DC FAQs By WSCA Staff


What is the age at which a patient can legally consent to chiropractic care? I thought that early and mid-teens could consent, am I wrong?


Yes, unfortunately, you are wrong. The legal age for a patient to consent to chiropractic care is 18. It’s true that younger patients can—in some scenarios—consent to primary care, emergency care, and some behavioral health services, but they must be 18 years old to consent to specialty care; and that’s what chiropractic is considered in this state.


Are chiropractors allowed to do cupping in Washington?


That depends on the type of cupping you want to do. There are basically three types: wet, dry, and fire. Wet cupping involves the lacerating the skin. That is clearly out-of-scope for Washington chiropractors.


On a somewhat related


note—when treating a minor, whose ID should I copy? Does the patient record need an ID on file?


Dry cupping and fire cupping, however, are probably the forms you’re thinking of. And while they are not expressly within scope, neither are they out-of-scope. So to determine which one they are, we look at how the procedures are done, whether any element of their delivery is potentially prohibited, if the conditions they are used to treat are among those treated by other widely accepted chiropractic techniques, and whether the mechanisms of the therapies are consistent with other approved chiropractic treatments.


If it’s not already a standard practice for you, you should be collecting copies of IDs for all patient records, including minor patients. Why? Well, there’s a couple reasons we can think of:


• You should organize your patient records as uniformly as possible. By that, I mean you should keep all the same paperwork in everyone’s record to the greatest extent possible. So if you take IDs from some patients, you should take them from all. Consistency is a best practice.


• If the minor has a government-issued ID (driver license, identification card, passport, etc.), get a copy of that. If they don’t have an ID though, it’s not absolutely necessary for their record until they’ve come of age.


• You should get an ID from the parent or guardian (whoever is consenting to care and/or responsible for payment). There are practical reasons for this, like having the contact info for whoever gets your bill. But there are also less common scenarios where having that information is important. As a healthcare provider, you are a mandatory reporter. If you suspect a minor patient is being abused at home, it would helpful to have the potential abuser’s information to give to the police and/or social services.


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Here, with dry cupping, the procedure involves placing a heated cup on the patient’s skin. The cooling of the air creates a suction effect. Fire cupping working in much the same way except that the cups are heated with open flame and massage oil may be used on the skin to create a better seal and/or permit the cup to be glided over a given muscle group. None of those things are prohibited for chiropractors. Generally, the conditions that chiropractors treat with these procedures are musculoskeletal pain—something expressly within the chiropractic scope. And finally, the basic action of both dry and fire cupping is the use of heat to manipulate soft tissue. In other words, massage…which is expressly within scope as well.


So, the answer is yes, dry and fire cupping are likely both within scope; however, it is important to note that every chiropractor has a professional duty to ensure they are sufficiently competent to perform any procedure they use. This means formal training, and as of the time of this publication, the CQAC has not recognized any single cupping training program for chiropractors. That does not mean they don’t exist or that you can’t obtain sufficient training to obtain or demonstrate that competency. It just means that you have to use your best clinical judgment while keeping the safety and wellbeing of your patients as your highest priority.


Each issue of Plexus features several frequently asked questions about chiropractic in Washington. If you have any questions you’d like to see shared in the magazine, please submit them to:


Washington State Chiropractic Association


c/o Shaka Forest, Membership Director 1120 Pacific Ave., Ste. 206 Tacoma, WA 98402 wsca@chirohealth.org


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