Chiropractor in NJ have a new scope of practice finally

Five years in the making to get our legislature to approve a new chiropractic scope of practice bill. We had many people who did not want this to happen, even though our previous scope has not been changed since 1953 and was antiquated and one of the worst in the nation. With the new scope of practice (parameters under which I can function as a chiropractor), I can now fully council patients on nutrition (before I had my hands tied), perform extremity work without relating it to the spine (I was fined years ago for those semantics) and practice the way most chiropractors are taught to in school. The bill also has continuing education requirements that were not required previously, although I had to get continuing ed for my sports certification. This one requirement is necessary to protect the public and to improve the chiropractor. Check out this press release:

Bill expands what New Jersey’s chiropractors can do

Chiropractors in New Jersey are going beyond the back.

Thanks to a measure that passed in both the state Senate and Assembly on Monday, state-licensed chiropractors would be able to treat extremities, prescribe medical tests and give nutritional advice as well as sell nutritional supplements in their offices.

The bill brings New Jersey in line with many other states that have similar regulations.

For example, under New Jersey’s current standards, a chiropractor can treat problems in the extremities such as hands and feet only if they directly relate to problems in the spine, according to Dr. James P. Farrell, a chiropractic physician at Farrell Chiropractic and Rehabilitation in Cape May Court House.

“If someone came into my office with carpal tunnel syndrome, I would have to relate it to the spine or I couldn’t treat it,” Farrell said.

Farrell explained that patients such as athletes, who might need immediate treatment, would be in a difficult position if the injury they sustained wasn’t along the spine.

“There’s only so much time in the day to be writing notes to the insurance companies,” Farrell said.

Farrell said today’s chiropractors are trained to treat beyond the spine, and that includes giving nutrition advice to their patients.

“It brings us into the 21st century,” said Dr. Robert Olivieri, a chiropractic orthopedist at Olivieri Chiropractic and Rehabilitation Center in Rio Grande.

Olivieri said chiropractors are trained to consult patients about nutrition — for example, skeletal pain might not be the result of an injury; it could be related to a vitamin D deficiency, which can lead to bone problems such as rickets and osteomalacia.

Under the new legislation, chiropractors still would not be able to write prescriptions for medications, but they would be able to recommend them.

“Your body’s not lacking Lipitor,” Olivieri said. “But it might be lacking in vitamin D.”

Some opponents of the legislation argued that since chiropractors could sell nutritional supplements in their offices, it could create a conflict of interest.

“We prohibit physicians from selling prescription drugs because if they sell they have a profit motive,” said Assemblyman Sam Thompson, R-Monmouth. “The same would apply to chiropractors.”

Local chiropractors disagree with that argument.

“We sell pillows and other supplies in our practice, and no one has said anything against that,” Farrell said.

Another argument some legislators presented against the bill was one concerning a chiropractor’s ability to perform pre-employment screenings, since they could apply to conditions related to the brain or heart and not to injuries or the spine.

Farrell said that chiropractors are more qualified to give the screenings than nurse practitioners who are currently allowed to give the same pre-employment screenings in the state.

While the bill expands the definition of a chiropractor’s duties in New Jersey, it also requires chiropractors to participate in continuing education programs.

Chiropractors have to complete 30 additional credits of annual training, while those who want to give out nutritional advice must participate in 45 hours in a nutritional study program.

The Assembly passed the bill 64-4 with eight people declining to vote. The Senate voted 23-11. Gov. Jon S. Corzine has to sign the bill for it to become law.

2009 was a tough year for many people. It looks like things in NJ are about to improve markedly for chiropractors and the patients they treat