I write in response to your inquiry regarding chiropractors in New York State using electromyography (EMG). This letter is based on past opinions of the Education Department that have been issued in response to various inquiries from members of the public.
Chiropractic use of EMG for the purpose of diagnosing a physical condition or disease is certainly restricted by the practice act in medicine and by several other provisions of the Education Law to appropriate licensed health practitioners practicing within the scope of their particular professions.
Education Law section 6551 defines the practice of chiropractic as "detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column," and "related" conditions.
EMG is a diagnostic tool which is useful for the purpose of detecting structural imbalance, etc., and related conditions. The use of EMG is currently deemed essential to the practice by the State Board for Chiropractic pursuant to section 73.3 of the Regulations of the Commissioner. Also, EMG devices have not been disapproved by the Federal Food and Drug Administration. Consequently, EMG may be used in the practice of chiropractic in this state, for the purpose of the diagnosis of "nerve interference and the effects thereof" resulting from "distortion, misalignment or subluxation of or in the vertebral column."
The same general principle of law may be applied to either needle insertion (invasive) EMG or surface EMG, which does not involve the use of needle electrodes, but uses surface sensors to monitor innervation with less accuracy. Any diagnostic testing utilizing electrical devices must conform to the same parameters as stated above.
Also please note that the Board of Regents Rules on Unprofessional Conduct holds that a practitioner may be in violation of Part 29.1(b)(9) if he or she is "performing professional responsibilities which the licensee knows or has reason to know that he or she is not competent to perform." It is clearly the responsibility of the licensee to acquire appropriate education and training in the use of any device before utilizing it in his or her professional practice. Special certification in the use of any device is not required prior to utilization in a professional practice, but certainly would provide evidence of competency in the event the licensee were charged with practicing beyond his or her level of competence.
Utilization of any test or treatment modality is addressed in Regents Rules on Unprofessional Conduct, Part 29.2(a)(7), which includes in the definition the "ordering of excessive tests, treatment, or use of treatment facilities not warranted by the condition of the patient" [emphasis added].
If you have further questions about this or other matters, please contact the Board office at the above numbers.
Norman G. Cohen
Executive Secretary