December 10, 2003
Charles L. Blum, D.C.
1752 Ocean Park Boulevard
Santa Monica, California 90405
Dear Dr. Blum:
Recently we received correspondence from you with questions regarding the
scope of practice of chiropractors in the state of Michigan as it relates
to the ability to perform "Temporomandibular Joint (TMJ) Evaluation and/or
Treatment" or "Craniopathy".
As you are aware, the practice of chiropractic is defined in section 16401(1)(b)(i)
of the Michigan Public Health code as practice pertaining to "diagnosis,
including spinal analysis, to determine the existence of spinal subluxations
or misalignments that produce nerve interference". Subsection (b)(ii)
of this section further defines the practice of chiropractic as "a chiropractic
adjustment of spinal subluxations or misalignments and related bones and
tissues for the establishment of neural integrity..." You have questioned
whether "related bones and tissues" can be construed to include TMJ and cranial
bones.
Because the scope of chiropractic is statutorily defined, the question
whether a given activity is within the scope of chiropractic is one of statutory
construction that is within the jurisdiction of the courts and not the Board
of Chiropractic. Two decisions, Attorney General v Beno
from the Michigan Supreme Court and Hofmann vs. Auto Club Insurance
Association from the Michigan Court of Appeals, address the scope of
chiropractic. While neither decision speaks specifically to practice
as it relates to TMJ or craniopathy, it should be noted that the courts have
narrowly defined chiropractic scope and diagnosis.
Enclosed for your information are copies of these decision.
Should you have further questions or concerns regarding this matter, please
feel free to contact me.
Sincerely,
Diane R. Lewis, Manager
Policy Administration
Health Licensing Division
(517) 335-1752