Proactive Information for the Profession

The New York Chiropractic Council is frequently used as a source of information for practicing chiropractors in NYS.

These are the Questions Related to Practice

The answers are color coded based on two things.

RED: THESE STATEMENTS ARE BASED ON NYS EDUCATION LAW FOR CHIROPRACTIC AND OUR CONVERSATION WITHIN THE NYS BOARD OF CHIROPRACTIC.

BLUE: THESE STATEMENTS ARE SOLELY THE OPINION OF THE NEW YORK CHIROPRACTIC COUNCIL AND NOT NECESSARILY THAT OF THE NYS BOARD OF CHIROPRACTIC.

Can an X-rays be used and/ or retaken in clinical practice to look for Subluxation and not just red flags or pathology.

Yes, a Chiropractor may take x-rays for the purpose of finding a Subluxation and not just rule out pathology. NYS Chiropractic regulations define chiropractic §6551. Definition of practice of chiropractic.

  1. The practice of the profession of chiropractic is defined as detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column.
    1. A license to practice as a chiropractor shall not permit the holder thereof to use radio-therapy, fluoroscopy, or any form of ionizing radiation except X-ray which shall be used for the detection of structural imbalance, distortion, or subluxations in the human body.

The Council did not find information regarding repeat x-rays in the NYS Education Law.

Some have questioned the need for Chiropractors to use X-rays in Practice.   X-ray is one of the tools we have at our disposal to analyze the physiological biomechanics. Some of these techniques to find where to adjust the Subluxation require the use of x-ray.  Dr. B. J. Palmer was the first to bring X-ray into our profession.  He was the first to use it on the spine, the lateral cervical. He performed research and many studies to better guide the Chiropractor to find Vertebral Subluxations. Some chiropractors use upper cervical analysis and adjusting. Others use the entire spine.  Some Subluxation techniques that use x-ray for analysis look for segmental Subluxations, others like CBP pioneered by Dr. Donald Harrison look at the global Subluxation.    One of the tools to find the Vertebral Subluxation is X-ray. It may also be used to assess the success of a chiropractic technique to improve the patient's health.  It can provide efficient analysis which will help us provide confident and focus-driven adjustments, because X-ray can allow us to locate and correct Subluxations. The public deserves basic and excellent procedures including X-ray to aid our delivering of the right adjustment, in the right way, and at the right time.  Not only is there value in taking an initial x-ray but repeat x-rays can have significant clinical value as well.  The Council agrees with the CCP practice guidelines regarding repeat x-rays.  ” The use of post- adjustment radiographs may also assist the chiropractor in determining effects of chiropractic adjustments on the spine when other less hazardous examination techniques cannot reveal the desired information.” _- ICA

The main purpose of a re-x-ray is to measure the progress or lack of progress of eliminating vertebral subluxations in a patient’s spine that is under chiropractic care. Specifically, a re-x-ray can measure: change in cervical and lumbar spine from abnormal kyphosis back towards a normal lordosis, change in biomechanical malpositioning of vertebra being adjusted, changes in flexion, extension, and rotational movement from fixations of vertebra, and status of internal muscular spasms close to the spinal segments.  The outcome of the repeat X-ray can help determine: if, and how much more care is needed; if a new spinal adjusting strategy should be instituted, if the spinal segments are stable enough to return to normal activities and when the subluxations will be corrected for that particular case under chiropractic care.

Kent C. An Evidence-Informed Approach to Spinal Radiography in Vertebral Subluxation Centered Chiropractic Practice. Annals of Vertebral Subluxation Research August 31, 2017. Pages 142-146

http://ccp-guidelines.org/guideline-2013.pdf

http://www.pccrp.org/

Can a chiropractor perform a DOT exam in NYS?

No.

The Department of Education has interpreted that our scope limits us to the exam for a Subluxation.  What they failed to address is the section that states and the effects there of.   We are trained to evaluate and recognize situations that present to us which may or may not relate to a Subluxation.  When it is not related to a Subluxation we are required to refer to the appropriate professional.  In our opinion the fact that our scope allows us to treat a Subluxation should not preclude us from doing an exam to measure a person's functional status and their ability to do their job. 

No individual health professional is an expert in all aspects of health specialties, but we are all trained at a high level to recognize potential health concerns that may need further evaluation by the appropriate professional.  For example, do we need to refer out.  We do an exam looking for a Subluxation but just like a cardiologist may find out there is a gastro problem and refer out.  We are not required to name the  other diagnosis but we are required to refer out to the appropriate profession when necessary.  This is a case where we are already held to the standard of documentation and to the level of an exam but told that we are unable to be paid for doing these exams.

The DOT exam is a basic exam to determine if the person can go to work.  It doesn't take an expert in all areas to be able to do this exam.  And you can never expect any profession to be an expert in all fields.  For example a Cardiologist is unable to be an expert in gastroenterology or orthopedics yet he can perform the DOT exam.

Is the DOT exam issue an important issue for the New York Chiropractic Council?

It's not so much an important issue as an issue of discrimination.  According to our Core Values a DOT exam is not a core office procedure that every chiropractor has to do.  Core value number three, states:  “We recognize that subluxations compromise the expression of innate intelligence, and that assisting in the prevention and reduction of subluxations will facilitate and promote the expression of optimal health.” This specifically mentions Subluxation and that is something all our exams should always be looking for, as we are Chiropractors.  But with that being said, the Council will fight against any discrimination to our profession.

 

Can we adjust extremities in NYS?

Yes, a Chiropractor may adjust extremities in NYS.  Chiropractic regulations define chiropractic as detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of/ or in the vertebral column.

If the extremity misalignment is related to, or can cause interference at the spinal level then adjusting that extremity to reduce dysafferentation from that neuromere is appropriate.

Can we recommend or prescribe nutrition supplements?

Yes, a chiropractor licensed in NYS if his college courses included nutrition, may provide counseling on this subject.  A chiropractor may also dispense food concentrates, vitamins, minerals, and other nutritional supplements.

Since chiropractic strives to bring about normal function of the body, to bring about health and not the treatment of disease, the use of nutrition in chiropractic practice should have a similar role. That role is to bring about health through eliminating a deficiency or toxicity and not the treatment of disease. This is most important when communicating expectations to a patient. You are not treating a disease. You are offering support to produce a healthier expression.

Can we perform urinalysis?

A NYS licensed chiropractor may collect and send out to a laboratory, or order a collection by a lab for the purpose of a urinalysis.

Can we discuss with the patient possible causes of Subluxation?  Can we discuss the possible stress on the body and nervous system from the use of drugs or foods and then send to the appropriate professional for further information? Can we comment on our patients medications?

The law is clear that we cannot prescribe, administer, dispense or use in legend drugs or medicines.  Nowhere in the law does it state that chiropractors are prohibited from providing information regarding the negative chemical effects on the body and the nervous system.

Yes, a responsible chiropractor can and should educate their patient on the causes of lifestyle stress to the nervous system that could cause a Subluxation.  There are three large categories of negative stress that can overwhelm the nervous system. Chiropractors can and should be able to explain this to improve their patient’s outcome and health. One of these categories of negative stress is a chemical cause.  Since a patient's medication, nutrition and, environmental exposures can create a negative overwhelm in the nervous system, a responsible chiropractor should be able to provide this information to their patient.   If the possible negative chemical overwhelm involves a medication, then imparting information to the patient and making a referral to the necessary health provider is appropriate. This does not allow a chiropractor to tell a patient to take, or not to take, a medication that is the realm of the medical doctor.

Can we do blood tests for our patients?

Chiropractors may refer out to and use a CLIA certified clinical lab to analyze blood for diagnostic purposes.

Can we perform the federal DOT exam for our patients?

 No.  We are only able to perform the exam for the purpose of determining whether the person has a Subluxation or not.  A DOT exam is not done for this purpose.

Can a chiropractor employ an unlicensed assistant to record a patient history, or results of a diagnostic test?

Yes.  As long as there is no interpretation of data, an unlicensed chiropractic assistant may record the results of testing.

  

The answers are color coded based on two things.

RED: THESE STATEMENTS ARE BASED ON NYS EDUCATION LAW FOR CHIROPRACTIC AND OUR CONVERSATION WITHN THE NYS BOARD OF CHIROPRACTIC.

BLUE: THESE STATEMENTS ARE SOLELY THE OPINION OF THE NEW YORK CHIROPRACTIC COUNCIL AND NOT NECESSARILY THAT OF THE NYS BOARD OF CHIROPRACTIC.

 

 

 



Central Office Hours

Monday: 8:00AM - 5:00PM
Tuesday: 9:00AM - 4:00PM
Wednesday: 8:00AM - 5:00PM
Thursday: 10:00AM - 3:00PM
Friday: 8:00AM - 5:00PM
Sat & Sun: Closed

 
Join us today and become a part of our growing community. Start enjoying the benefits of membership:


  • Professional Fellowship
  • Continuing Education
  • Reduced Rates to Seminars
  • Monthly District Meetings
  • Legal Advice
  • Community Out Reach Programs
  • and much more!

 

Click Here to View All Membership Benefits 

Get your CA's connected to Chiropractic Assistants of New York (CANY):

  • Monthly conference calls
  • Email blasts
  • Discounted registration at seminars
  • Ongoing training and education

Click Here to Learn More About CANY!