NYSBC opinion regarding chiropractic diagnosis or analysis

As regards the rendering of a chiropractic diagnosis or analysis, including differential diagnostic work-ups, New York State Education Law authorizes such activity within the lawful scope of chiropractic practice in New York State. The following excerpt of a 1994 response to an attorney addresses this matter:

You asked if chiropractors are permitted to perform examinations and render diagnostic impressions to determine if a patient can be treated within the lawful scope of chiropractic treatment. Education Law, section 6509(2) defines negligence and incompetence as acts of professional misconduct. Were a chiropractor to treat a patient without first having determined the need for treatment, he or she may be practicing negligently or incompetently. Moreover, without an initial work-up, a chiropractor may be treating a patient with conditions beyond the lawful scope of treatment as specified in Education Law, section 6551(3), but that need care from a health practitioner licensed in another profession. Therefore, it is not merely permitted that chiropractors may perform chiropractic diagnostic examinations, it is required for safe, competent and lawful practice...
[Further], given the express statutory prohibition on chiropractors treating specified conditions, it is the legal responsibility of a chiropractor to formulate chiropractic diagnostic impressions of conditions outside the lawful scope of chiropractic treatment for the purpose of [identifying contraindications to chiropractic care and] referral to another licensed health care professional. Failure to do so may constitute professional misconduct.

Finally, Education Law, section 6551 authorizes chiropractors to use such diagnostic testing modalities as x-ray, clinical laboratory services, and electrical devices. Electrical devices may include, but are not limited to Doppler ultrasound, somatosensory evoked potentials (SSEP), nerve conduction velocity (NCV) studies, electroencephalography (EEG), magnetic resonance imaging (MRI), surface and needle electromyography (EMG), and auditory brainstem testing. Such testing may be ordered or conducted within the statutory definition of practice of chiropractic for the purpose of diagnosing "nerve interference and the effects thereof" resulting from or related to "distortion, misalignment or subluxation of or in the vertebral column."

Norman G. Cohen
Executive Secretary

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