H-3766              _______________________________________________

                                                   HOUSE BILL NO. 1751

                        _______________________________________________

State of Washington                              50th Legislature                              1988 Regular Session

By Representatives Vekich, Meyers, Bumgarner, Sanders, Lux, Chandler, May, Bristow, Lewis, Cantwell, P. King and Basich

Read first time 1/25/88 and referred to Committee on Health Care.

AN ACT Relating to practice rights for chiropractors; amending RCW 18.25.005; and adding a new section to chapter 18.25 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 18.25 RCW to read as follows:

          The legislature finds that the purpose of this chapter is to ensure that every chiropractic physician practicing in this state meets minimum requirements for safe practice, in order to promote the public safety and welfare, to define the practice of chiropractic, and to assure the highest degree of professional conduct.

        Sec. 2.  Section 7, chapter 97, Laws of 1974 ex. sess. and RCW 18.25.005 are each amended to read as follows:

          For the purpose of chapters 18.25 and 18.26 RCW, the term "chiropractic" is a philosophy, science, and healing arts profession that deals with health and disease shall mean and include that practice of health care which ((deals with the detection of subluxations, which shall be defined as any alteration of the biomechanical and physiological dynamics of contiguous spinal structures which can cause neuronal disturbances, the chiropractic procedure preparatory to, and complementary to the correction thereof, by adjustment or manipulation of the articulations of the vertebral column and its immediate articulations for the restoration and maintenance of health; it includes the normal regimen and rehabilitation of the patient, physical examination to determine the necessity for chiropractic care, the use of x-ray and other analytical instruments generally used in the practice of chiropractic:  PROVIDED, That)) concerns the detection and treatment of vertebral subluxation, articular dysfunction and neuromusculoskeletal disorders for the restoration and maintenance of health.  "Subluxation" is  defined as a functional defect, alteration of the biomechanical and physiological dynamics, in a joint, with displacement detectable on x-ray, or which may be attended by any of the following:  Fixation, hypomobility, hypermobility, periarticular muscle spasm, edema, and inflammation; and which may cause neuronal disturbances.

It includes examination, analysis, and diagnosis to the extent necessary to determine the nature and appropriateness of chiropractic treatment, or to recognize abnormalities for referral to other licensed health care professionals, or both.  Examination, analysis, and diagnosis may include use of physical, clinical, thermal, laboratory, x-ray, or other generally accepted diagnostic methods and devices as approved by the chiropractic disciplinary board.  Patient records must document the diagnostic tests to justify the extent of treatment or referral.

It emphasizes the use of adjustive or manipulative procedures to reduce subluxations and relieve aberrations of the neuromusculoskeletal system which may cause neuronal disturbances.  Nonspinal manipulative procedures must be utilized in a manner complementary or preparatory to a chiropractic spinal adjustment and not solely as a treatment for a specific nonspinal condition or dysfunction.

It further includes the use of procedures such as:  Heat, cold, water, exercise; and only those physiological therapeutic procedures and instruments whose use is approved by the chiropractic disciplinary board.

It includes the provision of dietary advice and recommendation of nutritional supplementation, which is defined as any vitamins, minerals, foods, food concentrates, or food extracts.  It further includes the normal regimen and rehabilitation of the patient, first aid, and counseling on hygiene, sanitation, and preventive measures.

The chiropractic disciplinary and examining boards may recognize national accrediting agencies to designate chiropractic specialties.  The title "doctor of chiropractic," "chiropractic physician," or "chiropractor" identifies a practitioner of chiropractic as defined in this section.

No chiropractor shall prescribe or dispense any medicine or drug nor practice obstetrics or surgery nor use x-rays for therapeutic purposes((:  PROVIDED, HOWEVER, That)) nor perform colonic irrigation or venipuncture.

The term "chiropractic" as defined in this ((act)) chapter shall not prohibit a practitioner licensed under chapter 18.71 RCW from performing accepted medical procedures or a practitioner licensed under chapter 18.74 RCW from performing accepted physical therapy procedures which shall include skeletal mobilization procedures, except such procedures shall not include ((the adjustment by hand of any articulation of the spine:  AND PROVIDED FURTHER, That nothing herein shall be construed to prohibit the rendering of dietary advice)) manual or mechanical adjustment or manipulation or mobilization  of any vertebral articulation beyond the normal passive physiological range of motion.