General Regulation

General Regulation, M.R. 66/86 The Chiropractic Act , C.C.S.M. c. C100 Regulation 66/86 Registered March 12, 1986 bilingual version (HTML) Table of Contents Section 1 Definitions 2 Registration 3 Standards for practice 4 Incompetence and professional misconduct 5 Specialization 6 Repeal Definitions 1 In this regulation "Act" means The Chiropractic Act ; («  Loi  ») "association" means The Manitoba Chiropractors Association; (« association ») "board" means the board of the association; (« conseil d'administration ») "member" means a registered member of the association entitled to engage in the practice of chiropractic; (« membre ») "register" means the register established under the Act; (« registre ») "registrar" means the registrar of the association appointed under the Act. («  registraire ») Continuation of names in register 2(1) Every person whose name is, on the coming into force of the Act, entered in the register maintained by the association is duly registered under the Act. Registration of applicants 2(2) Subject to the provisions of clause (3)⁠(b) and subsections (13) and (15) any person who furnishes evidence satisfactory to the licensing committee that he (a) is a graduate of a chiropractic college which is accredited by the Council on Chiropractic Education (Canada) or approved by the board; (b) is of good moral character, mentally and physically competent; (c) has passed the Canadian Board examination, as prescribed from time to time by the National Examining Board, and the Manitoba Board examinations, as prescribed under subsection (6); (d) is reasonably fluent in English or French; (e) is authorized by the board to use x-ray; (f) has applied in writing in a form prescribed by the board; and (g) has paid the necessary fees prescribed by or pursuant to the by-laws of the association; is entitled to become a member of the association, to be entered in the register and to be issued a licence. Discretion of licensing committee 2(3) Upon application and payment of the necessary fees the licensing committee in its discretion may, pursuant to criteria established by the board: (a) waive the requirements of clause (2)⁠(c) and direct the registrar to enter in the register the name of any person otherwise qualified who is registered as a chiropractor in any other province, state, country or territory, or who, having been so registered, has resigned while in good standing; (b) enter in the register the name of any person who has satisfied all requirements of subsection (2) other than clause (e) thereof and issue to that person a licence to practise chiropractic subject to such conditions as may be imposed by that committee. Certain applicants to take refresher training course 2(4) An applicant for registration under the provisions of subsection (3) (a) who has not practised as a chiropractor for at least 120 working days in the 3 year period immediately preceding the date of application for registration; or (b) who has not successfully completed the Canadian Board examination and Manitoba Board examinations within the 3 year period immediately preceding the date of application for registration; may be required to successfully complete a course of refresher training approved by the board and administered by the licensing committee before his name is entered in the register. Examination policy 2(5) The board shall approve written examinations as may be required from time to time for administration by the licensing committee of the association. Administration of examinations 2(6) The licensing committee shall administer the written examinations and conduct such oral examinations, in this regulation collectively referred to as the Manitoba Board examinations, as it deems necessary to adequately examine the professional qualifications of the applicants for registration pursuant to subsection (2). Times for holding examinations 2(7) The licensing committee shall fix the times for the holding of the Manitoba Board examinations, which shall not be held after 8:00 p.m. and more often than 3 times in any year. Pre-requisite for taking Manitoba Board examinations 2(8) An applicant for registration is not entitled to take the Manitoba Board examinations unless he has written and passed the Canadian Board examinations with no more than two supplemental examinations to rewrite and paid the examination fee prescribed by or pursuant to the by-laws of the association. Limitation of taking Manitoba Board examinations 2(9) Subject to subsection (10), an applicant for registration is not entitled to take the Manitoba Board examination more than 3 times. Show cause proceedings 2(10) An applicant to whom subsection (9) would otherwise apply may make application to the board to show cause why that subsection should not apply to him and where the board in its discretion deems just, it may make an order accordingly. Non-disclosure of examination scores 2(11) The association shall not disclose the specific examination scores of an applicant except to the applicant; and upon request, each unsuccessful applicant shall be entitled to oral advice of the reasons for his failure. X-Ray authorization 2(12) Every member is authorized by the board in the use of x-ray and entitled to make such use of x-ray as is permitted by the Act if he has (a) satisfactorily completed a course in the techniques of taking and reading x-rays at a chiropractic college either accredited by the Council on Chiropractic Education (Canada) or approved by the board; and (b) passed a practical examination, administered by the board or its duly appointed representatives, in the use of x-ray; and any person who has passed the Manitoba Board examinations shall be deemed to have satisfied these requirements. Renewal of registration 2(13) Commencing with the 1985 registration year of the association, in order to qualify for renewal of registration a member must (a) have practised as a chiropractor for a total of at least 120 working days in the 3 year period immediately preceding the date of application for renewal of registration; or (b) have within 1 year immediately preceding the date of application for renewal of registration successfully completed a reasonable course of refresher training approved by the board; or (c) have practised under the supervision of another member, approved by the board, who has undertaken to the board to provide the necessary supervision and periodic reports required by the licensing committee, for such period of time as the board directs prior to the granting of an unconditional licence; and (d) unless that member made an application for and obtained an order under subsection (14), not be subject to any limitation, suspension or revocation of his right to practise as a chiropractor in any jurisdiction. Show cause proceedings 2(14) A person to whom clause (13)⁠(c) would otherwise apply may make application to the board to show cause why that clause should not apply to that person and where the board, in its discretion deems just it may order that the clause not apply to that person. Entitlement to have name maintained in register 2(15) A member who qualified for renewal of his registration and who for each registration year (a) has paid the licence fee prescribed by or pursuant to the by-laws of the association; (b) has applied in writing in form prescribed by the board; is entitled to have his name maintained in the register as a member. Application for restoration 2(16) A member whose licence has been revoked and whose name has been erased from the register for default in payment of fees or as a result of an order of the board following an inquiry by the inquiry committee shall, upon application for restoration, pay to the association a restoration fee, in addition to such other fees due to the association, to be fixed by the board by resolution which shall not exceed 10% of the licence fee for that year. STANDARDS FOR PRACTICE Premise, apparatus, equipment, etc., to meet standards 3(1) All premises in which chiropractic is being practised in Manitoba shall, at all times, be sanitary and all equipment, apparatus, instruments or appliances used for examination, diagnosis, or treatment shall, at all times, meet generally accepted standards and be in proper working order. Qualifications to use x-ray 3(2) No member shall permit any person in his employ to use x-ray unless that person is a member authorized by the board for the purpose, a graduate or student chiropractor operating under the direct supervision of a member, or a registered radiological technician. Use of x-ray 3(3) In utilizing x-ray, members shall ensure that (a) sufficient clinical indications exist for the taking of x-rays; (b) where acceptable x-rays have already been taken and are available from a colleague or other health professional, no additional x-rays are taken; (c) film is of an appropriate size in relation to the area under examination; (d) exposure technique is consistent with minimum radiation dosage to the patient to obtain maximum radiographic detail; (e) sufficient views are taken to be of diagnostic value, with a minimum of two views, at right angles, of the area of interest for an initial or new examination; (f) reasonable care is taken to protect the patient from excessive radiation with particular attention to protective devices and techniques such as collimation, gonad shielding, filtration and eye protection; (g) reasonable care is taken with female patients of child bearing age to avoid exposure to x-ray during pregnancy; (h) each x-ray film clearly shows the patient's age, sex, surname and initials, the date of exposure, identification of the chiropractor's office where the x-rays were taken, identification of side, right or left views, and position of the patient, such as standing, sitting, A-P, P-A, etc.; (i) where the use of full spine radiography is clinically justified beam attenuation shall be employed between the focal spot and the body being examined to compensate for the various body densities which occur; (j) records of all x-rays made of a patient and the technique used are maintained with the patient's file. Exposure of area to be adjusted 3(4) Palpation or adjustment of the spine or any other joint of the body shall be administered with adequate exposure of the patient's body as is necessary for the procedure. Maintenance of patient records 3(5) Every member shall maintain case histories of patients while under his care, including patients referred by other chiropractors or health care professionals who remain under the care of such referring chiropractors or health care professionals, and in particular shall keep a legibly written or typewritten record in respect of each patient of the member, showing (a) the name, occupation, address, sex, marital state and age of the patient, (b) each date the member sees the patient, (c) a comprehensive history of past and present health, including previous treatment, past illnesses and accidents, operations and an x-ray history of the patient, (d) particulars of each examination of the patient by the member, (e) each diagnosis made by the member respecting the patient, and (f) each treatment prescribed by the member of the patient. Keeping appointment record 3(6) Every member shall keep a day book, daily diary book or appointment record setting out the name of each patient seen or treated or in respect of whom a professional service is rendered by the member. Retaining records 3(7) Every member shall keep the records required under subsection (5) in a systematic manner and shall retain each record for a period of at least 6 years after the date of the last entry in the record except in the event of death or retirement of a member, in which event all records not placed in the custody of an active practising member of the association shall be placed in the custody of the board for distribution to members with the permission of the particular patients. Inspection of records 3(8) Every member shall make the records kept pursuant to subsection (5) and books, records, documents and things relevant thereto, available at reasonable hours and after reasonable notice for inspection by a person authorized to do so by the Act and regulations or any other Act of the legislature. Referral of patients 3(9) Upon the transfer or referral of a patient to another member or other health practitioner the following procedures shall be followed: (a) all relevant information on the patient shall be transferred by the referring member upon request and receipt acknowledged by the recipient; (b) all records transferred, including x-rays, case histories and progress reports shall remain the property of the original chiropractor and shall not be disposed of by the recipient without the consent of the original chiropractor unless 6 years have elapsed from date of preparation. Incompetence 4(1) An inquiry committee may find a member to be incompetent if in its opinion he has displayed in his professional care of a patient a lack of knowledge, skill or judgment or disregard for the welfare of the patient of such a nature or to such an extent that demonstrates that he is unfit to continue in practice. Professional misconduct 4(2) Without limiting the meaning of the term "professional misconduct" the following conduct shall be deemed to be professional misconduct: (a) failure by a member to abide by the terms, conditions and limitations of his licence; (b) contravention of any provision of the Act or the regulations; (c) failure to maintain the standards for practice set out in this regulation; (d) exceeding the lawful scope of practice as defined by the Act; (e) permitting, counselling or assisting any person who is not licensed under the Act to engage in the practice of chiropractic in Manitoba except as authorized by the Act or regulations; (f) failure to provide an itemized account for services rendered on request by a patient or a representative of the patient; (g) charging a fee for services not performed or a fee that is excessive in relation to the services performed; (h) providing treatment which is excessive in the circumstances and charging a fee therefor; (i) falsifying a record in respect of an examination or a treatment of a patient; (j) knowingly submitting a false or misleading account or false or misleading charges for services rendered to a patient; (k) engaging in the practice of chiropractic while the ability to perform a professional service is impaired by alcohol or drugs; (l) sexual impropriety with a patient; (m) failure to provide within a reasonable time and without proper cause any report or certificate requested by a patient or his authorized agent in respect of an examination or treatment performed by a member; (n) providing information concerning a patient's condition or any professional services performed for a patient to any person other than the patient, without the consent of the patient, unless required to do so by law; (o) sharing fees with any person who has referred a patient in excess of fees to which that person is lawfully entitled for services rendered, receiving fees from any person to whom a member has referred a patient in excess of the fees to which the member is lawfully entitled for services rendered or requesting or accepting a rebate or commission for the referral of a patient; (p) abusing a patient verbally or physically without cause; (q) using the designation "clinic" or any other designation indicative of the practice of chiropractic by a group where only one member is engaged in the practice of chiropractic or where two or more members are engaged in the practice of chiropractic under such designation but only one of whom is a full-time practitioner at the location where the practice is carried on; (r) publishing, displaying, or distributing or causing or permitting directly or indirectly, the publishing, displaying, distribution or use of any advertisement, notice or material of any kind whatsoever that contains falsehoods, misrepresentations, misleading or distorted statements as to bodily functions or malfunctions of any kind or as to cures by any method of treatment used by a member or as to a member's training, qualifications or attainments; (s) [repealed] M.R. 100/2008 ; (t) using in any way with respect to a member's practice, after the expiration of a period of 3 years from the date of its acquisition, the name of another member whose practice a member has acquired; (u) failure to observe the code of ethics approved pursuant to the by-laws of the association; (v) failure on the part of a member to comply promptly and completely with any recommendation of the standards committee of the association for the remedying of any unethical, unsanitary, illegal or improper condition, practice, equipment or procedure which its investigation may find; (w) conviction in any court of any indictable offence; (x) conduct or an act relevant to the practice of chiropractic that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional; (y) failure to furnish the Complaints Committee, within 10 days of the date of the request therefor, with a written explanation in respect of the complaint made against that member. M.R. 100/2008 4(3) and (4) [Repealed] M.R. 100/2008 M.R. 100/2008 Specialization 5(1) The recognized areas of specialization within the practice of chiropractic are (a) chiropractic roentgenology; (b) chiropractic clinical sciences; and (c) such others as are recognized by the Canadian Chiropractic Association and the board from time to time. Qualification as specialist 5(2) Any member who furnishes evidence satisfactory to the board that he has met all educational and practical requirements established from time to time by the board in respect of an area of specialization referred to in subsection (1) is entitled to hold himself out as a specialist in such area and to use such terms, titles or designations indicating such specialty as are approved by the board. Revocation of specialist designation 5(3) The specialist designation of a member who fails to maintain the qualifications established by the board from time to time for a specialist designation shall be suspended or revoked on such terms and conditions as the board may determine. Repeal 6 Manitoba Regulation 86A/45 and all regulations made by the board of the association prior to the making of this regulation are repealed. Made at the City of Winnipeg, this 18th day of June, 1985, by the board of the association. G. Dunn, President Raymond Shupena, Registrar