Federation of Chiropractic Licensing Boards 901 54th Ave., #101, Greeley, CO   80634     (970) 356-3500    FAX (970) 356-3599 Protecting the public and serving our member boards by promoting excellence in chiropractic regulation.

1. Scope of Practice:

• Specific definitions - e.g. Delaware (archaic) and Pennsylvania (detailed)

• General definitions - e.g. California (as taught in chiropractic colleges, without the use of drugs or surgery) and Illinois (the treatment of human ailments without the use of drugs and without operative surgery).

• No definition - e.g. UK, China (Hong-Kong), Australia, New Zealand.

• Problems with a defined scope - compromise and limitation; hard to change and becomes archaic; lack of consistency.

• Alternative of scope of practice in policy bulletin or regulation.

• Drugs - South Africa.

• Children - Denmark (under one year only with medical approval Article 7.3 Chiropractors' Act 1991).

2. The Regulatory Body

• Larger lay representation - compare Ontario ( 9 DCs and 7 lay persons for a total of 16) with California and Florida (5 DCs and 2 lay persons for a total of 7).

• Special representation - educational, medical etc. e.g. UK Chiropractors Act 1994, Schedule 1.

• Election of chiropractic representatives - e.g. Ontario and UK.

3. New Ontario's Starting Point

• Only turf protected is controlled acts which are authorized acts for various professions, Section 27 Regulated Health Professions Act.

• Controlled acts include diagnosis and manipulation ("moving the joints of the spine beyond the individual's usual physiological range of motion using a fast, low-amplitude thrust"). Manipulation is authorized to chiropractic, medicine and physiotherapy.

• Umbrella act providing common regulatory structure for all professions then 23 profession-specific acts.

• All professionals are registered not licenced.

• Greater lay representation on governing council.

• New statutory committees - including Quality Assurance Committee and Patient Relations Committee.

4. Terminology - What can and should be protected in the public interest

• Joint manipulation - "the application of force to a joint by hand or instrument using a sudden thrust or movement."
  
  This definition is scientifically accurate, clear enough for legal enforcement, and provides necessary public protection. It includes all joints, not only spinal joints.
  
  More easily defended than adjustment, mobilization and other definitions of manipulation.

• Chiropractic - expressly or impliedly holding oneself out as being a chiropractor/doctor of chiropractic/chiropractic physician or as practicing chiropractic.

5. Quirks from the international scene

• Cyprus - a regulatory body with a difference

• Hungary - when is a DC an MD?

• Sweden - when you have a registered chiropractor and a chiropractor; how is the public protected?

• Complementary and alternative medicine (CAM) - a new basis for chiropractic legislation.