Scope of Practice and Permitted Modalities
The scope domain tests the boundary between what a Connecticut chiropractor may lawfully do and what must be referred or left to other licensed providers. Questions usually turn on the definition of chiropractic, the status of adjunctive measures, and the hard statutory exclusions.
The core of the scope
Chiropractic is the analysis and adjustment by hand of subluxations and misalignments of the articulations of the human body, together with the diagnostic work needed to identify them. The practice includes taking a history, performing a physical and neurological examination, ordering and reading x-rays for diagnostic purposes, and using adjunctive physical measures that support the adjustment.
Permitted adjunctive measures (typical)
- Manual and mechanical adjusting and mobilization; traction.
- Physiotherapeutic modalities: ultrasound, electrical stimulation, hot and cold, therapeutic exercise.
- Orthotics, bracing, and ergonomic or nutritional counseling within the licensee's competence.
- Diagnostic imaging, provided the equipment and operator satisfy state radiation requirements.
Hard exclusions
No surgery. No prescribing or administering legend drugs or controlled substances. No radiation therapy. No injection therapy. No treatment of a condition the licensee is not competent to manage. When findings suggest fracture, tumor, infection, or another medical condition outside chiropractic, the standard is to stop, document, and refer.
Worked example
A patient asks the chiropractor to "give me a shot for this sinus infection so I don't have to see anyone else." The office keeps injectable vitamin B12 on hand. Reasoning: injections and legend drugs sit outside the chiropractic scope, and B12 injectables are no exception in Connecticut. Offering them is unlicensed practice of medicine and an independent ground for discipline even if the patient consents, because consent cannot create scope. The correct response is to decline, document the request, and refer to a physician or advanced practice provider.
Traps that cost marks
- Assuming that because a modality is taught at some chiropractic colleges it is automatically permitted in Connecticut.
- Letting an unlicensed assistant perform adjustments or interpret x-rays.
- Using x-ray for treatment rather than diagnosis.
- Believing a signed consent form or a patient's insistence expands scope.
- Missing the referral duty when red flags appear on examination.