What the statutes mean

For decades, the following scope of practice has defined the work of chiropractors.

The practice of chiropractic is the application of chiropractic science in the adjustment of the spinal column, skeletal articulations and adjacent tissue which includes diagnosis and analysis to determine the existence of spinal subluxations and associated nerve energy expression and the use of procedures and instruments preparatory and complementary to treatment of the spinal column, skeletal articulations and adjacent tissue. Diagnosis and analysis may include physical examination, specimen analysis, drawing blood, blood-analysis and the use of x-ray and other instruments.

The core of the work of a chiropractor is the treatment of spinal subluxations. While some states do not even mention the treatment of spinal subluxations in their scope of practice definitions, Wisconsin understands the importance of maintaining the unique identity of chiropractic.

X-Ray

X-ray is an important diagnostic tool used by chiropractors. However, there are several important restrictions/requirements on its use.

• X-ray may be used only for diagnostic or analytical purposes
• A chiropractor must comply with all safety guidelines required by the manufactorer of the particular piece of equipment they use.
• Chiropractors may not use x-ray procedures that require the introduction of drugs, clinical dyes or radioactive substances.
• Therapeutic x-rays may not be used.
• You must take all of your x-rays unless your staff has been trained in a 48-hour course approved by the examining board. Even if your staff has passed this course, they may only work under your direct, on premise supervision.

Prohibited practice

A chiropractor's scope of practice is limited. The following is a list of prohibited practices. It is very important to note that if you wish to do something that is not in the scope of practice, and is not on the prohibited practice list, you should still obtain written permission from the chiropractic examining board before performing the technique or service.

• You may adjust a patient during pregnancy but you may not practice obstetrics or perform abortions.
• You may not perform surgery.
• You may not administer substances subcutaneously. This includes TB testing.
• You may not practice acupuncture by needle insertion or laser application.
• You may not perform colonic irrigation.

Prohibited techniques

The statute specifically prohibits the following techniques. This prohibition includes using a technique with a different name that is similar to the prohibited technique. If there is any question as to whether a technique is allowed, you should obtain written permission from the chiropractic examining board before you use it in your practice.

• Aculips
• Pfeiffer technique or the application of magnets to the surface or near vicinity of the human body.
• Hair analysis if it is used as the only determinant for recommending chiropractic treatment or nutritional supplementation.
• Therapeutic ultrasound and galvanic therapy unless you have completed the physiologic therapeutics portion of the national board or completed a course approved by the board.
• Any of the following electro-diagnostic devices: EAV, Vegatest, Biotron 1000, Accupath 1000, Vi Tel 618, Interro System, Pro-Phyle, or substantially similar counterparts of any of these devices.
• Any practice system, analysis, method or protocol which does not include the competent assessment, evaluation or diagnosis of the condition to be treated before beginning treatment of the patient.
• Any practice system, analysis, method or protocol which relies upon diagnostic methods that are not generally recognized or accepted within the profession or which do not have scientific validity.
• Any practice system, analysis, method or protocol which is represented as a means of attaining spiritual growth, comfort or well being.

Statute excerpts

• 4.01 Authority
• 4.02 Definitions
• 4.03 Practice
• 4.04 X-ray
• 4.05 Prohibited practice

Chir 4.01 Authority.

This Chapter is adopted under authority in ss. 15.08 (5) (b), 277.11 and ch. 446, Stats., to interpret the statutory definition of chiropractic practice specified in s. 446.01 (2) Stats.

Chir 4.02 Definitions.

As used in this chapter,

1. "Chiropractic science" means that body of systematic and organized knowledge relating primarily to the identification, location, removal or reduction of any interference to nervous system integrity or nerve energy expression and the resulting change in biochemical or physiological homeostasis. It is based on the major premise that disease or abnormal function may be caused by abnormal nerve impulse transmission or expression due to biochemical factors, compression, traction, pressure or irritation upon nerves as a result of bony segments, either deviating from normal juxtaposition or function which irritates nerves, their receptors or effectors.
2. "Instrument" means a device employed or applied in accordance with the principles and techniques of chiropractic science, which is used in the practice of chiropractic to diagnose, analyze, treat or prevent the cause of departure from complete health and proper condition of the human.

Chir 4.03 Practice.

The practice of chiropractic is the application of chiropractic science in the adjustment of the spinal column, skeletal articulations and adjacent tissue which includes diagnosis and analysis to determine the existence of spinal subluxations and associated nerve energy expression and the use of procedures and instruments preparatory and complementary to treatment of the spinal column, skeletal articulations and adjacent tissue. Diagnosis and analysis may include physical examination, specimen analysis, drawing blood, blood-analysis and the use of x-ray and other instruments.

Chir 4.04 X-ray.

1. X-ray may be used only for diagnostic or analytical purposes in the practice of chiropractic. Note: The requirements of ch. HSS 157 apply to licensees who use x-ray equipment.
2. A chiropractor may not use the following forms of x-ray:
1. X-ray procedures that require introduction of drugs, clinical dyes or radioactive substances;
2. Therapeutic x-ray.
3. A chiropractor may employ a technician to operate x-ray equipment only upon submitting proof satisfactory to the board that the technician has successfully complete a course of instruction approved by the board. Any technician employed may work only under the direct supervision and direction of a licensee.

Chir 4.05 Prohibited practice.

1. Scope of Practice. A person who holds a license to practice chiropractic may engage in the practice of chiropractic, as described in s. Chir 4.03. A license to practice chiropractic does not authorize the license holder to engage in practice beyond the scope of chiropractic practice, as described in s. Chir 4.03. Practice beyond the scope of chiropractic includes, but is not limited to, the following:
1. Obstetrics and abortions, except nothing in this paragraph may be constructed to prevent the practice of chiropractic as described in s. Chir 4.03 during a patient's pregnancy;
2. Invasive procedures, such as:
1. Surgery.
2. Subcutaneous administration of substances.
3. Acupuncture by needle insertion or laser application.
3. Colonic irrigation
4. The prescribing, dispensing, delivery or administration of drugs as defined in s. 450.01 (10), Stats., except nothing in this paragraph may be construed to prevent the sale of vitamins, herbs, or nutritional supplements.
2. Techniques, Ancillary Procedures or Instruments. The use of techniques, ancillary procedures or instruments which are unsafe or ineffective, including but not limited to the following or their substantially similar counterparts, are prohibited in the practice of chiropractic:
1. Aculips.
2. Pfeiffer technique. Note: The Pfeiffer technique is the application of magnets to the surface or near vicinity of the human body, either alone or in conjunction with the use of other devices, as a purported basis of a chiropractic diagnosis which depends on the measurement or observation of changes to the functioning or structure of the human body resulting from the application of the magnetic force.
3. Hair analysis if it is used as the only determinant for recommending chiropractic treatment or nutritional supplementation.
4. Therapeutic ultrasound and galvanic therapy may be used by a licensee only if:
1. The licensee has completed the physiologic therapeutics portion of the examinations of the national board of examiners; or
2. The licensee has completed a course of instruction in therapeutic ultrasound and galvanic therapy approved by the board, submits proof of completion to the board and receives acknowledgment of submittal; and,
3. The use of therapeutic ultrasound and galvanic therapy is limited to neurological and musculoskeletal conditions that are amenable to treatment, are not contra-indicated, and are within the scope of chiropractic practice as described in s. 446.01 (2) (a) and (b), Stats.
5. The use of any device in the practice of chiropractic to diagnose, analyze, treat or prevent the cause of departure from complete health and proper condition of the human, which is not employed or applied in accordance with the principles and techniques of chiropractic science is prohibited. Such devices include, but are not limited to:
1. The following electro-diagnostic devices: EAV, VEGATEST, BIOTRON 1000, ACCUPATH 1000, VI TEL 618, INTERRO System, PRO-PHYLE, or substantially similar counterparts of any of these devices.
6. Any practice system, analysis, method or protocol which does not include the competent assessment, evaluation or diagnosis of the condition to be treated before beginning treatment of the patient.
7. Any practice system, analysis, method or protocol which relies upon diagnostic methods that are not generally recognized or accepted within the profession or which do not have scientific validity.
8. Any practice system, analysis, method or protocol which is represented as a means of attaining spiritual growth, comfort or well being.