The future of chiropractic is dependent upon preserving our unique contribution to the human experience -- the analysis and correction of vertebral subluxations. Unfortunately, imprecise terminology and ambiguous legislation has made this task challenging. In some circles, the term "manipulation" is used interchangeably with "chiropractic adjustment."

Imprecision in differentiating a chiropractic adjustment directed toward the correction of vertebral subluxation from joint manipulation has resulted in other professions claiming the ability to provide this service. Some managed care organizations have used non-D.C. providers to render "chiropractic manipulation," while groups of physical therapists assert that they address vertebral subluxations.

Through the efforts of the various chiropractic organizations in New Jersey, working together in the New Jersey Chiropractic Forum, a bill has been introduced which clarifies the difference between joint manipulation and spinal adjustments to correct vertebral subluxations. Furthermore, it provides that only a licensed chiropractor may perform spinal adjustments to correct vertebral subluxations.

The implications of this legislation are profound. It is my hope that it will serve as a model for similar legislation in every jurisdiction where chiropractic is regulated.

Following is the text of the bill and statement:

An Act concerning spinal adjustments and manipulations and supplementing P.L.1989, c.153 (C.45:9-41.17 et seq.) and P.L.1978, c.73 (C.45:1-14 et seq.).

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. The Legislature finds that it is in the public interest to protect health care consumers from the unauthorized, unqualified, incompetent and improper application of spinal adjustments and manipulations of the spine. The Legislature declares that the provisions of this act clarify and reemphasize section 19 of P.L.1939, c.115 (C.45:9-14.5) and that this act should be construed in conjunction with that act and P.L.1989, c.153 (C.45:9-41.17 et seq.).

2. a. Notwithstanding any other law or regulation to the contrary, no person, other than a chiropractor licensed by the State Board of Chiropractic Examiners pursuant to P.L.1989, c.153 (C.45:9-41.17 et seq.), or a osteopathic or medical physician licensed by the State Board of Medical Examiners pursuant to R.S. 45:9-1 et seq. shall perform a spinal manipulation on an individual.

b. Notwithstanding any other law or regulation to the contrary, no person, other than a chiropractor licensed by the State Board of Chiropractic Examiners pursuant to P.L.1989, c.153 (C.45:9-41.17 et seq.), shall perform a spinal adjustment on an individual to correct a vertebral subluxation.

c. For the purposes of this section, "spinal adjustment" means the application of a precisely controlled force applied by hand or by mechanical device to a specific focal point on the anatomy for the express purpose of creating a desired angular movement in skeletal joint structures in order to eliminate or decrease interference with neural transmission and correct or attempt to correct a vertebral subluxation; spinal adjustment utilizes, as appropriate, short lever force, high velocity force, short amplitude force or specific line-of-correction force to achieve the desired angular movement, as well as low force neuromuscular reflex technique procedures; "spinal manipulation" means the application of a direct thrust or leverage to move a joint of the spine at the end of passive movement, but without exceeding the limits of anatomical integrity; and "vertebral subluxation" means a complex of functional, structural or pathological articular changes, or a combination thereof, that compromise neural integrity and may influence organ system function and general health.

3. A board subject to the provisions of P.L.1978, c.73 (C.45:1-14 et seq.), after notice and hearing pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall revoke, suspend or otherwise condition a person's license, certificate or registration issued by that board upon proof that the person has violated section 2 of P.L. , c. (C. ) (now before the Legislature as this bill).

4. This act shall take effect on the 90th day following enactment.

STATEMENT

This bill allows only licensed chiropractors, osteopathic physicians and medical physicians to perform spinal manipulations and allows only licensed chiropractors to perform spinal adjustments to correct vertebral subluxations. Spinal adjustment is defined as the application of a precisely controlled force applied by hand or by mechanical device to a specific focal point on the anatomy for the express purpose of creating a desired angular movement in skeletal joint structures in order to eliminate or decrease interference with neural transmission and correct or attempt to correct a vertebral subluxation; spinal adjustment utilizes, as appropriate, short lever force, high velocity force, short amplitude force or specific line-of-correction force to achieve the desired angular movement, as well as low force neuromuscular reflex technique procedures. Spinal manipulation is defined as the application of a direct thrust or leverage to move a joint of the spine at the end of passive movement, but without exceeding the limits of anatomical integrity. Vertebral subluxation is defined as a complex of functional, structural or pathological articular changes, or a combination thereof, that compromise neural integrity and may influence organ system function and general health.

In addition to being subject to penalties imposed by the State Board of Chiropractic Examiners, the bill requires the professional board of any violator to revoke, suspend or otherwise condition that individual's license upon proof of a violation of the provisions of this bill. This bill does not intend to modify the scope of practice of any medical professional licensed by the State Board of Medical Examiners or the scope of practice of any other health care profession or occupation.

Permits only licensed chiropractors to perform spinal adjustments to correct vertebral subluxations.