Indiana State Chiropractic Association



0000 Indiana State Chiropractic Association Position Paper for Chiropractor’s Licensure LawThe Chiropractor licensure law has not been amended significantly for more than 30 years. The Federation of Chiropractic Licensure Boards after much study and deliberation released a Model Practice Act for Chiropractors on May 1, 2015. The ISCA reviewed this proposal along with surrounding states’ statutes. Because of this almost three-year endeavor, the ISCA is proposing an update to Indiana’s current chiropractic licensure statute. The proposal is modest and consistent with the scope of modern chiropractic education and the standard clinical practices of most chiropractic physicians. The key points that are included in the proposal are:Deletes some of the practice prohibition provisions.Rationale: To align chiropractic clinical practice in Indiana with the breadth and scope of clinical education currently taught at nationally accredited chiropractic institutions as well as to enable chiropractors’ full compliance with modern practice guidelines published by both governmental agencies and private insurance companies.Provide that a member of the Board of chiropractic examiners (Board) may not serve for more than four consecutive terms.Rationale: The Board sets the tone and direction for the profession. Effective board leadership and governance helps ensure that doctors of chiropractic are acting within the scope of their license. Creating an effective board is a continual process that includes recruitment, engagement and development. Term limits lead to healthier boards and reduce the likelihood that a few individuals will dominate board discussions and decisions. Allows the Board to adopt rules concerning peer review.Rationale: The peer review process must be recognized as a rigorous process that produces tangible results. By deferring to the Board, as a governmental agency, to oversee gross professional negligence and/or illegal acts, it relieves any private professional membership association of the responsibility and enhances the veracity of the process.Requires that an applicant for a license to practice chiropractic must, prior to entering chiropractic school, complete at least 90 semester hours of undergraduate training after June 30, 2020. Rationale: The purpose of this requirement is to upgrade the pre-chiropractic program entrance requirements, and to align such requirement with most states and all the chiropractic colleges and universities.Prohibits an individual from using certain titles or abbreviations to indicate or imply that the individual is a doctor of chiropractic unless the individual is so licensed by the state of Indiana as a licensed chiropractor.Rationale: Protects the public by ensuring that only a doctor of chiropractic licensed by the state of Indiana is using the title.Allows a doctor of chiropractic to order, perform and interpret laboratory, radiological, electro-diagnostic, or any other diagnostic studies including advanced imaging of all parts of the human body.Rationale: Doctors of Chiropractic (DC) are designated by the federal government as, direct access primary care physicians and are thus required to arrive at a patient’s diagnosis and, furthermore, deliver the proper standard of care treatment. To ensure the safety of the patient, such obligation demands full access to all diagnostic services chiropractors have been trained to perform and/or interpret. Without such access, arrival at an accurate diagnosis is made less likely and will undoubtedly hinder delivery of appropriate care and/or referral to an appropriate medical specialist when necessary and inevitably increase the cost of healthcare.Diagnose and treat, without the use of prescription medication and surgery, all human injuries, conditions and disorders that chiropractors are trained and competent to diagnose and treat.Rationale: The professional licensing board can discipline a chiropractic physician for engaging or permitting the performance of substandard patient care due to a deliberate or negligent act or failure to act, or for performing therapeutic actions that fall outside the scope of what is currently allowed in law or outside the accredited boundaries of what they have been taught in chiropractic colleges and universities both at the undergraduate and graduate level.The application or dispensing of assistive devices, inclusive of physical therapeutics and physiotherapy.Rationale: Assistive devices include a broad range of physical aids frequently used to assist in managing and assisting in the correction of structural problems of the feet, knees, lower back, neck, and wrists, as a meaningful contribution to the Standard of Care treatment of the patient's injury to a body part or to the improvement of or supporting of a deformed or weakened body limb or body area. Chiropractors currently do this.The use of solid filiform needles for the treatment of muscle pain.Rationale: Dry needling is a skilled intervention totally based on modern scientific neurophysiology and anatomy. It is used by properly trained health professionals (where allowed by state law) who use a thin, solid, filiform needle without injectate to penetrate the skin to manage neuromusculoskeletal pain and movement impairments, by stimulating underlying myofascial trigger points, muscular-connective tissues, muscle tension, normalizing biochemical dysfunction, and thereby facilitate the accelerated return to active rehabilitation. Dry Needling; currently utilized by Physical Therapists and chiropractors in the surrounding states of Ohio, Kentucky, and Illinois, is not acupuncture. Acupuncture is an ancient, comprehensive, Chinese treatment method based on manipulating a theoretical form of energy in the body (“Qi” or “Chi”) via the insertion of thin filiform needles within specific predefined “acupoints.” This needling is utilized to balance the “Yin/Yang” flow of “Qi.” This rebalancing of the “Qi” is thought to improve a vast range of medical pathologies. The only similarly between dry needling and acupuncture is primarily the fact that a thin filiform needle is the instrument used in both methods. Manage, coordinate or delegate patient care functions, including initiating referrals to specialists for concurrent, additional, or alternative services or care the doctor of chiropractic believe is most suited for the individual’s chiropractic condition.Rationale: Besides coordinating or delegating patient care functions, the doctor of chiropractic should refer patients to other practitioners or emergency care when such is warranted, i.e., when red flags are present at intake examination, or there is no response to chiropractic treatment, and all other alternative chiropractic avenues have been utilized or the patient’s condition has worsened with treatment or an emergency arises during management and care. This is currently being done and this is for clarification purposes onlyCounsel and instruct individuals regarding general health matters related to chiropractic treatment, including activities of daily living, diet, weight management, ergonomics, exercise, hygiene, nutrition, risk factor screening, wellness, and good health habits.Rationale: Historically Chiropractors have taken a leadership role in what is now the emerging new wellness model. Chiropractic can be viewed as a therapy with an emphasis on whole body health and wellness. Chiropractic care in addition to providing spinal manipulations gives the patient best lifestyle advice which helps the patient achieve total health and wellness. This is currently being done and the proposal simply clarifies and better defines what chiropractors are educated to do and currently doing. ************ ................
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