Chiropractic Professional Regulation FAQs

Why regulate health care professionals?

Government statute provides for a board (generally composed of both non-paid professional and consumer members) to handle regulation for each licensed profession.

Their responsibilities:

• to investigate consumer complaints;
• to oversee the general application of health care laws;
• to help update and develop regulations which better define appropriate conduct by professionals and clarify what the consumer may expect;
• to continually review required credentials for doctors to practice safely, effectively, and ethically;
• to apply appropriate disciplinary action or retraining to doctors who may have broken the public trust through violation of statute or regulation;
• to function in the global regulatory community to assist other professions or jurisdictions affected by chiropractic.

The Governor usually appoints the board members for regulated professions. An appointee's term may last three to six years, with reappointment permitted for a prescribed period of time.

Doctors of Chiropractic are licensed in all 50 states plus the District of Columbia and many U.S. territories. They are also regulated in many other countries throughout the world.

Through licensure, the board assures the public that the doctor has met certain credentialing criteria, and that he/she continues to abide by the laws and regulations of that state or province. The requirements to enter licensed chiropractic practice are defined by laws and regulations designed to protect the public's health, safety and welfare.

In general, certain common criteria cross jurisdictional borders. These include:

• Pre-chiropractic education - States may require a minimum of two years in an accredited undergraduate program, which includes a prescribed science content (biology, zoology, general or inorganic chemistry, and related laboratories). An increasing number of U.S. states require a bachelor's degree of candidates for licensure. Most candidates enrolling in chiropractic college today have their bachelor's degrees, while some may achieve it through parallel programs offered by the chiropractic college.
• Graduation from an accredited chiropractic college - All chiropractic colleges in the United States are currently accredited by the Council on Chiropractic Education, an agency recognized by the U.S. Department of Education. Most boards rely on the CCE to be certain the colleges meet both federal and professional educational standards for their programs, while several boards reserve the process of approving schools for the regulatory agency. The chiropractic college curriculum generally spans four to five years, with no less than 4,200 hours of classroom, laboratory and clinical experience under strict supervision. Courses include differential diagnosis, anatomy, biochemistry, physiology, microbiology, pathology, gynecology, pediatrics, geriatrics, radiology, spinal analysis, and a host of other subjects.
• Rigorous examinations - Most boards rely on a four-part examination offered by the National Board of Chiropractic Examiners. This testing series covers basic sciences, clinical sciences, and clinical competency and practical skills. Boards may also require special examinations to be successfully completed by practitioners relocating from another jurisdiction, or those under review for disciplinary or impairment reasons.
• Background investigation - Boards conduct a thorough investigation into the character and credentials history for each applicant for licensure.
• Understanding of state law - This is often called the jurisprudence portion of the board's assessment of the candidate. This is important because there are some differences among jurisdictions in the type of care a chiropractor may legally provide.

While the core concept of practice is based on healing without drugs or surgery, the specific scope may vary according to the laws of a specific jurisdiction. However, patients may commonly expect:

• A thorough physical examination to determine conditions which may be appropriate for chiropractic care;
• To be referred to another health care provider for conditions which are not appropriate for chiropractic care;
• To understand the type of care to be administered, and what results may be expected;
• Discussion with the doctor as the care continues, to evaluate both treatment effectiveness and projected duration;
• A clear understanding of financial arrangements;
• Appropriate, ethical care delivered in confidence, with respect for privacy and dignity.

An essential part of the regulatory board's responsibility is to discipline and/or retrain the small fraction of doctors who step outside law and regulation. Complaints are investigated thoroughly. If the complaint cannot be resolved satisfactorily through informal processes, formal hearings may be conducted to determine facts, severity of offense and whether these sanctions are appropriate:

• Formal letter of reprimand
• Fine
• Probation
• Suspension
• Revocation of License
• Retraining / re-examination
• Other appropriate sanctions

The public may contact the licensing board in each jurisdiction to determine the status of the doctor's license.

Also, the Federation of Chiropractic Licensing Boards maintains an on-line, international databank, known as CIN-BAD. This databank carries information on public actions by chiropractic regulatory agencies related to licenses of individual practitioners. It also lists doctors prohibited from receiving Medicare reimbursement due to federal sanctions imposed by U.S. Department of Health & Human Services. Members of the public may use a query form to request a search of the database.