NYSBC opinion regarding Manipulation Under Anesthesia.

I write in response to your inquiry regarding chiropractic manipulation under anesthesia.

Education Law, section 6551(1) states: "The practice of the profession of chiropractic is defined as detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column."

Section 6551(3) further states: "A license to practice chiropractic shall not permit the holder thereof to treat for any infectious diseases such as pneumonia, any communicable diseases listed in the sanitary code of the state of New York, any of the cardio-vascular-renal or cardio-pulmonary diseases, any surgical condition of the abdomen such as acute appendicitis, or diabetes, or any benign or malignant neoplasms; to operate; to reduce fractures or dislocations; to prescribe, administer, dispense or use in his practice drugs or medicines; or to use diagnostic or therapeutic methods involving chemical or biological means except diagnostic services performed by clinical laboratories which services shall be approved by the board as appropriate to the practice of chiropractic; or to utilize electrical devices except those devices approved by the board as being appropriate to the practice of chiropractic. Nothing herein shall be construed to prohibit a licensed chiropractor who has successfully completed a registered doctoral program in chiropractic, which contains courses of study in nutrition satisfactory to the department, from using nutritional counseling, including the dispensing of food concentrates, food extracts, vitamins, minerals, and other nutritional supplements approved by the board as being appropriate to, and as a part of, his or her practice of chiropractic. Nothing herein shall be construed to prohibit an individual who is not subject to regulation in this state as a licensed chiropractor from engaging in nutritional counseling."

Nothing in the above-quoted provisions of law would prohibit a chiropractor from performing spinal or extra-spinal manipulations on patients who are under anesthesia. However, the chiropractor is not authorized to order or administer anesthesia.

Any chiropractor licensed in New York State is obliged to know that he or she is competent to perform such a procedure by virtue of education or training. Also, the procedure must be warranted by the condition of the patient and, thus, would not constitute excessive treatment, which would be a violation of Part 29 of the Regents Rules on Unprofessional Conduct.

I would note that while it is permissible in New York State for chiropractors to perform manipulations on patients under anesthesia, the issues of obtaining hospital privileges and finding physicians willing to prescribe and administer anesthesia for this purpose must be addressed. Information regarding hospital privileges and appropriate conduct for a physician is within the jurisdiction of the New York State Department of Health. For that information, you may call or write to the General Counsel for the Department of Health, Corning Tower, 24th floor, Empire State Plaza, Albany, NY 12237, telephone (518)474-7553.

Norman G. Cohen
Executive Secretary

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