PA Chiropractic Jurisprudence flashcards

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Act 188 of 1986

Pennsylvania's Chiropractic Practice Act, which established the State Board of Chiropractic and defines the legal scope, licensure, and disciplinary framework for chiropractic practice in the Commonwealth.

Board composition

Nine members: five licensed chiropractors, one licensed physician, and three public members. Members serve four-year terms and require Senate confirmation before taking office.

Licensure requirements

Graduation from a Board-approved chiropractic college, passage of NBCE Parts I-IV or Board-accepted equivalent, and successful completion of the jurisprudence examination.

Continuing education hours

Twenty-four hours per biennial renewal period, including at least two hours in ethics and two hours in child abuse recognition and reporting, as required by Pennsylvania law.

License renewal cycle

Chiropractic licenses renew every two years. Practicing on an expired license is a summary offense and may result in criminal prosecution and Board discipline.

Unlicensed practice penalty

The Board may issue a cease-and-desist order and impose civil penalties of up to $1,000 per violation, with each day of unlicensed practice counted as a separate violation.

Record retention period

Patient records must be retained for at least five years from the date of the last patient encounter and released to the patient or authorized representative upon written request.

Grounds for discipline

Unprofessional conduct, practicing beyond scope, fraud in obtaining licensure, and practicing while impaired. The Board may suspend, revoke, restrict, or impose civil penalties.

Informed consent elements

Disclosure of diagnosis, proposed treatment, material risks, alternatives, and the right to refuse. Consent must be obtained before treatment and documented in the patient record.

Patient record documentation

Records must include the initial examination, diagnosis, treatment plan, objective findings, progress notes, and informed consent discussions. Documentation must be contemporaneous and legible.

Sexual misconduct prohibition

A sexual relationship with a current patient is expressly prohibited and constitutes grounds for immediate suspension or revocation, regardless of whether the patient consented.

Fee splitting prohibition

Paying or receiving commissions for patient referrals, and percentage-based arrangements with referral sources who provide no services, are unethical and subject to Board discipline.

Confidentiality exceptions

Disclosure is permitted or required for suspected child abuse, communicable disease reporting, and court orders. HIPAA and Pennsylvania law both govern patient privacy obligations.

Scope-of-practice advertising

Chiropractors may not advertise or claim to cure diseases such as cancer or diabetes through spinal adjustment; such claims are deceptive and subject to Board discipline.

Truthful advertising rule

Advertising must be truthful and not misleading. Testimonials implying guaranteed results, unsubstantiated superiority claims, and misleading use of the title 'doctor' are prohibited.

Impaired practice reporting

Impairment from alcohol, drugs, or physical or mental conditions requires self-reporting and may result in Board-ordered evaluation and monitoring through a professional health program.

Adjunctive certification requirement

Chiropractors may perform adjunctive procedures only after obtaining Board certification, which requires completion of a Board-approved course and passage of a procedure-specific examination.

Certified adjunctive modalities

Physiotherapy modalities such as electrical stimulation, ultrasound, diathermy, and traction, plus therapeutic exercise and manual therapy, are within scope when the chiropractor is certified.

Adjunctive training hours

Certification typically requires a minimum of 120 hours of Board-approved training covering anatomy, physiology, indications, contraindications, and practical application of the procedures.

Prohibited procedures

Chiropractors may not perform surgery, prescribe or administer controlled substances, or use invasive procedures outside the Practice Act, even when adjunctive-certified.

Venipuncture certification

Only chiropractors with additional Board-approved certification may perform phlebotomy for diagnostic purposes, and results must be interpreted within chiropractic scope.

Nutritional counseling scope

Nutritional counseling and supplementation may be provided as adjunctive care within the chiropractor's training; prescribing therapeutic diets to treat disease requires additional qualification.

Radiography authority

Chiropractors may take and interpret x-rays for diagnostic purposes within scope; advanced imaging such as MRI or CT interpretation requires appropriate training and is typically referred out.

Certification renewal

Adjunctive procedure certification must be renewed with the license. A lapsed certification bars the chiropractor from performing those procedures until recertification is complete.

Vertebral subluxation definition

The Practice Act defines chiropractic as diagnosis and treatment of vertebral subluxations and related neuromusculoskeletal conditions by manual or mechanical means.

NBCE examination parts

Parts I through IV of the National Board of Chiropractic Examiners examinations, or a Board-accepted equivalent, are required for Pennsylvania licensure.

Ethics CE requirement

Of the 24 biennial continuing education hours, at least two must be in ethics and two in child abuse recognition and reporting.

Contemporaneous documentation

Progress notes and treatment records must be created at the time of service, remain legible, and accurately reflect objective findings and the patient's response to care.

Referral fee prohibition

Chiropractors may not pay or accept commissions for patient referrals. Percentage-based referral arrangements are unethical and subject to Board discipline.

Child abuse reporting duty

Chiropractors are mandated reporters; suspected child abuse must be reported to ChildLine, and this duty overrides ordinary patient confidentiality obligations.

Therapeutic exercise scope

Therapeutic exercise and manual therapy techniques are adjunctive procedures within chiropractic scope when the chiropractor holds current Board certification in those procedures.

Phlebotomy limitation

Venipuncture is limited to diagnostically certified chiropractors; drawing blood for purposes outside chiropractic diagnosis or treatment is beyond the scope of practice.