The Chiropractic Scope of Practice in the United States: A Cross-Sectional Survey
Written by Editor   
Tuesday, July 22, 2014 12:32 PM

The scope of chiropractic practice in the United States has a high degree of variability. Scope of practice is dynamic, and gray areas are subject to interpretation by ever-changing board members. Although statutes may not address specific procedures, upon challenge, there may be a possibility of sanctions depending on interpretation.  

The purpose of this study was to assess the current status of chiropractic practice laws in the United States. This survey is an update and expansion of 3 original surveys conducted in 1987, 1992, and 1998.  A cross-sectional survey of licensure officials from the Federation of Chiropractic Licensing Boards e-mail list was conducted in 2011 requesting information about chiropractic practice laws and 97 diagnostic, evaluation, and management procedures.

Partial or complete responses were received from 96% of the jurisdictions in the United States. There were a total of 97 services surveyed.

The states with the highest number of services that could be performed were:

Missouri (n = 92), New Mexico (n = 91), Kansas (n = 89), Utah (n = 89), Oklahoma (n = 88), Illinois (n = 87), and Alabama (n = 86).

The states with the highest number of services that cannot be performed are New Hampshire (n = 49), Hawaii (n = 47), Michigan (n = 42), New Jersey (n = 39), Mississippi (n = 39), and Texas (n = 30).

Extremity examinations (n = 48), orthotic supports (n = 48), orthopedic examinations (n = 47), spinal supports (n = 47), lifestyle counseling (n = 47), and neurologic examinations (n = 46) may be performed by a chiropractor without additional education in every jurisdiction that responded.

Vitamin supplementation (n = 46), temporomandibular joint evaluation and treatment (n = 45), full-spine radiographs (n = 48), traction (n = 45), diet formulation (n = 44), electrical stimulation (n = 43), ultrasound (n = 42), tens (n = 42), botanical therapy (n = 39), IFC (n = 41), and microcurrent therapy (n = 41) may be performed in all jurisdictions that responded, but may require additional education.

Ninety percent or more of the jurisdictions report that limited prescription rights and minor surgery were not within the chiropractic scope of practice. 



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