"No person licensed under Tennessee Code Annotated, Title 63, may perform a spinal manipulation or spinal adjustment without first having the legal authority to differentially diagnose and have received a minimum of four hundred (400) hours of classroom instruction in spinal manipulation or spinal adjustment and a minimum of eight hundred (800) hours of supervised clinical training at a facility where spinal manipulation or spinal adjustment is a primary method of treatment."
The regulation does not apply to MDs or DOs.
Lamont Carter, CEO of the Tennessee Chiropractic Association, said the genesis of the legislation was the American Physical Therapy Association encouraging its state affiliates to pursue passage of a uniform practice act to give PTs the legislative authority to manipulate the spine. "We felt that this was an opportune time for us to draft legislation that would clearly protect the doctor of chiropractic and defining who could adjust the spine."
The TCA used the West Virginia legislation as a model. Besides stipulating 1,200 hours of training in spinal manipulation, the TCA decided to add that the practitioner had to be trained in differential diagnosis. "By adding this language, we knew we had eliminated any opportunity for other health care providers to have legal authority to manipulate the spine," explained Mr. Carter.
The TCA was able to educate the legislators on the difference between joint mobilization, as practiced by PTs, and spinal manipulation, as practice by DCs. Spinal manipulation and spinal adjustment were identified as interchangeable terms to identify the "skillful and beneficial treatment" that "uses direct thrust to move a joint of the patient's spine beyond its normal range of motion, but without exceeding the limits of anatomical integrity."
"The unanimous votes in committees and on the floor were certainly a testament to the hard work of the leadership of the Tennessee Chiropractic Association," observed Michael Massey,DC,CCSP, secretary to the TCA. "Our CEO Lamont Carter, and our lobbyist did a remarkable job in moving this legislation and keeping the intent clear throughout," Dr. Massey added.
Mr. Carter noted that the TCA has been working with other state chiropractic associations facing similar situations.
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