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Council on Chiropractic Practice - page 87 / 202





87 / 202

The determination of the need for such procedures should be made on a case-by-case basis and considered necessary only if indicated by the patient's presenting complaints or if a need becomes apparent through the patient history or initial examination findings and so long as they are consistent with the chiropractor’s practice objective.

If the performance of a particular examination procedure will add nothing to the determination of what the attending chiropractor is going to do with the patient then it should be apparent that this procedure is not necessary in the care of that particular patient.

Peer Review & Chiropractic Necessity - Added

Sub-Recommendation - Added

The purpose of chiropractic peer review is to determine if the services rendered to the patient were necessary from a chiropractic perspective.

The general standard for necessary care is any care, therapeutic treatment, or services reasonably expected to improve, restore or prevent the progression of any illness, injury, disease, disability, defect, condition or the functioning of any body member. This is understood to include care provided to detect the existence of vertebral subluxation and the care provided to reduce or correct it.

Rating: Established Evidence: E,L

Commentary - Added

Chiropractic peer review should be based on the best available rational and empirical evidence as it is reflected in journals of established repute, current national and state guidelines/regulations, and other chiropractic literature. Factors used in peer review should be based on widely and generally accepted standards for rendering determinations of the necessity of chiropractic care. In many instances of chiropractic and medical treatment for specific conditions, there is little or no documented scientific evidence for the treatment provided. In those cases where no such evidence exists, the fact that there is no evidence does not render the provided care and treatment unreasonable or unnecessary.


_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision

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