By the Division of Professional Licensure


From:   Massachusetts Board of Registration of Chiropractors

Re:       Policy Guideline on dietary and nutritional advice

Date:    January 6, 2012 (as revised October 4, 2012)

The Massachusetts Board of Registration of Chiropractors (Board) has voted to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the force or effect of law, as would Massachusetts General Law or a Board rule or regulation. However, the Board utilizes this and other guidelines as an internal management tool in formulating decisions that relate to issues of chiropractic practice.

Purpose

On numerous occasions, the Board has been asked if a licensed Massachusetts chiropractor may properly give dietary and nutritional advice to an individual without also providing a chiropractic adjustment.  The purpose of this guideline is to clarify for licensees and members of the public that chiropractors may provide dietary and nutritional advice as an independent service without any other accompanying primary chiropractic procedure, provided the chiropractor complies with all applicable laws and Board regulations.

Discussion:

General Law Chapter 112, Section 89 defines the practice of chiropractic in Massachusetts to include “the science of locating, and removing interference with the transmission or expression of nerve force in the human body, by the correction of misalignments or subluxations of the bony articulation and adjacent structures, more especially those of the vertebra column and pelvis, for the purpose of restoring and maintaining health.”  The science of chiropractic includes assessment of the three components of health, often described as:  structural, nutritional/biochemical and mental.  Evaluation of a patient’s nutritional health is recognized as both a primary and a supplemental chiropractic procedure.  For this reason, in defining the chiropractic scope of practice in Massachusetts, Board regulations refer to dietary and nutritional advice in two places: 233 CMR 4.01(1) (c) 2 as a supportive service and 233 CMR 4.01(1)(d) as an independent therapy. 

Furthermore, licensed chiropractors are primary health care providers. As such, it would be inconsistent to say that a licensed chiropractor may not answer questions or give advice regarding diet, nutrition and other health matters, unless they also provided a chiropractic adjustment.

Thus, “[c]ounseling and instructing patients of all ages regarding health matters, including but not limited to the following: nutrition, supplementation, diet, exercise, activities of daily living, ergonomics, and good health habits,” as described in 233 CMR 4.01(1)(d), may properly be provided by a chiropractor as a stand-alone service.