Unlicensed individuals are not permitted to diagnose,
analyze, or perform a chiropractic adjustment. An "unlicensed individual" is
defined as any person, including a student or graduate of a chiropractic
institution, who does not hold a valid California chiropractic license. An
exemption is hereby created for student doctors participating in board approved
preceptorship programs.
The permitted activities of unlicensed individuals are as
follows:
(a) Unlicensed individuals
may take the history of a patient. However, this activity is separate from the
consultation which at all times must be conducted by the licensed
doctor.
(b) Unlicensed individuals
may conduct standard neurological, orthopedic, physical and chiropractic
examinations, except they may not perform such examinations which require
diagnostic or analytic interpretations nor may they render a conclusion either
verbally or in writing regarding the patient's physical condition. As an
example, unlicensed individuals may not perform evaluations of heart or lung
soundings. Such individuals shall be at all times under the immediate and
direct supervision of a licensed Doctor of Chiropractic.
"Immediate and direct supervision" means the licensed Doctor
of Chiropractic shall be at all times on the premises where the examinations
are being conducted. The licensed Doctor of Chiropractic shall be responsible
for the verification of the recorded findings and will be solely responsible
for rendering a conclusion based on the findings.
(c) Unlicensed individuals may administer
physical therapy treatments as an adjunct to chiropractic adjustment, provided
the physical therapy treatment is conducted under the adequate supervision of a
licensed Doctor of Chiropractic. Adequate supervision shall include all of the
following:
(1) The doctor shall be present in
the same chiropractic facility with the unlicensed individual at least fifty
percent of any work week or portion thereof the said individual is on duty
unless this requirement has been waived by the board. The doctor shall be
readily available to the said individual at all other times for advice,
assistance and instruction.
(2) The
doctor shall initially examine and prepare a written treatment program for a
patient prior to the providing of physical therapy treatment by the unlicensed
individual.
(3) The doctor shall
provide periodic reevaluation of the treatment program and of the individual's
performance in relation to the patient. "Periodic reevaluation" shall mean at
least once every thirty days the patient is under active care.
(4) The doctor shall perform and record an
evaluation of the patient and his or her response to treatment at the
termination thereof.
(d)
Unlicensed individuals may mark X-ray films administered by a Doctor of
Chiropractic. "Marking X-rays" is defined as drawing and measuring between
reference points and making angular and linear measurements. Unlicensed
individuals are not permitted to make any diagnostic conclusions or
chiropractic analytical listings, and the licensed doctor is responsible for
any pathological entities covered or obstructed by the markings.
(e) Unlicensed individuals may not administer
X-rays unless they hold a valid X-ray technician certificate from the
Department of Health Services, or participate under the direct supervision of a
licensed Doctor of Chiropractic in a training program approved by that
department and set forth in Section
25668.1
of the California Health and Safety Code. This prohibition, set forth in
Section
30403 of Title 17 of the
California Administrative Code includes the following activities:
(1) Positioning of patient;
(2) Setting up of X-ray machines;
(3) Pushing a button;
(4) Developing of films. The Department of
Health Services has determined that unlicensed individuals may develop X-ray
film if that is their sole radiologic responsibility.
Unlicensed individuals who exceed the permitted scope of
practice set forth in this regulation shall be in violation of Section
15 of the Chiropractic Act and
shall be prohibited from applying for a California chiropractic license for
such time as may be determined by the board. Student doctors participating in
board approved preceptorship programs are not to be considered "unlicensed
individuals" when working in said program.
Notes
Cal. Code Regs.
Tit. 16, §
312
1. Repealer
and new section filed 7-16-79; effective thirtieth day thereafter (Register 79,
No. 29).
2. Amendment filed 2-1-80; effective thirtieth day
thereafter (Register 80, No. 5).
Note: Authority cited: Section
4(b) of the
Chiropractic Initiative Act of California (Stats. 1923, p. lxxxviii).
Reference: Section
15 of the Chiropractic Initiative
Act of California (Stats. 1923, p. lxxxviii) and Section
25668.1,
California Health and Safety Code; Section
30403 of Title 17, California
Administrative Code.
1. Repealer and new
section filed 7-16-79; effective thirtieth day thereafter (Register 79, No.
29).
2. Amendment filed 2-1-80; effective thirtieth day thereafter
(Register 80, No. 5).