Sandefur, R. & Coulter, I. (2001)
Chapter V – Licensure and Legal Scope of Practice,
Retrieved February 1, 2003 from http://www.chiroweb.com/archives/ahcpr/chapter5.htm

• Reviewed by Nan Turner

The article discusses the licensing and regulation of the practice of chiropractic. It addresses the licensure, reciprocity agreements, and legal scope of practice that states have related to the practice. The scope of practice and curriculums vary tremendously from state to state. Because of the differences in the state’s governing boards and regulatory structures, there are a variety of testing and licensing procedures….sounding familiar?? The National Board of Chiropractic Examiners (NBCE) functions similarly to the National Board of Medical Examiners. Only 5 states utilize the National Board of Chiropractic Examiner’s examination as the sole licensing examination. Other states require an additional state examination(s), which they construct and administer. States may even stipulate which colleges are eligible to have graduates take their state examination. It should be noted that all chiropractic colleges in the United States were accredited in 1996. In addition to the variance in State examinations, the NBCE offers an optional Physiotherapy Examination to those students who have received this training in their education (not all do). They have recently added yet a fourth exam – a practical exam. It is interesting to note that despite wide acceptance of the NBCE, all but 10 states continue to administer their own examinations.

The Federation of Chiropractic Licensing Boards is the established single body to facilitate coordination and communication between the State Boards. An independent accreditation agency for chiropractic educational institutions was established and federally recognized as the accrediting body in 1974. (Council on Chiropractic
Education (CCE)).

In terms of reciprocity, there are no states that automatically provide licensure based only upon them having been licensed in another state. The additional requirements vary greatly among states.

State statutes and regulations determine scope of practice, which has resulted in a variety of differences between states. They make a point of stating that the U.S. and State constitutions empower States to grant licensure and to regulate scope of practice. They also realize that the extent of scope of practice is influenced by laws enacted though various means. A table of licensing and reciprocity regulations by state clearly demonstrates the variances from state to state.

The article goes on to discuss the various categorizations of difference in scope of practice: restrictive, expansive, and intermediate.