What the statutes mean

A chiropractors right to practice in Wisconsin is based on a combination of statutes and administrative rules. The statutes detailed below describe the parameters of the chiropractic profession including a chiropractor's scope of practice and the creation of the Chiropractic Examining Board. The rules the Chiropractic Examining Board enforces for the day to day practice of chiropractic are found in Wisconsin Administrative Code. Other sections of this book describe these rules in detail.

Scope of Practice

There are more than a dozen chiropractic colleges that each have their own unique viewpoint about what they believe should be the limits for the scope of chiropractic profession. Some colleges believe that chiropractors should focus almost entirely on the detection and treatment of subluxations. Other colleges believe that chiropractors should have a more expanded role in the care of a patient.

After students obtain a license, what they learned at school becomes secondary to what is allowed under the law of the state in which they have chosen to practice. In Wisconsin, for example, chiropractors are not allowed to treat patients using acupuncture even though they many have learned those skills as a student. Other states preclude chiropractors from using some types of physical therapy modalities that are allowed under Wisconsin law.

The elements of Wisconsin's scope of practice are as follows:

• Chiropractors examine into the fact, condition, or cause of departure from complete health and proper condition of the human.
• Chiropractors treat without the use of drugs or surgery. The definition of a drug is very precise and is found in s. 450.01 (10). In some instances, nutritional substances, herbs, or vitamins can be considered a drug.
• Chiropractors counsel and advise patients on methods to restore and preserve their health.
• Chiropractors perform their activities for direct and indirect compensation.
• Chiropractors use a wide variety of means to advertise their practices. However, there are rules (see the index under advertising) that limit how a chiropractor may advertise.
• Chiropractors use chiropractic adjustments and the principles or techniques of chiropractic science in the diagnosis, treatment or prevention of any cause of human health or disease.

Practical advice

The definition of chiropractic has been further defined by rules passed by the chiropractic examining board. It is very important for a chiropractor to review the rules in Wi. Admin. Code Chir 4 (see index) to understand the full limits on the chiropractic scope of practice.

Chiropractors are not permitted to prescribe drugs as part of their practice. The definition of drugs is: "any substance intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease or other conditions in persons or other animals.

While a chiropractor is allowed to recommend supplements and vitamins for the "general health” of the patient they can not prescribe or recommend a supplement, vitamin, or herb for a patient's specific injury or health problem without violating the law.

Practice requirements

An individual may not practice chiropractic or claim that they practice chiropractic unless:

• They are licensed by the Wisconsin Department of Regulation & Licensing.
• They meet the requirements the examining board establishes for continuing education during each licensure period.
• They have:
• a bachelors degree from an accredited college or a university
• completed the educational requirements established by the examining board
• passed the exams required by the examining board
• paid the current license fee
• They have a temporary permit granted by the examining board.
• They practice under their own name. Specifically, a chiropractor may not change their name (excluding a change due to marriage or divorce) to unfairly compete with another chiropractor or to mislead the public.
• They personally provide all of the services rendered to a patient except for those that are delegated properly, under the rules established in Chir 10, and are performed under the direct, on-premises supervision of the chiropractor. A chiropractor may never delegate the making of a diagnosis, the performance of a chiropractic adjustment, the analysis of clinical information or a diagnostic test.
• They create and maintain a patient record for every patient they examine or treat. The patient record must contain complete and comprehensive health care information, as defined by the examining board in Chir 11 (see index). The clinical portion of the record, including x-rays, must be kept for 7 years from the date of the last entry into the record.
• They have professional liability insurance in the amount of at least $100,000 for each occurrence and $300,000 for all occurrences in one year.

No license is required for any of the following:

• A student or graduate who practices chiropractic in a program for the clinical training of students and graduates that is approved by the examining board.
• An individual who is licensed to practice chiropractic in another state or territory of the United States and who practices chiropractic under the jurisdiction of the U.S. armed forces, the federal public health service, or U.S. department of veterans affairs.
• An individual who is licensed to practice chiropractic in another state or territory of the United States or in another country and who holds a temporary Wisconsin permit to practice chiropractic.
• A person who performs services that are adjunctive to the practice of chiropractic and that have been properly delegated to them under the rules defined in Chir 10 (see index).

License denials, revocations, suspensions, limitations and reprimands

The examining board may reprimand a chiropractor and may deny, limit, suspend or revoke their license if the chiropractor has:

Obtained the license or certificate through error or fraud.
• Is addicted to alcohol or other drugs.
• Is convicted in any state or federal court of any violation of any law governing the practice of chiropractic or of any other felony.
• Has obtained or sought to obtain anything of value by fraudulent representation in the practice of chiropractic.
• Is guilty of unprofessional conduct.
• Has continued practice after knowingly having an infectious or contagious disease.
• Maintains a professional connection or association with any other person who violates these laws after receiving 10 days notice from the Department of Regulation and Licensing.

Unprofessional conduct

A chiropractor may lose their license for "unprofessional conduct." This section of the statutes only specifies a portion of the conduct that is considered to be unprofessional. A chiropractor also needs to review the rules adopted by the examining board under Chir 6 (see index) for a complete understanding of the types of conduct that are not permitted.

The statutory definition of unprofessional conduct includes:

• Any conduct of a character likely to deceive or defraud the public.
• Loaning of a chiropractic license or certificate to anyone.
• Has obtained or sought to obtain anything of value by fraudulent representation in the practice of chiropractic.

• Is guilty of unprofessional conduct.


• Has continued practice after knowingly having an infectious or contagious disease.

Maintains a professional connection or association with any other person who violates these laws after receiving 10 days notice from the Department of Regulation and Licensing.

• Splitting or dividing any fee for chiropractic service with any person except an associate licensed chiropractor.
• Use of unprofessional advertising which includes:
• Any advertising statement of a character tending to deceive or mislead the public.
• Advertising professional superiority or performance of professional services in a superior manner.

Hearing Procedures

The examining board may investigate and conduct hearings with regard to the conduct of any licensed chiropractor who, it has reason to believe, violated any statute or rule. Likewise, the chiropractor against whom a complaint has been filed has the right to appeal any action taken by the examining board.

If it appears to the examining board that a chiropractor is violating any of these statutes, the examining board or a county's district attorney may investigate the situation and, in addition to any other penalties, bring an injunction on behalf of the state.

Penalties

Anyone violating this chapter may be fined not less than $100 nor more than $500, or imprisoned not more than one year or both.

Statute excerpts

446.01 Definitions. In this chapter:

446.01(1) "Examining board" means chiropractic examining board.

446.01(2) "Practice of chiropractic" means:

446.01(2)(a) To examine into the fact, condition, or cause of departure from complete health and proper condition of the human; to treat without the use of drugs as defined in s. 450.01 (10) or surgery; to counsel; to advise for the same for the restoration and preservation of health or to undertake, offer, advertise, announce or hold out in any manner to do any of the aforementioned acts, for compensation, direct or indirect or in expectation thereof; and

446.01(2)(b) To employ or apply chiropractic adjustments and the principles or techniques of chiropractic science in the diagnosis, treatment or prevention of any of the conditions described in s. 448.01 (10).

446.02 Chiropractic regulated.

446.02(1) Except as provided in sub. (9), no person may engage in the practice of chiropractic or attempt to do so or hold himself or herself out as authorized to do so, unless such person:

446.02(1)(a) Is licensed by the examining board; and

446.02(1)(b) Meets the requirements of continuing education for license renewal as the examining board may require. During the time between initial licensure and commencement of a full 2-year licensure period new licensees shall not be required to meet continuing education requirements. Any person who has not engaged in the practice of chiropractic for 2 years or more, while holding a valid license under this chapter, and desiring to engage in such practice, shall be required by the examining board to complete a continuing education course at a school of chiropractic approved by the examining board or pass a practical examination administered by the examining board or both.

446.02(2)(a) The examining board shall grant a license to practice chiropractic to a qualified person who submits an application for the license to the department on a form provided by the department, accompanied by satisfactory evidence of completion of the educational requirements established in the rules promulgated under par. (b), passes the examination described under sub. (3) and pays the license fee specified in s. 440.05 (1).

446.02(2)(b) The examining board shall promulgate rules establishing educational requirements for obtaining a license under par. (a). The rules shall require that an application for the license that is received by the department after June 30, 1998, be accompanied by satisfactory evidence that the applicant has a bachelor's degree from a college or university accredited by an accrediting body listed as nationally recognized by the secretary of the federal department of education, and has graduated from a college of chiropractic approved by the examining board.

446.02(3) Examination shall be in the subjects usually taught in such reputable schools of chiropractic, and shall be conducted at least twice a year at such times and places as the examining board determines. The examination shall include a practical examination of the applicant as prescribed by the examining board. In lieu of its own written examination, the examining board may accept, in whole or in part, the certificate of the national board of chiropractic examiners.

446.02(3g)(a) The examining board may grant a license to practice chiropractic to an individual who is licensed in good standing to practice chiropractic in another state or territory of the United States or in another country if the applicant presents the license to the examining board, pays the fee specified in s. 440.05 (2) and meets the requirements established in rules promulgated under par. (b).

446.02(3g)(b) The examining board shall promulgate rules establishing additional requirements for obtaining a license under par. (a).

446.02(3r) The examining board may promulgate rules providing for the granting of a temporary permit to practice chiropractic to an individual who is licensed to practice chiropractic in another state or territory of the United States or in another country, and establishing requirements for practicing chiropractic under a temporary permit.

446.02(4) The renewal date and renewal fee for all licenses granted by the examining board are specified under s. 440.08 (2) (a).

446.02(5) The examining board shall keep a complete record of all applications, examinations, licenses, fees and proceedings.

446.02(6) No person may practice chiropractic in this state under any other given name or any other surname than that under which he or she was originally licensed or registered to practice chiropractic in this or any other state in any instance in which the examining board, after a hearing, finds that practicing under the changed name operates to unfairly compete with another practitioner or to mislead the public as to identity or to otherwise result in detriment to the profession or the public. This subsection does not apply to a change of name resulting from marriage or divorce.

446.02(7)(a) Except as provided in par. (b), a chiropractor who is licensed under this chapter may delegate to a person who is not licensed under this chapter the performance of services that are adjunctive to the practice of chiropractic if the services are performed under the direct, on-premises supervision of the chiropractor.

446.02(7)(b) A chiropractor may not delegate to a person who is not licensed under this chapter the making of a diagnosis, the performance of a chiropractic adjustment, the analysis of a diagnostic test or clinical information or any practice or service that the examining board, by rule, prohibits a chiropractor from delegating to a person who is not licensed under this chapter.

446.02(7)(c) A chiropractor who delegates the performance of a service that is adjunctive to the practice of chiropractic to a person who is not licensed under this chapter shall verify, according to standards and procedures established by the examining board by rule, that the person has adequate education, training and experience to perform the delegated service safely, and is responsible for that person's performance of the delegated service.

446.02(7m)(a) A chiropractor shall create and maintain a patient record for every patient the chiropractor examines or treats. A patient record created and maintained under this paragraph shall contain complete and comprehensive health care information, as defined by the examining board by rule.

446.02(7m)(b) A chiropractor shall preserve a patient record created and maintained under par. (a) for at least 3 years after the chiropractor makes his or her last entry or notation in the patient record or for any longer period that is otherwise required by law. (Note: The chiropractic examining board requires these records to be retained for 7 years.)

446.02(8) Every practicing chiropractor shall have in effect professional liability insurance. The examining board shall promulgate rules establishing the minimum amount of insurance required under this subsection.

446.02(9) No license under this chapter is required for any of the following:

446.02(9)(a) A student or graduate of a college of chiropractic who practices chiropractic, in a program for the clinical training of students and graduates that is reviewed and approved by the examining board, under the supervision of a chiropractor who is approved by the examining board to supervise the clinical training of the student or graduate and who is licensed under this chapter and is responsible for the student's or graduate's practice in an infirmary, clinic, hospital or private chiropractic office that is connected or associated for training purposes with a college of chiropractic approved by the examining board.

446.02(9)(b) An individual who is licensed to practice chiropractic in another state or territory of the United States and who practices chiropractic under the jurisdiction of the U.S. armed forces, as defined in s. 40.02 (57m), federal public health service or U.S. department of veterans affairs.

446.02(9)(c) An individual who is licensed to practice chiropractic in another state or territory of the United States or in another country and who holds a temporary permit that is granted under the rules promulgated under sub. (3r).

446.02(9)(d) A person who performs services that are adjunctive to the practice of chiropractic and that are delegated to the person under sub. (7).

446.02(10)(a) The examining board and the physical therapists affiliated credentialing board acting under s. 448.525 shall jointly promulgate rules that establish the circumstances under which and the extent to which a chiropractor licensed under this chapter may claim to render physical therapy or physiotherapy services within the scope of the practice of chiropractic.

446.02(10)(b) The examining board may promulgate rules relating to the circumstances under which and the extent to which a chiropractor licensed under this chapter may claim to render physical therapy or physiotherapy services within the scope of the practice of chiropractic only as provided under par. (a).

446.03 Reprimand; license revocation, limitation or suspension. The examining board, by order, may reprimand a licensee or registrant and may deny, limit, suspend or revoke any license or certificate of registration if the licensee or registrant:

446.03(1) Obtained the license or certificate through error or fraud;

446.03(2) Is addicted to alcohol or other drugs;

446.03(3) Is hereafter convicted in a court of competent jurisdiction, either within or without this state, or in federal court, of any violation of any law governing the practice of chiropractic or of any felony, subject to ss. 111.321, 111.322 and 111.335, a certified copy of the record of conviction to be conclusive evidence of such conviction;

446.03(4) Has obtained or sought to obtain anything of value by fraudulent representation in the practice of chiropractic;

446.03(5) Is guilty of unprofessional conduct;

446.03(6) Has continued practice, knowingly having an infectious or contagious disease; or

446.03(7) If the applicant or registrant maintains a professional connection or association with any other person continuing to violate this chapter after 10 days' notice in writing by the department.

446.04 Unprofessional conduct. Unprofessional conduct includes, without limitation because of enumeration:

446.04(1) Any conduct of a character likely to deceive or defraud the public;

446.04(2) Loaning of a chiropractic license or certificate to anyone;

446.04(4) Splitting or dividing any fee for chiropractic service with any person except an associate licensed chiropractor;

446.04(5) Use of unprofessional advertising which shall include without limitation because of enumeration:

446.04(5)(a) Any advertising statement of a character tending to deceive or mislead the public;

446.04(5)(b) Advertising professional superiority or performance of professional services in a superior manner.

446.05 Procedure for hearings.

446.05(1)Subject to the rules promulgated under s. 440.03 (1), the examining board may make investigations and conduct hearings in regard to the conduct of any licensed chiropractor who, it has reason to believe, violated s. 446.02 or 446.03. The person complained against may proceed to review any action of the examining board under ch. 227.

446.05(2) Upon application and satisfactory proof that the cause of such revocation or suspension no longer exists, the examining board may reinstate any license or registration suspended or revoked by it. This subsection does not apply to a license or registration that is suspended under s. 440.13 (2) (c) or that is revoked under s. 440.12.

446.06 Injunction to enforce this chapter. If it appears upon complaint to the examining board by any person or it is known to the examining board that any person is violating this chapter, the examining board or the district attorney of the proper county may investigate and may, in addition to any other remedies, bring action in the name of and on behalf of the state against any such person to enjoin such person from such violations.

446.07 Penalty. Anyone violating this chapter may be fined not less than $100 nor more than $500, or imprisoned not more than one year or both.