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Vuagniaux v. Department of Professional Regulation

November 20, 2003


The opinion of the court was delivered by: Justice Rarick


Docket No. 94073-Agenda 8-May 2003.

Dr. Thad Vuagniaux, a licensed chiropractic physician, was reprimanded by the Department of Professional Regulation (the Department) and fined the sum of $2,500 for violating the advertising provisions set forth in section 26 of the Medical Practice Act of 1987 (225 ILCS 60/26 (West 1998)). On administrative review of the Department's decision, the circuit court of Madison County reversed. In so doing, it found various sections of the Medical Practice Act, including section 26's advertising restrictions, to be unconstitutional and void. The Department appealed. Because the circuit court's judgment held statutes of the State of Illinois to be invalid, the appeal was taken directly to our court. 134 Ill. 2d R. 302(a). For the reasons that follow, we affirm in part, reverse in part and remand for further proceedings.

Although the record in this case is voluminous, the facts necessary to the disposition are straightforward. Thad Vuagniaux graduated from Logan Chiropractic College in 1993 and was licensed as a chiropractor by the State of Illinois in 1994. At all relevant times, Vuagniaux has maintained a practice in Madison County, Illinois, located in the St. Louis, Missouri, metropolitan area.

Two years after receiving his license, Vuagniaux published a series of advertisements for his practice in the St. Louis Post-Dispatch. The advertisements, which ran throughout 1996, appeared in editions of the paper circulated in Illinois. Each ad addressed a different ailment. The ailments discussed were migraine headaches, asthma, fibromylagia, carpal tunnel syndrome, Crohn's Disease/irritable bowel syndrome, learning disorders, "TMJ Dysfunction," whiplash and vertebral subluxations, and Meniere's Disease/vertigo.

Vuagniaux's ads described the causes and symptoms of the foregoing conditions and linked each of them to interference with the brain stem. The ads stated that a procedure termed "Specific Chiropractic" corrects or removes interference to the brain stem, enabling sufferers to recover normal function and achieve their "fullest health potential without the use of drugs or surgery."

Vuagniaux's ads publicized that he employed "Specific Chiropractic" in his practice. In fact, the first two ads represented that he was one of only two "Certified Brain Stem Specialists" in the St. Louis metropolitan area. Those ads included, under his photo, the notation that he is a "Kale Certified Brain Stem Specialist" and an officer of the "Kale International Research Council." Vuagniaux's third ad deleted the references to his being certified or a specialist and indicated simply that he was one of only two "Specific Chiropractors" in the St. Louis area. The same claim appeared in the fourth ad, but was deleted from the fifth and all subsequent ads.

Publication of Vuagniaux's ads elicited complaints from other chiropractors. After investigating the matter, the Department initiated disciplinary proceedings against Vuagniaux pursuant to section 22 of the Medical Practice Act of 1987 (225 ILCS 60/22 (West 1998)). The Department's complaint, which contained three counts, asked that Vuagniaux's license be suspended, revoked, or otherwise disciplined on the grounds that his ads violated the provisions of the Medical Practice Act governing advertising.

Advertising by persons licensed under the Medical Malpractice Act is subject to section 26 of the statute (225 ILCS 60/26 (West 1998)). Section 26 permits licensees to advertise the availability of their professional services in the public media or on the premises where the services are rendered. The statute provides, however, that any such advertising is limited to certain types of information. Information that may be published under the statute includes the licensee's "name, title, office hours, address and telephone number" (225 ILCS 60/26(a) (West 1998)); his "usual and customary fees for routine professional services" (225 ILCS 60/26(c) (West 1998)); his "areas of specialization, including appropriate board certification or limitation of professional practice" (225 ILCS 60/26(b) (West 1998)); announcement of the "opening of, change of, absence from, or return to business" (225 ILCS 60/26(d) (West 1998)); announcement of changes in professional licensed staff (225 ILCS 60/26(e) (West 1998)); and issuance of business or appointment cards (225 ILCS 60/26(f) (West 1998)).

Counts I and III of the Department's complaint both charged violations of the foregoing provisions. Count III made a general allegation that Vuagniaux's ads all contravened the Medical Practice Act because they are "not limited in the information provided to the information permitted in [section 26]." Count I focused specifically on the ads representing Vuagniaux as a "Certified Brain Stem Specialist" and a "Kale Certified Brain Stem Specialist." According to the Department, those ads violated the Act because the specialties identified in the ad were not legitimate. In the words of the complaint, "[t]here is no appropriate board certification as a Certified Brain Stem Specialist or a Kale Certified Brain Stem Specialist in Chiropractic medicine."

In addition to limiting the types of information a licensee may include in his advertising, section 26 of the Medical Practice Act also forbids a licensee from using statements in his advertising that contain "false, fraudulent, deceptive or misleading material or *** statements which play upon the vanity or fears of the public." 225 ILCS 60/26 (West 1998). Count II of the Department's complaint was premised on that prohibition. It alleged that Vuagniaux's claims that chiropractic treatment of the brain stem will treat asthma, Meniere's disease, learning disorders and the other conditions mentioned in the various ads "are deceptive or misleading and play upon the fears of the public."

After the Department served Vuagniaux with its administrative complaint, Vuagniaux sought declaratory and injunctive relief from the circuit court of Madison County to prevent the disciplinary proceedings against him from going forward. Vuagniaux's complaint, as amended, raised a variety of issues regarding the fairness and constitutionality of the process by which chiropractors in Illinois are subject to discipline and the standards by which their conduct is judged. Among the claims he made were (1) that subjecting chiropractors to regulation by the Department's Medical Disciplinary Board, which by statute includes but a single chiropractor among its seven voting members, denies chiropractors their rights to due process and equal protection, (2) that the advertising provisions in section 26 of the Medical Practice Act are uncertain and vague, and the Department has failed to enact standards for assessing whether those provisions have been violated, (3) that the Department has failed to adopt meaningful rules of discovery, and (4) that the Department should not be allowed to limit the location of evidentiary hearings in disciplinary matters to Chicago and Springfield.

At the same time he pursued this civil action, Vuagniaux vigorously contested various developments in the Department's disciplinary action against him. Among the actions he took was to move for exclusion of Dr. Lacy Cook, the sole chiropractic member of the Medical Disciplinary Board, from further participation in his case. Vuagniaux based that motion on claims that Cook would be prejudiced against him and the chiropractic theories he followed. Although the administrative law judge assigned to the case found no actual prejudice by Cook, the administrative law judge granted Vuagniaux's motion and excluded Cook to avoid the appearance of prejudice.

Once Cook was excluded from the case, the Department moved for appointment of a "Special Chiropractor" to the Medical Disciplinary Board so that the Board would include a chiropractic member when it considered Vuagniaux's case. The administrative law judge referred the motion to the Board for its consideration. The Board granted the motion and named Dr. Roger Pope, a doctor of chiropractic, to serve in Cook's place on the Board for the purposes of these proceedings.

Vuagniaux raised objections to Pope's appointment in both the disciplinary proceeding and the civil action. The principle basis for Vuagniaux's objection was that the Board's appointment violated the Medical Practice Act, which specifies that members of the Medical Disciplinary Board are "to be appointed by the Governor by and with the advice and consent of the Senate." 225 ILCS 60/7(A) (West 1998). Vuagniaux further claimed that the appointment would infringe on his right to confront and cross-examine witnesses.

Vuagniaux's objection to Pope's inclusion on the Board went unheeded. A motion he filed in the administrative proceeding for judgment on the pleadings or, in the alternative, to dismiss, was denied. Vuagniaux then moved for a preliminary injunction in his civil action. When that motion was also denied, an administrative hearing on the Department's disciplinary complaint was convened. The hearing took place over a series of dates during the summer of 1998. In the course of the hearing, the administrative law judge allowed the Department to delete from count II of its complaint the allegations pertaining to whiplash and vertebral subluxations. Experts witnesses were called by both sides, and Vuagniaux testified on his own behalf.

Following the hearing, the administrative law judge issued her findings and recommendations in accordance with section 35 of the Medical Practice Act (225 ILCS 60/35 (West 1998)). The administrative law judge concluded that the Department had proved all three counts of its complaint by clear and convincing evidence and recommended to the Medical Disciplinary Board that Vuagniaux be fined the sum of $2,500. The Medical Disciplinary Board adopted the administrative law judge's findings of fact and conclusions of law. It also agreed with the administrative law judge's recommendation that Vuagniaux be fined $2,500. Unlike the administrative law judge, however, the Board believed that the sanctions imposed on Vuagniaux should also include a reprimand. The Board's recommendation, made with the concurrence of five members, including the specially appointed chiropractor, Pope, was adopted by the Department's director. In an order signed by the director and dated December 16, 1998, the Department reprimanded Vuagniaux's license and ordered him to pay a $2,500 fine.

Vuagniaux sought administrative review of the Department's decision pursuant to article III of the Code of Civil Procedure (the Administrative Review Law) (735 ILCS 5/3-101 et seq. (West 1998)) in the circuit court of Madison County. On Vuagniaux's motion, the circuit court subsequently consolidated that action with Vuagniaux's suit for declaratory and injunctive relief and allowed Vuagniaux to make various amendments to his complaint for declaratory and injunctive relief. Following those amendments, the Department moved for summary judgment against Vuagniaux on his suit for a declaratory judgment and injunction. As grounds for its motion, the Department argued that where, as here, the Administrative Review Law is applicable and provides a remedy, the circuit court may not redress a party's grievance through any other type of action. The circuit court found this argument to be meritorious, granted the Department's motion for summary judgment, and dismissed Vuagniaux's complaint for declaratory and injunctive relief with prejudice.

The proceedings for administrative review remained pending. Vuagniaux was allowed to amend his complaint for administrative review to include a number of different claims, including claims he had previously asserted in his action for declaratory and injunctive relief. Following a hearing, the circuit court entered an order setting aside the Department's decision and dismissing the Department's complaint against Vuagniaux. The court gave numerous reasons for reaching that decision. Among these were that appointment of Dr. Pope to replace Dr. Cook on the Medical Disciplinary Board was not authorized by law and was unconstitutional, that the statutory composition of the Board violates due process and equal protection, that the Department's administrative complaint was defective, that the Department had failed to properly prove its case against Vuagniaux, and that the provisions of the Medical Practice Act regulating advertising are unconstitutionally vague and violate "Vuagniaux's right to engage in free commercial and educational speech." This appeal by the Department followed.

The Department took its appeal directly to us based on the circuit court's determination that provisions of the Medical Practice Act were invalid. See 134 Ill. 2d R. 302(a). Although the constitutionality of those provisions has been the focus of the parties' arguments in our court, a fundamental principle of judicial decisionmaking is that questions regarding the constitutionality of statutes should be considered "only where essential to the disposition of a case, i.e., where the case cannot be determined on other grounds." Bonaguro v. County Officers Electoral Board, 158 Ill. 2d 391, 396 (1994). Having reviewed the record and the applicable law, we have concluded that the disciplinary action ...

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