STATE OF WISCONSIN
CHIROPRACTIC EXAMINING BOARD
------------------------------------------------------------------------------------------------------------
IN THE MATTER OF RULEMAKING : ORDER OF THE
PROCEEDINGS BEFORE THE :CHIROPRACTIC EXAMINING
CHIROPRACTIC EXAMINING :BOARD
BOARD :ADOPTING RULES
:(CLEARINGHOUSE RULE 18-071)
------------------------------------------------------------------------------------------------------------
ORDER
An order of the Chiropractic Examining Board to repeal Chir 4.03, 4.04 (Note), and 4.05 (1) (a) to (d) and (2) (intro.), (a) to (d), and (e) 1.; to renumber and amend Chir 4.05 (1) (intro.) and (2) (e) (intro.) and (f) to (h); to amend Chir 4.01, 4.02 (2), 4.04 (2) (a) and (Note), and 4.07 (1); to repeal and recreate Chir 4.02 (1); and to create Chir 4.02 (1m) and (3) to (5), relating to chiropractic practice.
Analysis prepared by the Department of Safety and Professional Services.
------------------------------------------------------------------------------------------------------------
ANALYSIS
Statutes interpreted:
Statutory authority:
Explanation of agency authority:
Section 15.08 (5) (b), Stats., provides that examining boards, such as the Chiropractic Examining Board, “shall promulgate rules for its own guidance and for the guidance of the trade or profession to which it pertains . . .” Section 227.11 (2) (a), Stats., sets forth the parameters of an agency’s rule-making authority, stating an agency “may promulgate rules interpreting provisions of any statute enforced or administered by the agency. . .but a rule is not valid if the rule exceeds the bounds of correct interpretation.” Related statute or rule:
Chapter Chir 6 establishes standards of conduct for chiropractors. Section Chir 6.02 (4) provides that unprofessional conduct includes “[p]racticing or attempting to practice beyond the scope of a license issued by the board, including but not limited to acts prohibited under s. Chir 4.05 (1).” Plain language analysis:
The Board conducted an evaluation and update of ch. Chir 4 to ensure consistency with current professional practices and standards and applicable Wisconsin statutes. As a result, the following updates have been made: - Section Chir 4.01 is revised to accurately describe the purpose of ch. Chir 4 as revised. - The definition of “chiropractic science” under s. Chir 4.02 (1) was created in 1985 and has not been substantively revised since that time. The proposed rules revise the definition to reflect current chiropractic practice. - Definitions of “examination,” “physiotherapy,” and “treatment” are created to achieve consistency and clarity of that terminology as it is used in ch. Chir 4. - The meaning of “practice of chiropractic” under s. Chir 4.03 is replaced with the meaning given in s. 446.01 (2), Stats. - The rules remove the references under s. Chir 4.05 (1) and (2) to specific techniques, procedures, and instruments that are beyond the scope of chiropractic or prohibited. The section as revised provides criteria for determining if the use of an instrument or a practice system, analysis, method, or protocol is beyond the scope of the practice of chiropractic. Summary of, and comparison with, existing or proposed federal regulation:
None.
Comparison with rules in adjacent states:
Illinois: The Illinois Medical Practice Act specifies the scope of chiropractic practice through a definition of “chiropractic physician” (225 ILCS 60/2). The Act defines a chiropractic physician as “a person licensed to treat human ailments without the use of drugs and without operative surgery. Nothing in this Act shall be construed to prohibit a chiropractic physician from providing advice regarding the use of non-prescription products or from administering atmospheric oxygen. Nothing in this Act shall be construed to authorize a chiropractic physician to prescribe drugs.”
Iowa: Iowa statutes specify the scope of chiropractic practice through a definition of “chiropractic” (Iowa Code 2017, section 151.1). The following activities are identified:
- Treating human ailments by the adjustment of the neuromusculoskeletal structures, primarily, by hand or instrument, through spinal care.
- Utilizing differential diagnosis and related procedures.
- Withdrawing or ordering withdrawal of a patient’s blood for diagnostic purposes.
- Performing or utilizing routine laboratory tests.
- Performing physical examinations.
- Rendering nutritional advice.
- Utilizing chiropractic physiotherapy procedures.
A license to practice chiropractic does not authorize the licensee to practice operative surgery or administer or prescribe prescription drugs or controlled substances (Iowa Code 2017, section 151.5).
Rules of the Iowa Board of Chiropractic include acupuncture in the scope of chiropractic practice. A chiropractic physician who engages in the practice of acupuncture must maintain documentation that shows successful completion of a course in acupuncture consisting of at least 100 hours of traditional, in-person classroom instruction with the instructor on site (645 IAC 43.5).
Michigan: Michigan statutes specify the scope of chiropractic practice through a definition of “practice of chiropractic” (MCL 333.16401). The following activities are identified:
- The diagnosis of human conditions and disorders of the human musculoskeletal and nervous systems as they relate to subluxations, misalignments, and joint dysfunctions.
- The evaluation of conditions or symptoms related to subluxations, misalignments, and joint dysfunction.
- The chiropractic adjustment of subluxations, misalignments, and joint dysfunction and the treatment of related bones and tissues for the establishment of neural integrity and structural stability.
- The use of physical measures, analytical instruments, nutritional advice, rehabilitative exercise, and adjustment apparatus.
The practice of chiropractic does not include any of the following:
- The performance of any procedure that cuts or punctures the skin.
