|SUMMARY OF SCOPE OF PRACTICE: (Contact State for precise definition by state law)
Pursuant to section 11 (1) of the Health Practitioners Competence Assurance Act 2003, the Board specifies one Scope of Practice for a Chiropractor as a primary healthcare profession concerned with the relationship between structure (primarily of the spine) and function (primarily of the nervous system) as that relationship may affect the restoration, preservation and promotion of health and well-being. Chiropractic principles recognise the inherent recuperative power of the body.
► Essential to the practice of Chiropractic are:
• the assessment of conditions related to the spine, non-spinal articulations and the neuromusculoskeletal system
• the diagnosis, prevention, rehabilitation, management of and education about those conditions.
Aspects of Chiropractic: Forming and communicating a differential diagnosis, diagnosis or clinical impression to identify a cause which impacts on a person’s symptoms, neuromusculoskeletal system and/or well-being and relates to:
• disorders arising from structures or functions of the spine and their effects on the neuromusculoskeletal system; and/or
• disorders arising from structures or functions of the non-spinal articulations.
Note: Primary contact objectives mandate an appropriate level of competence in the disciplines of anatomy, physiology, orthopaedics, neurology, rheumatology, pathology and clinical practice in order to:
• recognise conditions requiring referral to other health care practitioners and make such referrals as appropriate. (Such referral does not obviate the responsibility of the chiropractor for providing appropriate chiropractic care.);
• recognise contraindications to chiropractic care;
• recognise the need to modify chiropractic techniques as required;
• recognise the need for concomitant care;
• recognise and respect the cultural values of individuals and families.
In the process of forming a differential diagnosis, diagnosis or clinical impression a chiropractor may:
• elicit a case history and conduct appropriate components of a routine physical examination;
• perform a comprehensive functional spinal assessment;
• take or order x-rays as an analytical tool used in the detection, location, evaluation, reduction, correction and monitoring of spinal and/or non-spinal articulations, dysfunctions, and to determine structural integrity, anomalies, mobility / immobility, and contraindications to chiropractic care;
• utilise other diagnostic modalities consistent with chiropractic practice including by way of example and not by way of limitation: neurocalometry, thermography, surface electromyography (sEMG);
• order or make recommendations for other such diagnostic or analytical tests consistent with chiropractic practice including by way of example but not by way of limitation: bioanalytical laboratory tests, diagnostic musculoskeletal ultrasound, radiology, computerised axial tomography (CT), magnetic resonance imaging (MRI), radio-isotope bone scan, invasive electromyography and nerve conduction studies;
In the process of delivering chiropractic care, a chiropractor may:
• utilise chiropractic adjustment(s) and/or manipulation(s) in order to address 1) dysfunctions or disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the neuromusculoskeletal system; commonly referred to by chiropractors as the vertebral subluxation complex (VSC); 2) dysfunctions or disorders arising from the structures or functions of the non-spinal articulations.
• manage dysfunctions or disorders arising from environmental, physical, psychological and nutritional irregularities which can impact on the neuromusculoskeletal system and the well-being of the person.
• utilise adjunctive or supportive procedures and advice including by way of example but not by way of limitation: myofascial trigger point therapy and other soft tissue techniques, application of heat/ice, taping, bracing, stretching, strengthening exercises, dietary advice, nutritional supplementation, ergonomic assessment and guidance, psycho-social support, physiological therapeutics (e.g. ultrasound) and other healthful living practices.
• recommend and deliver chiropractic care as determined by chiropractic analytical procedures, even in the absence of subjective symptoms.
• recognise the need for activity based rehabilitation incorporating a cognitive behavioural approach and either provide or refer patients as required for activity based rehabilitation.
• insert a gloved finger into the oral cavity for the purpose of adjusting the temperomandibular joint (TMJ) and cranial articulations.
• insert a gloved finger into the nasal passage for the purpose of adjusting cranial articulations.
• insert a gloved finger beyond the anal sphincter for the purpose of adjusting the coccyx and testing for sphincter integrity
• provide chiropractic care across the full spectrum of gender, age, religion and culture. Chiropractic care can also extend to animals.
Where a Doctor of Chiropractic:
• can demonstrate academic, post-graduate certification, diploma/diplomate status within; and/or
• holds New Zealand registration within another health care discipline, that Doctor of Chiropractic may utilise his/her specialties in conjunction with, or preparatory to, their care regime for the well being of patients.
Note: Only appropriately qualified practitioners are able to perform analysis and provide chiropractic care for non-spinal articulations.
In the course of carrying out Chiropractic services, the Doctor of Chiropractic must adhere to the New Zealand Chiropractic Board’s Code of Ethics and Standards of Practice and other directives of the New Zealand Chiropractic Board and abide by relevant Government legislation and common law.