear and convincing evidence that Dr. Greene violated § 
33-10-110(a)(vi); Chapter 6, Section 2(b), (c), (f), (o) and (r) of the Board 
Rules; and the American Chiropractic Code of Ethics A(6), A(7), A(10) and 
C(2).  The Board ordered Dr. 
Greene's license suspended indefinitely with the opportunity to apply for 
reinstatement upon satisfying specified conditions.  Dr. Greene filed a petition for review 
of the Board's order in district court.  
The district court entered an order affirming the suspension of Dr. 
Greene's license, and Dr. Greene appealed to this Court.  While the appeal was pending, Dr. Greene 
filed a motion to stay the order suspending his license until the appeal was 
decided.  We granted the 
motion.                 

 
 
STANDARD 
OF REVIEW

 
 
[¶9] 
 We review an administrative 
decision as if it came directly from the agency and do not defer to the district 
court's ruling.  Dale v. S & S Builders, LLC, 2008 WY 
84, ¶ 8, 188 P.3d 554, 557 (Wyo. 2008).  
Rulings on the admission of evidence are within the sound discretion of 
the agency as the trier of fact; we will set aside an evidentiary determination 
only if the agency abused its discretion.  
McIntosh v. State ex rel. Wyo. 
Med. Comm'n, 2007 WY 108, ¶ 42, 162 P.3d 483, 494 (Wyo. 2007).  We review an agency's conclusions of law 
de novo, and affirm such conclusions 
only when they are in accordance with the law.  Id.  

 
 
[¶10]  Disciplinary actions before licensing 
boards require a more exacting level of proof than typical administrative 
actions.  Dorr v. Wyo. Bd. of Cert. Pub. 
Accountants, 2006 WY 144, ¶ 13, 146 P.3d 943, 949 (Wyo. 
2006).

 
 
A 
disciplinary proceeding before a licensing board is an adversary proceeding 
where the burden is on the complaining party to present its case in a proper 
manner and to state with precision the charges against the licensee.  Those charges must be established by 
clear and convincing evidence.  We 
have defined clear and convincing evidence to be the "kind of proof which would 
persuade a trier of fact that the truth of the contention is highly 
probable."  

 
 

Id. 
(citations omitted).  

 
 
[¶11]  We apply the arbitrary and capricious 
standard when agency action prejudices a party's substantial rights or is 
contrary to, but does not easily fall within, the other standards of 
review.  Id.  The arbitrary and capricious standard is 
not meant to apply to true evidentiary questions but applies instead when, for 
example, an agency refuses to admit clearly admissible testimony or exhibits or 
fails to provide appropriate findings of fact or conclusions of law.  Id.              

 
 
DISCUSSION

 
 
1.         
Evidentiary Error

 
 
[¶12]  Dr. Greene asserts the Board committed 
evidentiary error in five instances.  
We consider each of his claims separately.  We begin with his contention that the 
Board erred when it denied him access to SS's mental health records and the 
right to inquire into her mental health.

 
 
a.         
Mental Health Records

 
 
[¶13]  After receiving notice of SS's 
complaint, Dr. Greene attempted to obtain copies of her mental health 
records.  SS objected to production 
of the records.  Dr. Greene then 
served SS with a subpoena duces tecum to produce the records at a 
deposition.  SS did not produce the 
records and declined to answer questions concerning her mental health treatment 
during her deposition.  Dr. Greene 
filed a motion to compel production of the records and to require SS to appear 
and answer questions concerning her treatment.  Following a hearing, the Office of 
Administrative Hearings (OAH) examiner denied the motion finding that the 
information Dr. Greene sought was protected by the patient-mental health 
professional privilege provided for in Wyo. Stat. Ann. § 33-27-123 and § 
33-38-113 (LexisNexis 2005) and did not fall within any exception.  

 
 
[¶14]  Dr. Greene contends it was error to deny 
him access to SS's mental health information because she placed her mental 
health at issue by filing the complaint against him.  He cites § 33-27-123(a)(vi), governing 
privileged communications between psychologists and patients, and § 
33-38-113(a)(iii), governing such communications between professional counselors 
and patients, as support for his claim that the information was not privileged 
under the circumstances.  Those 
provisions state in pertinent part as follows:

 
 
§ 
33-27-123.  Privileged 
communication.

 
 
(a) In judicial proceedings, whether civil, 
criminal, or juvenile, in administrative proceedings, and in proceedings 
preliminary and ancillary thereto, a patient or client, or his guardian or 
personal representative, may refuse to disclose and may prevent the disclosure 
of confidential information, including information contained in administrative 
records, communicated to a person licensed or otherwise authorized to practice 
under this act, or to persons reasonably believed by the patient or client to be 
so licensed, and their agents, for the purpose of diagnosis, evaluation or 
treatment of any mental or emotional condition or disorder.  The psychologist or school psychologist 
shall not disclose any information communicated as described above in the 
absence of the express waiver of the privilege except in the following 
circumstances:

 . . . .

    (vi)  Where the patient or client, by alleging 
mental or emotional damages in litigation, puts his mental state in issue and 
production of those materials by the patient or client is required by law. 

 
 
§ 
33-38-113.  Privileged 
communication.

 
 
(a)  In judicial proceedings, whether civil, 
criminal, or juvenile, in legislative and administrative proceedings, and in 
proceedings preliminary and ancillary thereto, a patient or client, or his 
guardian or personal representative, may refuse to disclose or prevent the 
disclosure of confidential information, including information contained in 
administrative records, communicated to a person licensed or otherwise 
authorized to practice under this act, and their agents, for the purpose of 
diagnosis, evaluation or treatment of any mental or emotional condition or 
disorder.  A person licensed or 
otherwise authorized to practice under this act shall not disclose any 
information communicated as described above in the absence of the express waiver 
of the privilege except in the following circumstances:

. 
. . .

(iii)  Where such information is necessary to 
defend against a malpractice action brought by the patient or 
client[.]

 
 
Dr. 
Greene contends SS put her mental state in issue by filing a complaint against 
him with the Board and that information concerning her mental health was 
necessary for him to defend himself before the Board against what were 
essentially allegations of malpractice. 

 
 
[¶15] 
The standards governing our interpretation of statutes are 
well-established.

 
 
We 
begin by making an inquiry respecting the ordinary and obvious meaning of the 
words employed according to their arrangement and connection.  We construe the statute as a whole, 
giving effect to every word, clause, and sentence, and we construe all parts of 
the statute in pari materia.   When a statute is sufficiently 
clear and unambiguous, we give effect to the plain and ordinary meaning of the 
words and do not resort to the rules of statutory construction.  

            

KO 
v. LDH 
(In re MEO), 2006 WY 87, ¶ 18, 138 P.3d 1145, 1151 (Wyo. 2006).  
Applying these standards, we conclude that neither of the exceptions upon 
which Dr. Greene relies applied under the facts of this case.  

 
 
[¶16]  For the exception in § 33-27-123(a)(iii) 
to apply, a patient must allege mental or emotional damages in litigation.  SS did not allege mental or emotional 
damages in litigation; rather, she was a witness in an administrative licensing 
proceeding before the Board to determine whether Dr. Greene had violated the 
Practice Act and whether his license should be suspended.  No damages were recoverable in that 
proceeding nor did SS allege any damages.  
The mere fact that SS testified as a witness in the disciplinary 
proceeding did not place her mental status in issue, nor did it constitute a 
waiver of the privilege existing between her and her treating therapist.  See St. Lucia v. Novello, 726 N.Y.S.2d 488, 
490 (N.Y. 2001) (holding a patient's testimony in a disciplinary hearing 
involving claims of moral unfitness to practice medicine brought against her 
general surgeon did not place the witness's psychological status in issue, nor 
did it constitute a waiver of the patient-therapist privilege).  

 
 
[¶17]  For the exception contained in § 
33-38-113(a)(iii) to apply, the mental health information sought must be 
necessary to defend against a malpractice action brought by the patient.  SS did not file a malpractice action 
against Dr. Greene; rather, she filed a complaint with the disciplinary board 
and was subpoenaed to testify at an administrative hearing brought by the 
Board.  Giving effect to the plain 
and ordinary meaning of the words, SS did not waive her privilege and Dr. Greene 
was not entitled to disclosure of her mental health 
information.

 
 
b.         
Lack of Notice

 
 
[¶18]  Dr. Greene asserts that the Board erred 
in considering evidence of which he had no notice.  He points specifically to the following 
findings of the Board:

 
 
His 
conduct has the appearance of professional impropriety when he hugs, kisses, 
moans, and rubs his groin area against his patients, and more specifically [SS]. 
The practice of chiropractic medicine has a definite component of touching but 
it is clearly unethical and a violation of the Practice Act and Board's Rules 
for Dr. Greene to have inserted his own affection into the therapeutic 
treatments he provided to [SS], including . . . pressing his groin area against 
her.

 
 
Dr. 
Greene asserts he had no notice of evidence showing that he pressed his groin 
against SS; inserted affection into his treatments; or acted improperly with 
patients other than the two complaining witnesses and the witness who came 
forward during the investigation.  Dr. Greene cites Slagle v. Wyo. State Board of Nursing, 
954 P.2d 979 (Wyo. 1998) as support for his contention that the Board violated 
his right to due process by considering this evidence without giving him prior 
notice.

 
 
[¶19]  Ms. Slagle was licensed in Wyoming as an 
advanced nurse practitioner and treated prisoners in the Fremont County 
jail.  The State Board of Nursing 
received a complaint against Ms. Slagle from one of the prisoners.  The Board of Nursing requested 
information from Ms. Slagle concerning her standing as an advanced nurse 
practitioner and notified her that her license was limited to geriatric 
patients.  The Nursing Board did not 
notify her concerning the prisoner complaint.

 
 
[¶20]  Ms. Slagle, her supervising physician 
and the director of the nursing program where she obtained her degree sent 
information to the Nursing Board concerning Ms. Slagle's qualifications to treat 
adult and geriatric patients.  The 
Nursing Board did not respond except by telling Ms. Slagle that she could obtain 
a specialty license to treat adult patients.  Subsequently, the Nursing Board issued 
an order dismissing the inmate's complaint but finding that Ms. Slagle had 
violated the Nursing Board's Rules and Practice Act by treating adult patients 
and directing her to stop treating non-geriatric patients.  Ms. Slagle continued to treat adult 
patients and the Nursing Board filed its own complaint against her for exceeding 
the scope of her license by treating non-geriatric adults.  After a hearing, the Nursing Board 
suspended Ms. Slagle's license based in part upon findings that she continued to 
treat adult patients after the Nursing Board ordered her to stop and practiced 
fraud and deceit by submitting untruthful information in her 1993 
application.  The Board's complaint 
had not alleged either of these violations.  

 
 
[¶21]  This Court reversed, holding that the 
Nursing Board violated Ms. Slagle's due process rights because it did not give 
her notice that she was alleged to have violated the Board's earlier order and 
submitted false statements and yet relied on those allegations in suspending her 
license.  Slagle stands for the principle that a 
licensing board may not consider in a contested case hearing matters concerning 
allegations of which the licensee has not been given notice.  Penny v. State ex rel. Wyo. Mental Health 
Professions Licensing Bd., 2005 WY 117, ¶ 50, 120 P.3d 152, 175 (Wyo. 
2005).   

 
 
[¶22]  In contrast to Slagle, the State in this case notified 
Dr. Greene by letter that it intended to seek disciplinary measures against him 
for violations of the Board's Practice Act and Rules.  The letter notified Dr. Greene that the 
violations involved inappropriately touching the breasts of three different 
patients during the course of treatment which constituted unethical, 
unprofessional and immoral behavior.  
In a separate notice of hearing, the State notified Dr. Greene that he 
allegedly touched SS on her left breast "in addition to performing other acts 
which collectively, were unprofessional, inappropriate and intimidating, and 
consisted of the following:  
pressing yourself up against [her] from behind, holding her, kissing the 
top of her head, moaning, kneeling in front of her with your face very close to 
hers, attempting to place your palms against [hers] while directing her to take 
(your) energy.'"  The notice advised 
Dr. Greene that such conduct violated § 33-10-110(a)(vi), Chapter 6 of the 
Board's Rules, and the American Chiropractic Association Code of Ethics, 
specifically the Addendum Advisory Opinion:  Sexual Intimacies with a Patient.  The Petition and Complaint filed against 
Dr. Greene reiterated the above allegations involving SS. 

 
 
[¶23]  During discovery, the State disclosed to 
Dr. Greene notes taken during witness interviews conducted during the 
investigation of the complaints made against him.  The notes included the following witness 
statements:

 
 
"Dr. 
[Greene] gave [PW] a hug and pushed his hips against her thigh & moved his 
hips back and forth.  . . . he was 
partially aroused on the 1st two incidents of hip grinding." 

 
 
"[A] 
patient . . . told [the witness] that Dr. [Greene] grabbed her breast and 
pressed his groin up against her with a hug."  

 
 
At 
the hearing, SS testified that Dr. Greene "was pressed up against the back of 
me.  This included his genital area 
that would have been pressed up against me.  I want to make that clear."   

 
 
[¶24] 
The letter of intent and notice of hearing clearly notified Dr. Greene of the 
allegations giving rise to the disciplinary action. From documentation provided 
in discovery, Dr. Greene had notice of witness statements specifically 
describing him pressing his groin area against the first complaining witness 
and, "press[ing] himself against [SS] from behind."  Although the disclosures to Dr. Greene 
did not allege that he "inserted his own affection into his treatment" of SS, 
they did allege that he hugged and kissed SS, moaned, and touched her breast 
during his treatment.   Given 
that these actions were the basis for the Board's determination that he inserted 
his own affection into treatments, we find no due process violation.  We also find nothing in the Board's 
findings suggesting that it considered evidence concerning patients other than 
the two complaining witnesses and a third witness who came forward during the 
investigation.  From the record 
before us, there is no question that Dr. Greene had notice of the conduct and 
violations being alleged against him and the matters the Board considered at the 
hearing.

 
 
c.         
Non-complaining Witness Testimony

 
 
[¶25]  Dr. Greene asserts the Board erred in 
allowing a non-complaining witness to testify about his conduct during her 
treatment in the mid-1980s.  He 
argues that her testimony was not admissible because she did not file a 
complaint against him, it was improper character evidence, it was not relevant 
to the complaints filed by the other two witnesses, the risk of prejudice from 
its admission outweighed its probative value, it was so remote in time as to 
make it inadmissible and it was not corroborated by any other evidence.   

 
 
[¶26]  Addressing the claim that the testimony 
was inadmissible because the witness did not file a written complaint against 
Dr. Greene, we find no such requirement in any statute or rule.  While a person who wishes to bring a 
complaint against a chiropractor is required to file a written signed complaint, 
there is no requirement that a patient having information relevant to 
proceedings against a chiropractor brought by another patient must file a 
complaint.  The witness at issue 
here had information relevant to the allegations against Dr. Greene, the State 
disclosed her identity and expected testimony to Dr. Greene and the only 
limitations on her testimony at that point were those contained in the Wyoming 
Administrative Procedures Act (WAPA), Wyo. Stat.  Ann. §§ 16-3-101 to -115 (LexisNexis 
2007).

 
 
[¶27]  Dr. Greene contends the testimony was 
inadmissible under Wyoming Rule of Evidence 404(b), which precludes the use in 
court of evidence of a person's character to prove that he acted in conformity 
with it but allows such evidence for other purposes, such as proof of motive, 
opportunity, and intent.  
Administrative hearings are governed by WAPA, and administrative agencies 
acting in a judicial or quasi judicial capacity are not bound by the rules of 
evidence that govern trials by courts or juries.  Griffin v. State ex rel. Dep't of 
Transp., 2002 WY 82, ¶ 11, 47 P.3d 194, 197 (Wyo. 2002).  The standard for admissibility of 
evidence at an administrative hearing is contained in § 16-3-108(a), which 
states in pertinent part:  

 
 
. 
. . irrelevant, immaterial or unduly 
repetitious evidence shall be excluded and no sanction shall be imposed or 
order issued except upon consideration of the whole record or such portion 
thereof as may be cited by any party and unless supported by the type of evidence commonly relied upon by 
reasonably prudent men in the conduct of their serious affairs.  

 
 
(emphasis 
added.)  The Board found the witness 
testimony at issue relevant to show that Dr. Greene's actions with the two 
complaining witnesses were not isolated events, a mistake, inadvertent or 
unintentional, but instead demonstrated a pattern of conduct by Dr. Greene.  We hold that the Board reasonably 
concluded that the testimony was admissible for that purpose.       

 
 
[¶28]  Dr. Greene contends the Board abused its 
discretion in allowing the testimony because it concerned an alleged incident 20 
years before the complaints giving rise to the disciplinary proceeding and was 
too remote in time to be relevant.  
The remoteness of alleged acts does not automatically make testimony 
inadmissible.  Griswold v. State, 994 P.2d 920, 926 
(Wyo. 1999).  Whether testimony 
should be excluded because of remoteness is a discretionary decision for the 
agency.  We find no abuse of 
discretion in allowing the testimony to show a pattern of conduct by Dr. 
Greene.  

 
 
[¶29]  Dr. Greene asserts the evidence was more 
prejudicial than probative and should have been excluded for that reason.  Again, the Board had the discretion to 
admit or exclude the evidence.  The 
testimony was not immaterial, irrelevant or unduly repetitious and the Board was 
not required pursuant to § 16-3-108(a) to exclude it for any of those 
reasons.  The Board could reasonably 
have concluded the testimony was the type of evidence commonly relied upon by 
reasonably prudent men in the conduct of their serious affairs.  We find no abuse of discretion in the 
Board's decision to allow the testimony.    

 
 
d.         
Mr. Blanchard's Testimony

 
 
[¶30]  Dr. Greene's next assertion of error 
concerns the testimony of Geral Blanchard, a licensed professional counselor in 
Wyoming, who Dr. Greene called to testify on his behalf.  The Board's findings of fact contain the 
following concerning Mr. Blanchard:

 
 

46.    
Geral 
Blanchard (Blanchard), a licensed professional counselor in Wyoming, testified 
on behalf of Dr. Greene.  Blanchard 
has been working in the field of sexual abuse, counseling, teaching, authoring, 
and working with both victims and perpetrators of sexual crimes for the past 36 
years.  Blanchard conducted a 
battery of tests on Dr. Greene and ruled out antisocial personality disorder and 
sexual addiction.  However, 
Blanchard went on to testify that, "There was a deficit that I discovered in 
training and education around boundaries, the maintenance of boundaries, the 
development of boundaries, and a limited amount of education on the sexual 
dilemma that healthcare providers encounter in dealing with patients, some of 
the vulnerability that patients bring to healthcare providers."  Blanchard referred to Dr. Greene as 
having a deficit in education around sexual dilemmas and the healthcare 
profession and the need for ongoing and continuous education in that area.  

 
 
[¶31]  Dr. Greene asserts the Board's finding 
is arbitrary and capricious because it makes no mention of Mr. Blanchard's 
testimony on direct examination concerning the factors he considers in 
determining whether allegations of sexual abuse are exaggerated or false.  Although Mr. Blanchard had never met 
either of the women who filed complaints against Dr. Greene, he was called as a 
witness for Dr. Greene to testify that individuals with a past history of 
unresolved sexual abuse sometimes experience transference, meaning that an 
experience in the present that resembles one from the past can trigger similar 
feelings and confusions.  Mr. 
Blanchard also testified that in his opinion, in determining whether an 
allegation of sexual abuse is exaggerated or false, it is important to know 
whether the individual has been diagnosed with borderline personality 
disorder.  Mr. Blanchard stressed on 
direct examination the importance of knowing the history of both the accuser and 
the accused in cases involving allegations of sexual abuse.  In its finding, the Board made no 
mention of this testimony but focused instead on Mr. Blanchard's testimony in 
response to the Board's questioning about the opinions he formed from tests he 
performed on Dr. Greene.

 
 
[¶32]  In support of his argument that the 
Board failed to mention all of Mr. Blanchard's testimony, Dr. Greene cites cases 
in which this Court has emphasized the importance of expert testimony in 
administrative proceedings involving matters not within the general knowledge of 
the courts.  Devous v. Wyo. State Bd. of Medical 
Examiners, 845 P.2d 408, 418 (Wyo. 1993); Billings v. Wyo. Bd. of Outfitters & 
Guides (In re Billings) 2001 WY 81, ¶ 18, 30 P.3d 557, 566-67 (Wyo. 
2001).  In those cases, this Court 
held that without expert testimony supporting the administrative ruling, there 
was not substantial evidence in the record from which it could be affirmed.  Those cases have no application here 
where the Board allowed the expert testimony.   

 
 
[¶33]  Dr. Greene also reiterates his argument 
that he was entitled to disclosure of SS's mental health records.  He asserts the records were essential in 
order for the Board to assess her credibility.  As discussed above, mental health 
records are privileged communications under Wyoming law, subject to disclosure 
in only limited circumstances.  None 
of the exceptions applied in this case, and Dr. Greene was not entitled to the 
records.  Mr. Blanchard's opinions 
concerning the importance of such records in making credibility determinations 
does not change that result.

 
 
[¶34]  As the trier of fact, the Board was 
entitled to give Mr. Blanchard's testimony the weight it concluded it deserved 
in light of other evidence presented.  
McIntosh, ¶ 20, 162 P.3d  at 
489.  In addition to Mr. Blanchard's 
testimony, the Board heard and considered the testimony of SS and Dr. 
Greene.  It is apparent from its 
lengthy ruling that the Board fully considered all of the evidence presented and 
reasonably concluded that SS's testimony was credible.  We find no error in the Board's failure 
to make findings concerning the entirety of Mr. Blanchard's testimony in its 
ruling.  

 
 
e.         
Licensing Records of Dr. Greene's Experts

 
 
[¶35]  Dr. Greene asserts that error occurred 
when the State obtained and used information contained in the professional 
licensing files of Mr. Blanchard and another expert witness, Bret Brown, 
D.C.  Dr. Greene contends that 
professional licensing information is confidential and the State acted 
inappropriately when it obtained the information in its advisory role and then, 
in its prosecutorial role, used the information at the 
hearing.

 
 
[¶36]  Prior to the hearing, the State 
supplemented its earlier disclosure statement with additional exhibits, 
including materials related to the licensure of Mr. Blanchard and Dr. 
Brown.  When the hearing convened, 
Dr. Greene objected to the exhibits on the grounds that they were late, 
irrelevant, confidential, and obtained in violation of the State's obligation to 
keep separate its prosecutorial and advisory functions.  The hearing examiner ruled that the 
exhibits would not be admitted "at this time" while informing the State that it 
could try again during the course of the hearing.  The State did not attempt again to 
introduce the exhibits but did attempt to use some of the information contained 
in them during its questioning of Mr. Blanchard and Dr. Brown.  

 
 
[¶ 
37]  In cross-examining Mr. 
Blanchard, the State established that he did not have a Ph.D. in psychology and 
the requirements for licensure as a professional counselor in Wyoming might be 
different today than they were when he obtained his license. The State sought 
but failed to establish that Mr. Blanchard did not meet the requirements for 
licensure in Wyoming.  Although the 
State objected to his testimony as an expert, the hearing officer overruled the 
objection and allowed Mr. Blanchard to testify as an expert.  

 
 
[¶38]  With respect to Dr. Greene's 
chiropractic expert, Bret Brown, D.C., the State asked to voir dire the witness in an effort to 
show that he was not qualified to testify as an expert witness.  During its voir dire, the State established that 
Dr. Brown had been practicing chiropractic for only five years, was not a member 
of any national or state chiropractic panels or affiliations, had never 
testified as an expert in any chiropractic malpractice action, had no "knowledge 
base" concerning the American Chiropractic Association Code of Ethics, had no 
experience with the use of therapeutic touch in chiropractic practice, and, 
after taking the chiropractic exam twice and failing both times, successfully 
challenged the results on the second exam and received his license.  On the basis of Dr. Brown's testimony 
during the voir dire examination, the 
State objected to Dr. Brown testifying as an expert.  Counsel for the Board agreed with Dr. 
Greene that Dr. Brown should be accepted as an expert based on his licensure in 
Wyoming, commenting that the adequacy of his credentials went to the weight of 
his testimony not its admissibility.  
The hearing examiner accepted Dr. Brown as an expert witness.  The State did not cross-examine Dr. Brown 
concerning his credentials. 

 
 
[¶39]  From this record, we conclude neither 
the Board nor the OAH committed any evidentiary error with respect to Dr. 
Greene's expert witnesses' licensing records. The hearing examiner properly 
declined to admit the records into evidence.  The State's questions to Dr. Blanchard 
concerned information found in his curriculum vitae.  With only one exception, the State's 
questions to Dr. Brown likewise did not require his licensing records.  The one area of questioning that likely 
came from the records concerned Dr. Brown's score on one part of one exam, to 
which the hearing officer sustained an objection, and the fact that he obtained 
his license after successfully challenging his score after taking the 
examination a second time.  While 
confidential licensing records concerning Mr. Blanchard and Dr. Brown may have 
been improperly obtained, they were not admitted into evidence for consideration 
by the Board.  No confidential 
information was used in questioning Mr. Blanchard and the State's effort to use 
information questionably obtained about Dr. Brown to disqualify him from 
testifying as an expert was unsuccessful.  
The Board did not rely upon, or even mention, the information in its 
findings regarding Dr. Brown's testimony.  
Dr. Greene received a fair hearing and the OAH handled the records 
appropriately in a manner that did not violate his due process rights or 
materially prejudice him. 

 
 

[¶40]  Despite 
our conclusion that Dr. Greene's due process rights were not violated, we are 
concerned about the State's effort to use information concerning Dr. Brown from 
the Board of Chiropractic Examiners' file.  
Chapter 
8, Section 1(a), of the Board's rules provides: 

 
 
The 
information in files compiled by the Board concerning each chiropractor, except 
for Board decisions concerning licensure or certification, is confidential and 
shall be released only to the chiropractor to whom the record pertains, to 
others upon the chiropractor's notarized written consent or upon court 
order.

 

The 
majority of the information the State obtained concerning Dr. Brown appears to 
be confidential, yet there is no indication in the record that it was obtained 
with his consent or by court order.  
Under these circumstances, the assistant attorney general was not 
authorized to obtain and the Board was not authorized to release confidential 
information from Dr. Brown's file.2  

 
 
[¶41]  We have previously emphasized the 
importance of separating prosecutorial and advisory functions in contested cases 
before licensing boards.  Dorr, ¶ 20, 21 P.3d  at 745; Painter v. Abels, 998 P.2d 931, 938-39 
(Wyo. 2000).  We have also stressed 
the importance of agencies following their own rules.  Id. at 938.  In Dr. Greene's case, the OAH acted 
appropriately by not admitting the records and sustaining an objection to a 
question concerning confidential information obtained from the records, and no 
due process issue resulted.  The 
fact remains, however, that the Attorney General's office, in its role as 
prosecutor, should not have had access to the records without fully complying 
with the applicable rules.  We 
expect such compliance in the future.   

 
 
2.         
Sufficiency of the Evidence

 
 
[¶42]  Dr. Greene's final claim is that the 
Board's ruling was not supported by substantial evidence.  Essentially, Dr. Greene asserts the only 
evidence presented to show that he acted improperly with SS was her testimony, 
she was not a credible witness, and his testimony and that of other witnesses 
contradicted her testimony.  In 
determining whether clear and convincing evidence was presented to support the 
Board's finding we consider whether the kind of proof was presented which would 
persuade a trier of fact that the truth of the contention was highly 
probable.  Dorr, ¶ 8, 21 P.3d  at 741.  

 
 
[¶43]   SS testified at the hearing that 
she had been receiving treatments from Dr. Greene in 2003 for migraines she was 
having following a car accident.  On 
the day in question, she was in one of the treatment areas when Dr. Greene came 
in, shut the curtains and told her to sit down on the adjustment table.  She testified that this was the first 
time she had seen him shut the curtains.  
She testified that he came up very close behind her, put his left leg up 
on the table with his genital area pressed up against her and his arms around 
her.  He began to rub her right 
earlobe, saying it would relax her neck muscles.  He adjusted her neck and then continued 
to hold her from behind in the same position, kissed her on the top of her head 
and began moaning.  He began to rub 
her breast with the thumb of his left hand.  She tightened up and he stopped, saying 
that he thought he was touching her shoulder.  He moved around in front of her, got 
down on his knees, placed his face very close to her face, held his palms up and 
told her to take his energy.  SS 
stared at the floor until Dr. Greene left the room.  She did not return to Dr. Greene for 
further treatment.  SS's hearing 
testimony was consistent with her complaint, her statements to the investigative 
board member and her deposition testimony. 

 
 
[¶44]  In addition to SS, two other former 
patients of Dr. Greene testified at the hearing.  PW testified that in the course of 
treatment in 2001, Dr. Greene placed his hand under her breast and yanked it up 
three times very quickly.  She 
testified that she did not file a complaint immediately because she thought Dr. 
Greene was leaving Cheyenne; when she learned later that he was still practicing 
here, she filed a complaint with the Cheyenne Police Department (no action was 
taken against Dr. Greene) and the Board.  

 
 
[¶45]  BV testified that in the course of 
giving her a massage as part of her treatment in the late 1980s, Dr. Greene 
massaged her breasts.  She testified 
that she did not file a complaint then and felt badly about not doing so.  When in the course of this 
investigation, she was asked if she would come forward, she did 
so.

 
 
[¶46]  Dr. Greene denied giving BV a 
massage.  Concerning PW, Dr. Greene 
testified that one side of his thumb may have contacted her breast as he was 
adjusting her ribs but it was not intentional or sexually motivated.  Addressing SS's allegations, Dr. Greene 
testified that he performed several adjustments on her on the day in question, 
including a neck adjustment.  He 
testified that before the neck adjustment, he rubbed her ear lobe using the 
auriculoproprioceptive reflex to relax the rectus capitis muscle under the 
skull.  As he felt the muscle relax, 
he did the neck adjustment.  The 
bone released very loudly, SS jumped in the air, and her skull hit Dr. Greene in 
the jaw.  He fell back and 
instinctively grabbed SS because she was going to fall off the table. He 
realized his hand was near her breast, immediately removed it and apologized, 
stating he thought his hand was on her shoulder.  SS started sobbing, "looked very 
withdrawn and very upset and very almost traumatized from the adjustment."  He moved around to the front of her, 
asked if she was okay, and told her to put her hands up and let him give her 
some of his good energy.  Dr. Greene 
denied holding SS, kissing her, moaning, intentionally touching her breast and 
intentionally touching her in any sexual manner. 

 
 
[¶47]  In its findings, the Board specifically 
found that BV, PW and SS were credible witnesses and the statements they gave 
during the investigation were consistent with their hearing testimony.  In contrast, the Board found that Dr. 
Greene's testimony concerning events was sometimes not supported by his notes on 
patient charts.  Dr. Greene 
testified, for example, that he had "a fantastic memory for adjustments" and 
remembered precisely what procedures he performed on PW and SS.  His notes on the patients' charts, 
however, did not reflect that he ever performed the procedure he testified that 
he performed.  

 
 
[¶48]  The Board also found that Dr. Greene's 
statements during the investigation were sometimes different than his hearing 
testimony and his testimony on cross-examination sometimes contradicted his 
direct examination testimony.  For 
example, in his initial letter denying the allegations in PW's complaint, Dr. 
Greene "categorically denied" the "outlandish allegations" and specifically 
denied ever touching her breast.  At 
the hearing, however, he admitted on direct examination that his hand came into 
contact with PW's breast.  Then on 
cross-examination, he denied touching PW's breast and said he touched below her 
breast.    

 
 
[¶49]  The Board also found the testimony of 
other non-patient witnesses contradicted Dr. Greene's testimony.  The Board specifically found:  "Dr. Greene's testimony was inconsistent 
throughout, inconsistent with SS's chart notes, inconsistent with Dr. Greene's 
written statement to the Board, and inconsistent with the testimony of other 
credible witnesses. . . ."  Having 
reviewed the record in its entirety, we hold that clear and convincing evidence 
was presented which would persuade the Board that the truth of the contentions 
that Dr. Greene acted improperly and violated the Board Rules and ethical 
standards was highly probable.

 
 
[¶50]  The Board's order suspending Dr. 
Greene's license is affirmed.  The 
stay of the suspension shall be lifted upon issuance of the mandate from this 
Court.         

 
 
FOOTNOTES

 
 

1In addition to the statutory provisions and Board Rules identified in its 
initial letter of intent, the notice of hearing alleged Dr. Greene's conduct 
violated the following additional Board Rules:

 
 
Chapter 6.  Suspension, 
Revocation or Denial of License.

 
 
Section 1.  
Ethics.

 
 

(a)   The protection of the public health, safety, welfare and interest of the 
public shall be the primary guide in determining the appropriate professional 
conduct of all chiropractors whose activities are regulated by the 
Board.

(b)   The current national code of ethics as promulgated by the American 
Chiropractic Association, . . . as appropriate to the individual practitioner, 
shall be used by the Board to provide guidelines to ethical standards for all 
chiropractors licensed under the Act.  
Any violation of the ethics shall be a violation of the 
rules.

 
 
Section 2.  Suspension, 
Revocation, and Denial of Licenses and Other Disciplinary Sanctions.  

. . . .

 
 
(e)  Harassment, intimidation 
or abuse, sexual or otherwise, or a client of 
patient;

. . . .

(g)  Practicing outside the 
areas of professional competence as established by education, training and 
experience;

. . . .

(k)  Exercising undue 
influence to exploit a patient . . . for . . . personal advantage to the 
practitioner . . .;

. . . .

(o)  Violation of the current 
National Code of Ethics as set forth by the American Chiropractic Association; 

. . . .

(r)  Willfully or negligently 
violating any of the provisions of the Act;

 
 
The Board notified Dr. Greene that his alleged conduct violated the 
following provisions of the American Chiropractic Association Code of 
Ethics:

 
 

A.    
Responsibility to the Patient

 
 
A(6) . . . doctors of chiropractic . . . should not exploit the trust and 
dependency of their patients.

 
 
A(7)  Doctors of chiropractic 
owe loyalty, compassion and respect to their patients.  Their clinical judgment and practice 
should be objective and exercised solely for the patient's 
benefit.

. . . .

A(10)  Doctors of 
chiropractic should maintain the highest standards of professional and personal 
conduct . . . .

. . . .

C.    
Responsibility 
to the Profession.

 
 
C(2)  Doctors of chiropractic 
should by their behavior, avoid even the appearance of professional impropriety 
and should recognize that their public behavior may have an impact on the 
ability of the profession to serve the public.  Doctors of chiropractic should promote 
public confidence in the chiropractic profession.

 
 
Addendum ACA Ethics Committee Advisory 
Opinions:. . . [I]t 
is the opinion of the Committee that sexual intimacies with a patient is 
unprofessional and unethical based on the existing ethical provisions in the ACA 
Code of Ethics:  A(6), A(7), A(10) 
and C(2).  

 
 
The physician/patient 
relationship requires the doctor of chiropractic to exercise utmost care that he 
or she will do nothing to "exploit the trusts and dependency of the 
patient."

 
 

2We do not 
have the same concern with respect to the documentation involving Mr. Blanchard, 
which consisted of correspondence between him and the Board of Psychology, the 
Board of Psychology and the American Psychological Association and others 
relating to Mr. Blanchard's membership in the North American Association for 
Masters in Psychology.  This 
information does not appear to be confidential and likely could have been 
obtained from 
various sources, including the Board of Psychology and the American 
Psychological Association neither of which licenses Mr. Blanchard or maintains 
his file since he is not a psychologist.