An Oregon licensed chiropractic physician provides care for
many conditions using a variety of therapeutic procedures, including but not
limited to chiropractic adjustment and manipulation. There is one standard of
care for all patients, irrespective of the condition, service, or advice
provided. All chiropractic physicians licensed under ORS chapter 684 are
subject to the following:
(1) Clinical
justification, within accepted standards and understood by a group of peers,
must be shown for all opinions, diagnostic, and therapeutic procedures. The
singular accepted standard of care includes obtaining a history that informs
the examination, conducting an examination that informs the diagnosis, and
using the diagnosis to inform the management plan which includes relevant
outcome markers.
(2) "Accepted
standards" means skills and treatment which are recognized as being reasonable,
prudent, and acceptable under similar conditions and circumstances.
(3) For neuro-musculoskeletal conditions, all
initial and subsequent examinations performed by a chiropractic physician to
determine the need for treatment shall include a functional chiropractic
analysis. Some combination of at least two of the following PARTS exam
constitutes a functional chiropractic analysis:
P - Location, quality, and intensity of pain or tenderness
produced by palpation and pressure over specific structures and soft
tissues;
A - Asymmetry of sectional or segmental components identified
by static palpation;
R - The decrease or loss of specific movements (active,
passive, and accessory);
T - Tone, texture, and temperature change in specific soft
tissues identified through palpation;
S - Use of special tests or procedures.
(4) Chiropractic physicians shall treat their
patients as often as necessary to allow for favorable progress. Evidence-based
outcomes management shall determine whether the frequency and duration of
curative chiropractic treatment is, has been, or continues to be necessary.
Outcomes management shall include both subjective, or patient-driven,
information as well as objective, provider-driven, information. In addition,
treatment of neuro-musculoskeletal conditions outside of the Oregon Practices
and Utilization Guidelines may be considered contrary to accepted standards.
Chiropractic physicians treating outside of the Practices and Utilization
Guidelines bear the burden of proof to show that the treatment, or lack
thereof, is clinically justified.
(5) Copies of any independent examination
report must be made available to the patient, the patient's attorney, the
treating doctor, and the attending physician at the time the report is made
available to the initial requesting party.
Notes
Or. Admin. Code
§
811-015-0010
2CE 1-1978, f. 6-16-78, ef.
7-1-78; CE 1-1995, f. & cert. ef. 10-30-95; BCE 2-2003, f. & cert. ef.
12-11-03; BCE 1-2005, f. 1-28-04, cert. ef. 2-1-05; BCE 1-2007, f. & cert.
ef. 11-30-07;
BCE
1-2020, amend filed 01/22/2020, effective
1/22/2020
Statutory/Other Authority: ORS 684
Statutes/Other Implemented: ORS
684.155
