Chiropractic is a unique health care system distinct from orthodox medicine. It is a discipline of the scientific healing arts concerned with the pathogenesis, diagnosis, therapeutics and prophylaxis of functional disturbances, and pain syndromes of the neuro-musculo-skeletal system, especially of the spine and pelvis.
The most frequently seen conditions include neck pain, arm pain, shoulder pain, upper and lower back pain, sciatica, knee pain, ankle pain and heel pain. Chiropractors also treat conditions resulting from sports injury and motor vehicle accidents, pregnancy-induced / post-partum back pain, and musculo-skeletal problems associated with occupations.
A statement of Dr. David D. Palmer, the acknowledged founder of Chiropractic best illustrates the principles of chiropractic.
...disease was due to interference with the nervous system, primarily at the site where the spinal nerves exit the intervertebral foramen
Dr. Palmer attributed interference with normal nerve function to approximation of vertebrae, which he termed SUBLUXATION.
The modern theory of chiropractic is based on the hypothesis that reversible joint lesions (SUBLUXATION) of the spine produce far ranging effects on the human body. Modern chiropractic does not claim to be a total therapy, but it does adhere to the idea that biomechanical dysfunction can have a profound effect not only on the musculoskeletal system but also on the other systems of the body. While the restoration and normalization of joint motion is the mechanism of chiropractic therapy, the ultimate goal is to promote HOMEOSTASIS of the body.
NUTRITION
VITAMIN AND MINERAL
Your chiropractor is trained in nutrition and how diet affects your health and overall well being. To your chiropractor, nutrition comprises more than simply three meals a day. The chiropractic profession views nutrition as the materials needed to maintain your health, and includes the vitamin, mineral, and tissue building quality of what you eat. Some foods should be avoided, while others consumed more frequently. You should consult your chiropractor directly for your specific nutrient requirements, but here is a general list to consider.
The following items can serve as general tips:
- A KEY TO YOUR GOOD HEALTH
Since your spinal cord is responsible for the proper functioning of your entire nervous system, bad or improper posture can lead to excessive stress upon the spine resulting in increased stress on your body. For example, poor posture can constrain the normal functioning of your lungs, causing breathing problems. The same problem can exist for other vital organs.
Here are some simple tests to determine if you have good posture:
1)Stand facing a wall. Your posture is correct if your chest touches the wall. If your head touches the wall is posture is fair, if your stomach touches, you have bad posture
2)Look at yourself in a full length mirror. If one shoulder is higher than the other, your posture is in imbalance and you should consultant a chiropractor
If your posture is not right, you should consult a chiropractor.
You should not only develop good posture for your back and health, proper care should be observed when lifting any objects.
Here are some tips for safe lifting:
> Establish firm footing with feet shoulder width apart.
> Wear non-slip shoes.
> Lift with your legs.
> Keep your stomach muscles tight
> Do not reach
> Do not bend your back. Bend at the hips and knees.
> Keep the object close to your body.
> Turn with your feet. Don't twist!
> Pull, push, rock, roll or slide the object if possible instead of lifting
Are you suffering from lower back pain? Or, do your headaches never seem to go away?
Have you been injured at work or in a car accident and are having trouble dealing with the pain?
Are you active in sports, but after the game have stiff joints and shooting pains?
Are you pregnant with an aching back?
Are you in your Golden years and having trouble enjoying retirement because those aches and pains are getting in the way?
Are you concerned with the health of your whole body, and are looking for a different approach to health care?
Are you concerned with your newborn's or child's long term well being and growth?
If you answered yes to any of these questions, you should visit your local chiropractor. Every day in Canada, over 120,000 people receive treatment from Doctors of Chiropractic. Your chiropractor is a doctor with over 7 years of university education in the art of hands-on healing. Chiropractors use a combination of treatments for your condition. They are specialists in using exact, gentle manipulations of your spine to make you feel great. Chiropractic treatment also includes diet and exercise programs to get you back into tip-top shape.
On your first visit to the doctor's office, your Chiropractor will:
Review your health history
Learn important information about any surgeries, major illnesses or events in your past that could contribute to your current health problem
Conduct a thorough neurological, orthopaedic, and chiropractic examination
Perform essential diagnostic physical tests, such as reflexes and muscle strength
If necessary, take an appropriate x-ray
Just as there are different reasons for visiting a chiropractor, there are different types of care. Which approach you take depends on what you are trying to achieve. Some patients simply want relief from pain. Others are looking for a way to stay healthy. In either case, chiropractic care works.
I thought chiropractors were just for back pain!
Chiropractic care addresses spinal problems (called subluxations) anywhere in your spine, not just in your low back. A subluxation exists where spinal bones become misaligned or lose their normal range of movement. These problem sites irritate or put pressure on local nerves, which interferes with communication between your brain and body (and vice versa). Using highly skilled, gentle adjustments the unhealthy effect on your body is reduced and corrected. In time, the spine and its nervous system can function normally again. To help you accomplish this, there are different types of chiropractic care available.
What types of chiropractic care are there?
All chiropractic care begins with an initial examination, after which x-rays may be recommended to determine the seriousness of your condition. In addition to being adjusted, you may be given exercises to do, diet suggestions and ways to improve your posture.
Relief Care is provided for acute pain and discomfort. Depending on the diagnosis, your age and physical condition, frequent visits over a relatively short period of time may be required.
Corrective Care treats long term spinal problems. Because they have existed for some time they require a longer period of care, similar to crooked teeth slowly improving with braces.
Maintenance Care helps you retain the benefits you have achieved from the relief and corrective care. Continuing to work with your chiropractor and having periodic adjustments will keep you as healthy as you can be in your particular lifestyle.
Chiropractic visits, exercise and a sensible diet will help you enjoy the best of health well into the future. So now, if you do happen to become a grandparent, it really can be grand.
The word wellness has become a catch phrase that means different things to different people. To your chiropractor wellness is the state of health where your body is free of interruption or interference to any part of your nerve system, enabling you full expression and enjoyment of life. For example, how well you feel is not a dependable indicator of your actual health. Even if you feel you are coping well with recurrent long-term and familiar aches and pains you are still overtaxing your body, resulting in a low overall wellness score.
My chiropractor treats my spine for back and neck problems, what has that got to do with wellness?
Let's start at the beginning. First, it is your nervous system that determines how well you feel mentally, emotionally and physically. When your nervous system isn't up to par because of spinal problems it has to work overtime to compensate.
The effect of an overworked or stressed nervous system can be headache, fatigue, muscle ache and pain and a host of other unpleasant symptoms which can become more serious or lead to more complicated conditions as time passes. The solution can be a simple one: chiropractic care. Your chiropractor is a spinal specialist who can help you restore health to your spine. This will allow your nervous system to work at its best so you can get on with your life.
So you could say my chiropractor is a wellness specialist, right?
Right. Your chiropractor will discover any problems that are interfering with your nervous system and through hands-on healing will work with you to eliminate them. After chiropractic adjustment your body will be better able to heal itself. This, in turn, aids your body in maintaining optimum health and thus contributes to your overall wellness. So yes, in addition to relieving spinal back and neck pain your chiropractor is a wellness specialist.
First of all, if it makes life more difficult for you, that's serious in itself. Even it goes away in a few days you haven't really gotten rid of the problem. It will most likely return and if left untreated, could be more debilitating the next time. Which is why we recommend seeing a chiropractor at the first sign of back pain.
Lower back pain can also be accompanied by a variety of symptoms, some of which indicate very serious problems. Do you currently have or have you ever had:
Leg pain with numbness, tingling and/or weakness?
Back or leg pain with coughing or sneezing?
Difficulty standing up after sitting for any period of time?
Morning stiffness?
Pain after extended walking?
Pain in hip, buttock, thigh, knee or foot?
If you've answered "yes" to any of these symptoms, its time you got help from a doctor. A doctor of chiropractic.
Why a chiropractor?
Chiropractors are doctors with over seven years of university level education in the art of hands-on healing. They're the doctors that have been proven to get the best results in the relief of back pain. The Manga Report (a milestone study by the Ontario Ministry of Health) concluded that chiropractic care is safer, more effective and more scientific, than any other treatment available. Isn't it time you got relief for that aching back?
What will a chiropractor do?
Chiropractors use highly specialized hands-on healing techniques (called adjustments) to correct spinal problems and offer long term relief. Your first visit will include neurological, orthopaedic and chiropractic examinations, and if necessary, an x-ray may be recommended to assist in diagnosing your problem. Once your chiropractor fully understands your condition he'll give you a complete explanation of your test and x-ray results along with an effective plan of treatment. Next Step? Relief.
How does it work?
Through chiropractic adjustments your body is given the opportunity to heal itself. That's because once the spine is properly aligned your entire nervous system can work the way it was intended. Health is restored naturally to your lower back and your whole body.
But long-term relief from back pain is a team effort. There's plenty you can do as well. Consider a healthier lifestyle, moderate exercise, a well-balanced diet and improving your posture. Your chiropractor will do the rest by providing your body with the necessary adjustments to help your spine be healthier and stay healthier.
It will help to understand what causes most headaches. Your spine protects your nervous system which starts with the brain and becomes the spinal cord. When the vertebrae in your neck are unable to move properly, it irritates or puts pressure on the nerves in that area. That can cause headaches. To correct this problem (called a subluxation) a chiropractor gently adjusts the vertebrae. Since most headaches are caused by subluxations, they will soon disappear.
Why would I have spinal problems in my neck?
There are many reasons. They can originally occur during the birth process, and as your body grows and matures. Also, falls, sports activities, motor vehicle accidents, bad posture or simply the stresses of daily living can cause spinal problems. It is also very common for headache sufferers to experience neck pain and stiffness.
But my headaches are migraines?
Migraine headaches are usually severe and sharp, throbbing in nature, and generally affect one side of the head. Tension headaches tend to occur frequently, last a long time and are characterized by a dull, steady pain that feels like a band of pressure around the neck. But despite these differences they are closely related. Chiropractic care has been proven to be extremely effective in treating migraine and tension headaches as well as neck pain and stiffness.
What will the chiropractor do to treat my headaches?
Your first visit will include a consultation, examination and possibly an x-ray to help diagnose your problem. Once your condition is fully understood, your chiropractor will explain your test and x-ray results and outline a treatment plan that is tailored to your needs. Your chiropractor will use highly skilled, gentle manipulations to adjust the spine.
Once my headache stops, does the chiropractic care end?
Your body continues to heal after the pain has gone. Continuing to have chiropractic adjustments helps to retrain your vertebrae to hold their healthy positions. Your nervous system will function more efficiently and your body will be better able to heal itself. In time, exercise, a healthy diet, and periodic visits to the chiropractor will help you stay healthy, pain free, and live life to the fullest.
The wear and tear of everyday life is hard on your spine. It can become misaligned and cause many health problems. This is because the nervous system runs through your spine and controls every function of your body. Chiropractic adjustments are highly skilled, gentle manipulations of your spine. Adjustments help your nervous system to function properly again, which allows your whole body to regain and maintain its good health.
What causes these spinal problems?
These problems are known as subluxations and can initially occur during the birth process. As your body grows and matures, falls, sports activities, accidents, bad posture or simply the stresses and strains of daily life can cause additional spinal problems to occur or can further irritate those that already exist. Left uncorrected, subluxations lead to conditions such as colic in infants, and headaches, back pain and generally poor health in adults.
What is it like to be adjusted?
Patients feel comfortable and relaxed while being adjusted. As the photos suggest, there are many adjustment techniques that your chiropractor may use to best treat your condition.
When should I be adjusted?
If you are experiencing back pain, headaches or any other pain or health problem, you should see your chiropractor immediately. Once your spinal problems have been corrected with adjustments and exercise, it is easy to maintain a healthy spine. Having periodic adjustments, even when you are feeling ok, is the best way to keep your spine in great shape. You might be surprised at how healthy you become, even if you thought you were fine before!
The wear and tear of everyday life is hard on your spine. It can become misaligned and cause many health problems. This is because the nervous system runs through your spine and controls every function of your body. Chiropractic adjustments are highly skilled, gentle manipulations of your spine. Adjustments help your nervous system to function properly again, which allows your whole body to regain and maintain its good health.
What causes these spinal problems?
These problems are known as subluxations and can initially occur during the birth process. As your body grows and matures, falls, sports activities, accidents, bad posture or simply the stresses and strains of daily life can cause additional spinal problems to occur or can further irritate those that already exist. Left uncorrected, subluxations lead to conditions such as colic in infants, and headaches, back pain and generally poor health in adults.
What is it like to be adjusted?
Patients feel comfortable and relaxed while being adjusted. As the photos suggest, there are many adjustment techniques that your chiropractor may use to best treat your condition.
When should I be adjusted?
If you are experiencing back pain, headaches or any other pain or health problem, you should see your chiropractor immediately. Once your spinal problems have been corrected with adjustments and exercise, it is easy to maintain a healthy spine. Having periodic adjustments, even when you are feeling ok, is the best way to keep your spine in great shape. You might be surprised at how healthy you become, even if you thought you were fine before!
Just when you thought you'd be saying goodbye to your chiropractor, she is suggesting a maintenance care program. However, it is important for you to know that your chiropractor is committed to your long-term health and well being. Are you feeling confused? Read on, we will explain. Maintenance care is important and it will benefit you, your spine and especially your overall health.
Remember, how you feel does not always reflect how healthy you really are. As a spinal health expert your chiropractor realizes it is easier to prevent spinal problems than to correct them. That is why a maintenance care program consisting of regularly scheduled chiropractic spinal examinations is being recommended to you.
My problems aren't going to come back, are they?
With proper follow-up chiropractic care your spine will continue to get stronger, but without it, chances are your old problems (and the pain that comes with them) will resurface. Ongoing spinal check-ups and treatments by your chiropractic doctor can not only prevent the return of old problems, they may also stop new problems from developing.
So a healthy spine means a healthy body?
By following a chiropractic maintenance program you will be rewarded with a strong, healthy spine and a renewed sense of well-being.
Your chiropractor and you. It is a team that makes good sense.
Recommending chiropractic care is like passing on the torch of good health.
Doesn't everybody know about chiropractic these days?
Unfortunately not. Many people still turn to traditional medicine to relieve all their pains and illnesses and have no idea about the restorative and preventative benefits of chiropractic care. And even if they have heard of it, they tend to think it's only for back pain.
My sister told me about it, but only after my arthritis became very bad. I wish she had told me a lot sooner.
People often wait until a friend or relative has a serious health problem before they tell them about chiropractic care. This is unfortunate because a chiropractor could prevent many of those problems from developing in the first place by reducing their subluxations* and other spinal problems. If you think someone you know might be interested in chiropractic care, take some of the brochures on display here, and give them to her or him. And perhaps you could tell your friend about your own experience, and how it has helped you.
* Ask your chiropractor for a brochure explaining subluxations.
I feel uncomfortable trying to convince others to use chiropractic care.
There's no need to force the subject. People who are looking for answers to their health problems will welcome whatever information you give them, particularly if it's from your own experience. Good health is a priceless gift. Most people would appreciate knowing how to achieve it, whether or not they choose to pursue it.
Don't chiropractors advertise?
The Chiropractic Doctors' Association of Hong Kong advertises on behalf of chiropractors to help raise awareness of chiropractic and its benefits. However, individual chiropractors rely almost completely on 'word of mouth' references from their patients. If you feel enthusiastic about chiropractic care, please share it with those you care about. Not only would you be passing the torch of health to someone else, but you would be helping chiropractors do what they do best: helping others live healthier lives.
The Chiropractic Philosophy
Your chiropractor uses highly specialized hands-on healing techniques which assist your spine, central nervous system, and body to heal themselves naturally. Chiropractic care helps you return to optimum health by restoring and maintaining nerve and joint function. The end result? You are healthier and pain free, allowing you to live life to the fullest once again.
I thought a chiropractor would cure me with spinal adjustments. Is there more to it than that?
A chiropractor adjusts your spine to reduce the problem areas – called subluxations* – which cause so many health conditions. When your spine is correctly aligned, it allows your nervous system to function properly, and your body can heal itself. Spinal adjustments give your body the opportunity to heal.
* Ask your chiropractor for a brochure explaining subluxations.
What can I do?
Here’s a list to keep on the fridge:
Healing takes place during sleep. You must get a good night’s sleep, and rest when you’re really tired.
Healing takes energy, the kind that comes from proper nutrition. You may need nutritional supplements, which your chiropractor may prescribe, but you definitely need good, wholesome food, eaten calmly and regularly. Avoid foods that are preserved, packaged, or unnatural. Read labels and avoid those that contain chemicals, as well as fatty, salty, or sugary junk foods and excessive amounts of tea, coffee, colas, or alcohol. Learn to appreciate the taste of foods and drinks that are as close to their natural state as possible such as spring water, juices, fresh fruits and vegetables.
Your body was designed to move. Healing requires strong and supple muscles, and a heart and lungs that can send vital nutrients and oxygen to every single cell. Exercise – which is just another word for moving – is essential. Your chiropractor will recommend stretches and exercises to complement your treatment, but good health requires a permanent commitment to making your body move.
Laugh. Research has shown that a key to living long is to live happy. Attitude is hugely important, and the best attitude comes from living with joy in your heart. Surround yourself with family, friends, books and music. Treasure and enjoy the gift that is your life. Learn from your mistakes and make every day count.
Lighten your load. A body in pain, a sick body, may well be a body overcome by tension. Give yourself time to think, time to reflect, time to heal. Remember, in your struggle to achieve a better tomorrow, today is all you really have.
Write about it. Keeping a daily journal makes you stop and think. It can help you to understand yourself better and to grow, and that encourages healing.
Listen to your body. Illness is a normal response a healthy body makes to an unhealthy situation. It’s a signal that something in your life needs to be changed.
Be patient. Keep your chiropractic appointments. Each adjustment builds on the previous one, so it is essential to maintain the schedule your chiropractor prescribes for you.
If my symptoms are gone, why would I continue seeing the chiropractor?
Symptoms usually appear in the last phase of a health problem and are the first to disappear when you begin chiropractic care. However, the spinal problem, called a subluxation*, that caused the symptoms does not go away as quickly. Your chiropractor is trained to treat the cause of your problem, not just the symptoms. Before you received chiropractic care, your body had to compensate for poor spinal alignment. Your nervous system, which runs through your spine, could not function properly and this eventually contributed to your health problems. It’s easy for the spine to fall into old patterns of misalignment and malfunction. That’s why, at regular intervals, your chiropractor will re-evaluate your progress and will suggest options for continuing care, even if your symptoms are gone.
* Ask your chiropractor for a brochure explaining subluxations.
Won’t my spine ever stay healthy without help from a chiropractor?
In time, with chiropractic adjustment, damaged connective tissues heal, and eventually these damaged areas will learn to hold the spine in a healthy position.
So when my spine is completely healthy does chiropractic care end?
That’s up to you. Stress and tension from busy lifestyles, desk and computer work, too much driving, slips and falls, poor sleep patterns, and lack of exercise can recreate subluxations. Regular chiropractic check-ups can help deal with subluxations before they become serious, keeping your spine strong and healthy.
Is it necessary to go on seeing a chiropractor for life?
That all depends on your health goals. For many people, regular chiropractic adjustments are just part of a healthy lifestyle which includes adequate exercise, good nutrition, and a positive mental attitude. It’s a combination you can’t beat. Ask your chiropractor for more information about how to achieve optimal health. And start living your life to the fullest.
Chiropractic care can help prevent joints from wearing out!
Bones don’t “rub” on each other. Instead, each joint is enclosed in a “Capsule” of fluid that should offer a lifetime of friction-free movement. When there is a loss of proper motion or position of spinal bones, this movement can be restricted. Spinal joints above or below attempt to make up the difference by moving too much. Obviously, areas of too much movement are left to stabilize during the healing process. Instead, chiropractic spinal adjustments are directed only to those areas that are “stuck” and not moving enough.
Critics mislead by suggesting that adjustments to the neck can subject patients to unnatural stress or compromise blood supply to the brain. But if the spine were that fragile, people would fear bending over to tie their shoe laces or looking up to enjoy an evening sunset!
Thousands will die this year from anesthesia or needless back surgeries.
Thousands more will perish from common aspirin or destroy their kidneys from so-called “safe” pain medicines. Adverse reactions to prescription medication are the fourth leading cause of death in the United States.
Meanwhile, the rare complications from chiropractic care can be counted on one hand!
Since many spinal problems get started from traumatic births, accidents, or other long-standing problems, permanent correction can be difficult. Years of muscle damage, scar tissue, and ligamental instability can set the stage for a relapse. Some patients find a program of supportive care (like regularly brushing your teeth) to be helpful.
After enjoying initial relief many patients choose to continue with periodic checkups. Decide for yourself whether you want Initial Intensive Care for temporary relief, Rehabilitative Care to stabilize and strengthen the spine, or Wellness Care for non-symptomatic elective care.
It varies from case to case. Some patients will feel better after 3 to 4 treatments whereas others will need more treatments. The number of treatments required largely depends on the severity and chronicity of the problem, patient compliance and lifestyle factors.
The cousultation fee ranges from $300 to $500 generally.
Chiropractors are not physiotherapists. Chiropractic doctors are primary health care practitioners who are able to diagnose, treat and refer out if necessary
This again depends on many factors. Your chiropractor will advise you on the frequency of treatment appropriate to your presenting complaint.
No, it generally does not hurt to get treated though you may sometimes feel mild discomfort after the initial treatment. This is just a reaction from the treatment and it will disappear in 1 or 2 days.
Chiropractic treatment is absolutely safe for pregnant females / older ladies. Chiropractic doctors will only employ gentle manourves on these patients.
It varies from one case to another. Your chiropractor will decide whether you need x-rays taken of your spine for diagnosis before giving you treatment.
The Chiropractors Council is established under the Chiropractors Registration Ordinance, Chapter 428. The Council’s main functions are to maintain a register of persons practising chiropractic and to promote proper standards of professional practice and professional conduct amongst these persons.
The purpose of this book is to provide a Code of Practice applicable to the profession. The Code is intended to provide guidance for conduct and relationships in carrying out the professional responsibilities consistent with the ethical obligations of the profession.
A person who contravenes any part of the Code of Practice may be considered to be guilty of unprofessional conduct but the fact that any matters are not mentioned in the Code shall not preclude the Council from judging a person to have acted in an unprofessional or improper manner by reference to those matters.
The Council wishes to emphasize that whatever is contained in the Code, every case referred to it will be considered on its own merits.
The question of whether any particular course of conduct amounts to misconduct or neglect in any professional respect, and the gravity of such misconduct, are matters which will be determined by the Preliminary Investigation Committee and as appropriate an Inquiry Committee established by the Council, after hearing evidence in each individual case.
If a person desires to have detailed advice on questions of professional conduct arising in particular circumstances, he is advised to consult his professional association, his own legal adviser or senior colleagues for advice. The Council, having a quasi-judicial function, is not able to advise individuals directly.
The Council also wishes to emphasize that, in considering convictions, an inquiry committee is not required to inquire whether the registered chiropractor was properly convicted. A person who faces a criminal charge should remember this if he is advised to plead guilty, or not to appeal against a conviction, in order to avoid publicity or a severe sentence. It would be difficult for him, if he has been convicted of an offence, to argue before an inquiry committee that he was in fact innocent. It is therefore unwise for a person to plead guilty in a court of law to a charge to which he believes that he has a defence.
This Code does not purport to be a complete guide to the Chiropractors
Registration Ordinance, to which reference should be made in relation to specific matters.
CHIROPRACTIC – A BRIEF HISTORY
Chiropractic as a profession was founded in 1895 by a Canadian healer residing at the time in Davenport, Iowa, in the United States of America. Dr. Daniel D. Palmer was a man of vision whose teachings and writings on many subjects, although hypothesis at the time, have been proven as scientific fact generations after his death. Although manipulation has been used by physicians since time immemorial, Dr. D. D. Palmer was the first one to systematise the art of manipulation into a science.
Today there are degree courses in Australia, Canada, Denmark, France, South Africa, U.K. and U.S.A. The admission requirements are on par with those of Medicine and Dentistry. The graduate chiropractor is a Portal-of-Entry Physician trained to diagnose and differentiate between patients that can be successfully treated by chiropractic and those that should be referred to other health discipline(s).
In Hong Kong, chiropractic dates back to before the Second World War. The profession started to become organized in 1967 with the formation of the Hong Kong Chiropractors’ Association (HKCA), and has grown from the founding three to forty-five in 1998. The term 脊骨神經科 has been used since 1981 as the Chinese title for chiropractic and 脊骨神經科醫生 for chiropractors when they were agreed at an HKCA meeting in 1981. The Chiropractors Registration Ordinance in Hong Kong was passed in February, 1993. The legal Chinese term accorded to registered chiropractors is 註冊脊醫. The Ordinance became the first legal act in Asia to officially recognize chiropractic and register chiropractors under a Council. Equally importantly they have been placed on an equal footing with Medicine and Dentistry in the health care system. Chiropractors are acutely aware of the responsibility that has been given to them and look to the Council for mature and unbiased guidance.
SCOPE OF CHIROPRACTIC PRACTICE
Chiropractic is a distinct health care system. It is not a part of orthodox medicine. Chiropractic is a discipline of the scientific healing arts concerned with the pathogenesis, diagnostics, therapeutics and prophylaxis of functional disturbances, pathomechanical states, pain syndromes and neurophysiological effects related to the statics and dynamics of the locomotor system, especially of the spine and pelvis.
To reach a proper diagnosis of a condition, chiropractors apply their knowledge in chiropractic diagnosis, motion palpation, human biomechanics and kinesiology together with diagnostic imaging and laboratory examinations. Proper clinical diagnosis is stressed to distinguish the conditions between those that can be treated by the registered chiropractor and those that cannot. The registered chiropractor should refer any condition that needs alternate care to the appropriate health practitioner.
The practice and procedures which may be employed by the registered chiropractor include the use of diagnostic and therapeutic procedures based on the academic and clinical training received in and through accredited chiropractic institutions or post-graduate chiropractic studies.
Patient care is conducted with due regard for environmental, nutritional and psychotherapeutic factors, as well as first aid, hygiene, sanitation, rehabilitation and physiological therapeutic procedures designed to assist in the restoration and maintenance of neurological integrity and homeostatic balance.
PROFESSIONAL CONDUCT
1. Meaning of ‘misconduct or neglect in any professional respect’
In Doughty v General Dental Council reported in 1988 the Privy Council interpreted the English dentists’ legislation, which uses the words “serious professional misconduct”. The learned judge used these words: “… what is now required is that the General Dental Council should establish conduct connected with his profession in which the dentist concerned has fallen short, by omission or commission, of the standards of conduct expected among dentists, and that such falling short as is established should be serious.”
Following the decision of the Court of Appeal in Hong Kong in Koo Kwok Ho v The Medical Council of Hong Kong, Civil Appeal 23 of 1988 which adopted these comments except for the requirement that the falling short should be serious, the Chiropractors Council will use the test of whether the chiropractor’s conduct has fallen short of the standard expected amongst chiropractors.
2. Basic ethical principles
A registered chiropractor shall :-
2.1 Respect the rights and dignity of all individuals/patients, their rights to a full knowledge of their condition, diagnosis, treatment and any other information pertinent to the aforementioned.
2.2 Serve and attend to his patients regardless of social status, culture, creed, politics, race or nationality.
2.3 Respect the confidence imparted to him in the course of his professional duties, and comply with a patient’s authorization to provide records to those whom the patient designates as authorized to inspect or receive all or part of such records.
2.4 Endeavour to practise with the highest degree of professional competency and honesty in the proper care of his patients. His clinical judgement and practice should be objective and exercised solely for the patient’s benefit.
2.5 Strive continually to update and extend his professional knowledge and skill.
2.6 Be ready to consult and seek the talents of other healthcare professionals when such action would benefit his patients or when his patients express a desire for such consultation.
2.7 Maintain the highest standards of professional and personal conduct, and should refrain from all illegal conduct as well as the appearance of professional impropriety.
2.8 Recognize that his public behaviour may have an impact on the ability of the profession to serve the public.
2.9 Maintain an active interest in the planning and the provision of adequate health service for the community.
2.10 Ensure that professional integrity is not compromised by motives of profit or greed.
2.11 Promote public confidence in the chiropractic profession – a learned profession dedicated to the promotion of health, the prevention of illness and the alleviation of suffering.
2.12 Promote cordial relationships and respect and cooperate with other members of the chiropractic profession and other related professions in an effort to promote information advantageous to the public health and well-being.
2.13 Support and participate in proper activities designed to enable access to necessary chiropractic care on the part of persons unable to afford the fees for such care.
2.14 Only teach chiropractic knowledge and techniques where it is appropriate and would not prejudice the standards and integrity of the chiropractic profession. Any lecture or course of instruction intended to provide competency in chiropractic other than within or through accredited institutions, whether in Hong Kong or anywhere else, may be deemed unethical conduct.
3. Convictions and types of professional misconduct which may lead to disciplinary proceedings and penalty
3.1 Conviction of an offence which may bring the profession of chiropractic into disrepute
It is emphasized that any conviction in Hong Kong or elsewhere which may bring the profession of chiropractic into disrepute may lead to subsequent disciplinary proceedings by the Chiropractors Council, irrespective of the sentence imposed by the court.
The Chiropractors Council will take a serious view if a registered chiropractor is convicted of offences such as criminal deception (e.g. obtaining money or goods by false pretences), forgery, fraud, theft, indecent behaviour or assault, in Hong Kong or elsewhere, whether in the course of his professional duties or not, which brings the profession of chiropractic into disrepute.
3.2 Disregard of professional responsibilities towards patients
Disciplinary proceedings may be instituted in any case in which a registered chiropractor appears to have disregarded his professional responsibility to treat or care for a patient or otherwise to have neglected his professional duties.
3.3 Abuse of alcohol or drugs
Convictions for drunkenness, or other offences arising from the abuse of alcohol or drugs (such as driving a motor car when under the influence of alcohol or drugs), may lead to disciplinary proceedings.
A registered chiropractor who treats patients or performs other professional duties while under the influence of alcohol or drugs to such an extent as to be unfit to perform his professional duties is also liable to disciplinary proceedings.
3.4 Labelling of dispensed supplements
All supplements dispensed to patients directly or indirectly by a registered chiropractor should be properly labelled with the following essential information:-
(a) name of patient;
(b) date of dispensing;
(c) method and dosage of administration if different from that inscribed on the ORIGINAL sealed packagings;
(d) trade name or pharmacological name of the supplements if they are not dispensed in their ORIGINAL sealed packagings.
3.5 Abuse of professional confidence
The fact that a registered chiropractor has, without proper justification, disclosed information which was obtained in confidence from or about a patient would be an abuse of professional confidence.
Whatever the circumstances, a registered chiropractor must always be prepared to justify his action if he has disclosed confidential information. If a registered chiropractor is in doubt about disclosing information in a particular situation, he would be wise to seek advice from a professional association or his legal adviser.
3.6 Abuse of professional position in order to further an improper association or commit adultery
A registered chiropractor who abuses his professional position in order to further an improper, immoral, or indecent association or to commit adultery with a person with whom he stands in a professional relationship may be subjected to disciplinary proceedings.
3.7 Advertising
3.7.1 Registered chiropractors should not engage in self-advertisement.
Advertising is incompatible with principles which should govern relations between members of the professions, and could be a source of danger to the public. ‘Advertising’ in this context will be regarded by the Council in its broadest possible sense to include any means by which a registered chiropractor is publicized, either by himself, his servants, agents or others, in a manner which can reasonably be regarded as promoting his own professional advantage. Whether a registered chiropractor actually benefits from publicity is no defence to a charge of advertising.
3.7.2 The unprofessional conduct of advertising may arise from the publication either directly or indirectly (in any form in Hong Kong or elsewhere) of matter commending or drawing attention to the professional skill, knowledge, services or qualifications of a registered chiropractor when the registered chiropractor concerned has instigated, sanctioned or connived at or organized such publication or failed to take adequate steps to prevent publication.
3.7.3 Advertising may also be considered to occur if a registered chiropractor permits or fails to take adequate steps to prevent the publication either directly or indirectly (in any form in Hong Kong or elsewhere) by other persons of matter which commends attention to his own professional attainments or services, or if a registered chiropractor is associated professionally with or employed by persons or organizations which advertise clinical, diagnostic or other services connected with the practice of chiropractic. In determining whether unprofessional conduct has occurred, it is relevant to take into account:-
(a) the extent and nature of, and possible reason for the publicity; and
(b) the question whether the arrangements appear to have been intended to serve to promote the registered chiropractor’s own professional advantage or financial benefit, or for the promotion of the chiropractic profession.
3.7.4 Advertising may arise from notices or announcements displayed, circulated, or made public by a registered chiropractor in connection with his own practice, if such notices or announcements materially exceed the limits customary in the profession : examples of permitted notices and announcements are given in Appendices I to IX. Rules for the guidance of registered chiropractors in relation to signs, visiting cards, etc., entries in street or telephone directories, circulars and entertainment are set out below:-
3.7.4.1 Signs : The Council disapproves of the exhibition in connection with a practice of any sign which, by its nature, position, size or wording, exceeds what is reasonably necessary to indicate the location of, and entrance to, the premises concerned.
The following are general guidelines in respect of Signboards/Directory Board/Directional Notices and Notices of Consulting Hours :-
(a) Signboards (general)
(i) Definition – The word signboard means any composite or individual notice containing the particulars mentioned at subparagraph
(ii) below which is exhibited in connection with a registered chiropractor’s own practice.
(ii) Restriction
Signboards may not be exhibited other than on the premises at which the practice to which they refer is carried on. Signboards may not be of an ornate type nor may they be illuminated except at night or when situated in a dark place; the illumination should not be more than is necessary to allow the contents to be read. On no account will flashing signs be permitted.
The only particulars which may appear on the signboards are :
(1) The name of the registered chiropractor with the appropriate prefix Dr./Mr./Mrs./Ms./Miss/脊醫 (OR the name by which the practice is known) in Chinese and English or other title(s) acceptable to the Council.
(2) The appropriate term registered chiropractor (註冊脊醫)or other titles acceptable to the Council.
(3) Qualifications registered with the Council together with the appropriate Chinese translation acceptable to the Council.
(4) An indication of the situation in the building of the registered chiropractor’s office.
(5) Other titles acceptable to the Council.
[Note : The terms ‘Registered Chiropractor’, ‘Doctor of Chiropractic’, ‘脊醫,’脊醫註冊’ and ‘脊骨神經科醫生’ can be used interchangeably, provided that it is not used in circumstances which may mislead others to believe that the chiropractor is a medical doctor.] (amended on 31.8.2011)
(iii) Dimensions and sizes
The area of a signboard should be reasonable.
(b) Signboards (location and numbers permitted)
(i) For Ground Floor offices with direct access from the pavement
One Signboard to be exhibited below First Floor level, visible from the street.
(ii) For offices situated within a building having one public entrance
One Signboard to be exhibited at the floor level where the practice is conducted, visible from the street.
One Signboard to be exhibited adjacent to the public entrance to the building, visible from the street.
(iii) For offices situated within a building having more than one public entrance
One Signboard to be exhibited at the floor level where the practice is conducted, visible from the street.
Two Signboard to be exhibited adjacent to a maximum of two public entrances to the building, visible from the street.
(c) Additional signboard permitted
Every registered chiropractor is permitted to exhibit one signboard on or beside the actual door of his clinic/office. The size of the signboard on/beside the actual door of the clinic/office is to be of reasonable size.
(d) Directory boards
Where directory boards are provided in buildings having a number of entrances and lobbies there will be no objection to the use of whatever number of boards are provided. The particulars which may appear on directory boards are those which may appear on signboards. Each entry must conform to the norm for every other entry on the board.
(e) Directional notices
Directional notices must not contain more particulars than those which may appear on signboards. They can only be exhibited within a building. The numbers which may be exhibited will be left to the discretion of the practitioner but the guidance given at the beginning of this section under ‘3.7.4.1 Signs:’ must be given due consideration.
Directional notices must be of reasonable size.
(f) Notices of consulting hours
Every registered chiropractor is permitted to exhibit one separate notice containing his particulars and details of his practice hours provided that this information is not already shown on some other sign. The placement of such a notice is left entirely to the practitioner. However, it is emphasized that only one such notice is permitted and its size should be of reasonable dimensions.
(g) Specific guidance
The Council wishes to warn each registered chiropractor specifically against:-
(i) the use of the word ‘clinic’ or ‘polyclinic’ in any language on his signboards or stationery to describe his private consulting rooms, except prefixed by the word “chiropractic” or otherwise acceptable to the Council.
(ii) the use of such terms as ‘X-Ray’, ‘Red Cross’, ‘Painless Adjustment’, ‘Specific Technique’, ‘Treatments of Diseases’, etc., in any language on his signboards or stationery to advertise services that may or may not be available;
(iii) the exhibition of letters of appreciation or of commendation other than within the chiropractor’s premises;
(iv) the use of any academic qualifications other than those entered against his name in the register in any language on his signboards or stationery;
(v) the use of any descriptive wording such as ‘Specialist’ or ‘Specialist in …’ in any language on his signboards or stationery other than such as has been approved by the Council; and
(vi) the use of his name with his title or degree in any advertising materials such as circulars.
Whilst the exhibition of showcases of equipment or displays of orthotics, spinal supports, nutritional products, herbal products, etc is not prohibited, any such exhibition or display must be discreet and non-obstructive. A chiropractor must not take advantage of his professional capacity in the promotion and sale of such equipment and products and must not abuse the patient’s trust or exploit his lack of knowledge.
3.7.4.2 Stationery etc. : Stationery (that is visiting cards, letterheads, envelopes, notices, etc.) may contain only those particulars which may appear on signboards together with details of the registered chiropractor’s address(es), telephone numbers and consultation hours. Such stationery should not be ornate or professionally flattering or contain any other qualifications or any indication of honorary or other positions held. Any registered chiropractor whose stationery contains other information, qualifications which may be taken by a lay person to represent an additional qualification, indications as to registration(s) acquired, reference to courses of clinical training or periods of study or positions previously held at universities, hospitals, or chiropractic colleges, etc., may be considered to be guilty of unprofessional conduct.
Note : See Section 3.10, misleading and unapproved descriptions and announcements, below.
3.7.4.3 Announcements of commencement of practice and of altered conditions of practice such as change of address, change of partnership or assistantship, telephone number, etc., are permissible provided that :-
(a) A notice of reasonable size should only be placed in publications selected by or acceptable to the Hong Kong Chiropractors Council.
(b) A notice in any newspaper should be in black type only and no coloured decorations, characters or wording should be used. The notice itself should be of a reasonable size.
(c) Where a registered chiropractor’s commencement of practice is announced in a notice of partnership, associateship or assistantship, a separate individual notice of commencement of practice should not be published.
(d) When giving notice of the closure of a branch office, mention should not be made of the address of any other office which is being used by the registered chiropractor.
(e) A notice of ‘Recommencement of Practice’ should only be published where a registered chiropractor has not practised in Hong Kong for a continuous period exceeding twelve months, and then only on condition that cessation of practice was not the result of disciplinary action by the Chiropractors Council.
Draft notices which in the view of the Chiropractors Council are in accordance with the ethics of professional conduct are given as Appendices I to IX.
A registered chiropractor who finds it necessary to inform his patients of a modification in the circumstances of the practice including change of consulting hours may do so by means of a printed letter or card enclosed in a sealed envelope. The wording of such a notice should be restricted to a statement of the modification which has taken place without any addition which might be held to draw attention to the professional skill of any practitioner or to constitute an invitation to consult or visit any practitioner. The chiropractor is responsible for ensuring that it is sent only to persons whom he is reasonably entitled to assume to be his patients. Cards notifying patients of the time which has elapsed since their previous appointments should only be sent with the prior agreement of the persons to whom they are addressed.
3.7.4.4 Entries in street or telephone directories: Such entries should be in normal type only and should accord with the particulars permitted to be used on signboards. Entries in some other section of the Yellow Pages other than within the alphabetical listing of registered chiropractors are not permitted.
3.7.4.5 Circulars: The circulation of visiting cards, announcements or circulars in other forms to persons who are not Chiropractic, Dental or Medical Practitioners may lead to a charge of advertising.
3.7.4.6 Entertainment: The Council is of the opinion that holding an entertainment at a registered chiropractor’s professional premises by a practitioner on opening or transferring a practice is acceptable provided that it is done in a quiet and unobtrusive manner.
3.7.4.7 Supplementary Guidance: The question of advertising may also arise in a number of other contexts, such as books written by registered chiropractors, articles or letters or other items written by or about them in newspapers or magazines, and talks or appearances by registered chiropractors on radio or television. In such cases the identification of a registered chiropractor needs not in itself raise a question of advertising, but such a question may arise from the nature of the material printed or spoken.
Official spokesmen for Government, University, professional associations, hospitals and charitable organizations when discussing matters of public interest may, however, find it necessary, in order to lend authority to their statements, to divulge their names and qualification as a chiropractor (脊醫), a registered chiropractor (註冊脊醫) or other title(s) acceptable to the Chiropractors Council (Refer to Section 3.10, misleading and unapproved descriptions and announcements, below) but no mention should be made of experience or other personal professional particulars (such as the fact that they are in practice).
The giving of lectures to lay audiences (e.g. club or association luncheon speeches) is permitted if the aim is to give general
information or to promote chiropractic and provided that publicity on radio, television or in the lay press is not sought intentionally.
The Council does not consider it unethical for the name and qualification as a chiropractor (脊醫) or a registered chiropractor (註冊脊醫) (Refer to Section 3.10, misleading and unapproved descriptions and announcements, below) of a registered chiropractor to be mentioned in press reports dealing with matters of general interest but again no mention should be made of experience or other personal professional particulars (such as the fact that he is in practice).
Registered chiropractors should take steps to ensure that ethical codes are respected whenever they have dealings with radio, television and press interviews and reporters.
In upholding a decision of the Disciplinary Committee of the General Medical Council, the Judicial Committee of the Privy Council in the United Kingdom have stated some principles which, though enunciated in relation to books and articles, may be regarded as of general application and also applicable to the chiropractic profession :-
‘The Disciplinary Committee were entitled to have regard to the content of the written material, the form in which it was written, and the selected media for its publication in forming conclusions as to what were the purposes which animated the writer. The Committee were entitled to consider whether a desire to give information about a subject and to direct attention to such a subject could have been achieved without directing attention to the personal and unique performance and abilities of the writer.’
‘On the one side of the line there might be a book or an article which is an exposition of a particular subject either written as a text-book for medical students or practitioners or written impersonally in order to give information to the general public. No exception could be taken to such a publication. As an example on the other side of the line there might be a book or an article an essential theme of which is the praise and commendation of the skill and abilities of the writer himself with an express or implied suggestion that his successes in dealing with cases show that potential patients would do well to have resource to him. That would be unethical advertising.’
3.8 Depreciation of other registered chiropractors
The depreciation of the professional skill, knowledge, services, chiropractic techniques or qualifications of another registered chiropractor or other registered chiropractors may lead to disciplinary proceedings.
3.9 Canvassing
Canvassing for the purpose of obtaining patients, either by himself, his servants, agents or others whether directly or indirectly, and association with or employment by persons or organizations which canvass, may lead to disciplinary proceedings. Except in emergency the Council does not consider it permissible for a registered chiropractor to call upon or communicate with any person who is not already a patient of his practice with a view to providing advice or treatment unless expressly requested to do so by that person or by a parent or guardian of that person. Moreover, the Council does not consider it permissible for a registered chiropractor to canvass by means of the distribution of visiting cards, announcement cards or business cards to individuals other than as a result of a request for a card by that individual.
Association by registered chiropractors with nursing homes, medical benefit societies, insurance companies, etc., which advertise clinical and diagnostic services but which allow a free choice of practitioners does not violate ethical codes, but registered chiropractors are warned that association with any such institutions, companies, etc., which advertise clinical or diagnostic services to the general public and direct patients to particular registered chiropractors may be regarded as canvassing. This does not preclude any practitioner or panel of practitioners from being employed by an organisation, company, school, etc., which does not advertise clinical or diagnostic services provided that the names of such practitioners are supplied only to bona fide employees, scholars and their families by the management.
3.10 Misleading and unapproved descriptions and announcements
General :
The Council warns registered chiropractors specifically against the use of descriptive wording which indicates or implies superiority other than such as have been specifically accepted by the Hong Kong Chiropractors Council (such as academic degrees recognized by the Hong Kong Government and/or acceptable to the Hong Kong Chiropractors Council). Reference to unapproved titles or positions held, employment, honourary appointments, or experience and qualifications which are not registrable by the Chiropractors Council, on signboards, stationery, visiting cards, letterheads, envelopes, prescription slips, notices etc, may amount to misconduct. Any registered chiropractor who uses any title or description which may reasonably suggest that he possesses any professional status or qualifications, other than those which he in fact possesses and which are indicated by the particulars entered against his name in the register, may also be guilty of misconduct.
The name of every registered chiropractor regularly attending patients should be shown in the sign exhibited at the premises where he practises. The names of persons other than chiropractors employed in the practice, such as assistants, may not appear on signs outside the premises or in any other form of advertisement.
Registered chiropractors who operate as part of a multi-disciplinary clinic must ensure that any advertising by that clinic, where the services of the registered chiropractor would be deemed to be a part, must not offend the Chiropractors Council’s Code of Practice.
In general the Council considers that any act or omission by a registered chiropractor in connection with his practice which may mislead the public may be held to constitute misconduct.
Detailed advice on the use of acceptable descriptions :
Registered chiropractors are warned that the use of any chiropractic qualification in Chinese characters immediately before or after the registered chiropractor’s name is not allowed. The prefix or suffix in Chinese allowed to be used with the registered chiropractor’s name is “脊醫”,”註冊脊醫”,”脊骨神經科醫生” (See Note below) or other chiropractic titles acceptable to the Chiropractors Council. Chiropractic qualifications in Chinese or in English which are acceptable to the Chiropractors Council may be indicated but such qualifications when used for such purpose must be uniform dimensions. (amended on 31.8.2011)
The Council does not approve of a chiropractor carrying on a practice in a name other than in his name as it appears in the Chiropractors Register or of signs indicating that a chiropractor is in regular attendance at a practice when he is not. If the chiropractor ceases to practise at that location, the sign should then be removed within a reasonable time which should not exceed one year.
A chiropractor can retain his name or sign in his own clinic (owner of the lease or the premises) when he is not practising, while taking leave, etc., for a period of no more than three years. When a chiropractor is working as an associate or employee in a chiropractic clinic, upon termination of the contract, the associate or employee chiropractor has the right to have his name removed from the premises or signs of that particular clinic.
[ Note : The terms ‘Registered Chiropractor’, ‘Doctor of Chiropractic’, ‘脊醫‘,’註冊脊醫’, and ‘脊骨神經科醫生’can be used interchangeably, provided that it is not used in circumstances which may mislead others to believe that the chiropractor is a medical doctor.] (amended on 31.8.2011)
Group Practices :
Signs should not be designed to draw public attention to the services of one practice at the expense of others. In selecting a name, and particularly a collective title for a group or partnership, it is desirable to avoid a name which could be interpreted as implying that the services being provided have received some official recognition not extended to other local chiropractors. For this reason terms which might imply that chiropractic practised therein enjoys some special status in a particular place or area should not be used.
Conclusion :
The Chiropractors Council holds the view that the prior advice of the Hong Kong Chiropractors Council should be sought if any chiropractor wishes to practise in a name other than his own, or if in company with other chiropractors it is considered necessary to identify the practice by the use of a collective title.
3.11 Improper financial transactions (fees sharing)
Sharing fees with any person who has not taken a COMMENSURATE part in the service for which the fees are charged is considered to be an unethical practice, as also is the receipt of rebates from diagnostic laboratories, etc., and may lead to disciplinary action.
3.12 Untrue or misleading certificates and other professional documents
Registered chiropractors are required to issue certificates for a variety of purposes (e.g. incapacity to work through illness, injury certificates, medico-legal reports, progress reports, etc.) on the assumption that the truth of the certificates can be accepted without question. In some cases the certificates are required to include a statement that a patient has been examined and/or treated on a particular date. Registered chiropractors are expected to exercise care in issuing certificates and kindred documents, and should not include in them statements which the registered chiropractor has not taken appropriate steps to verify. Any registered chiropractor who in his professional capacity gives any certificate or similar document containing statements which are untrue, misleading or otherwise improper, renders himself liable to disciplinary proceedings. In particular, registered chiropractors are warned that the signing of blank certificates is prohibited by the Council.
3.13 Covering
The Council considers that a registered chiropractor should in no way countenance, help, encourage or assist, either wilfully or by neglect, the practice of chiropractic by an unregistered person.
3.14 Improper delegation of professional duties
A registered chiropractor who improperly delegates to a person who is not a registered chiropractor duties or functions in connection with chiropractic treatment on a patient for whom the registered chiropractor is responsible or who assists such a person to treat patients as though that person were a registered chiropractor is liable to disciplinary proceeding. The proper employment of *bona fide chiropractic students or ancillary personnel trained to perform specialized functions relevant or supplementary to chiropractic is entirely acceptable provided the registered chiropractor concerned exercises effective personal supervision over any person so employed and retains personal responsibility for the treatment of the patients. Such personnel are required to complete and return the forms as set out at Appendix VI and Appendix VII, as appropriate, before beginning and after terminating such assistantship.
A registered chiropractor, as a Primary-Portal-of-Entry Physician, is expected to refer any patient whom he considers would be better served by such a referral to another health professional.
[ Note : Some of the accredited chiropractic institutions may require their students to spend a stipulated number of hours of study and observation in a registered chiropractor’s office as part of their clinical training curriculum. ]
* A bona-fide chiropractic student is a person who is undergoing or has completed internship at an institution recognized by the Council.