Validating the Role of the Chiropractic Assistant

:dropcap_open:W:dropcap_close:e are all familiar with the National Board of Chiropractic Examiners (NBCE) and the existence of National Boards parts I, II, III, IV and P.T. for students in the doctor of chiropractic program. However, no such assessment has existed for general employees in chiropractic offices that aid in the performance of physiotherapy modalities on patients until now. Standards of excellence in chiropractic now extend to our chiropractic assistants.
The History of the Issue
successhellonametageConcerns surrounding chiropractic office employee training escalated from what is known as “incident to” concerns, which stemmed from the interests of third-party payers who were being billed for services performed by office employees that did not have documented training. In 2008 the American Chiropractic Association (ACA) and the Federation of Chiropractic Licensing Boards (FCLB) asked the postgraduate subcommittee of the Association of Chiropractic Colleges (ACC) for recommendations surrounding chiropractic employee training to help address this issue. 
The request was prompted by the above-stated “incident to” issue regarding untrained staff performing billable modalities. But even more important were the concerns of the FCLB surrounding patient protection, safety and office liability. From 2005-2007 alone, NCMIC reported that 5.1% of chiropractic claims stemmed from burns to the patient—clearly a result of modality use. It is important to note that the majority of these reports may fall under the vicarious liability category, which means that the supervising DC is liable for the actions of their employees.
Since the time that the issue was brought forth, the FCLB has been working diligently to find a solution. They have implemented a Certified Chiropractic Clinical Assistant (CCCA) application process as well as guidelines that are now in place; the very first CCCA examination was scheduled for March 1, 2013 and is now available online.
Win-Win Benefits
The creation of the CCCA application and test process is a “win” for the profession on a multitude of levels. Not only does it increase patient safety, it also promotes credibility within our profession and provides a tangible process for third-party payer criteria.
Just as importantly, it provides professional credentialing and validation for the important work that our CAs do every day with our patients, something that has been missing for many CAs. Certification will increase patient-care standards and satisfaction, improve interactions and increase the CAs self-worth for the job they perform for you. Ultimately, certification will further streamline your office operations and cut down on office turnover.
How to Proceed
Start by visiting the FCLB website at for information about the CCCA program application process and for links to approved programs such as The FCLB application fee includes eligibility determination, records management, the examination, and a photo ID badge. Plus, with Internet-based testing, the process is extremely affordable and convenient.Online training programs in particular make high-quality training affordable and convenient. Proof of training or equivalency is required as part of the application process. At, learners can engage in a streamlined, 24-hour training program that meets or exceeds FCLB guidelines in every area of study.   
Invest in your office today by validating your CA. Full price for training is an affordable $339 for the entire 24-hour program. Plus, has special discount programs available for Congress of Chiropractic State Association (COCSA) members, participating colleges and other organizations. Ask your local COCSA chapter for your specific discount code. Not a member? If you have received this article through The American Chiropractor Magazine, you can still enjoy a discount. Have your assistant use AMCHIRO as your discount code. When this code is entered during the registration process, it will automatically provide a $15 discount off the regular price of the program through July 31, 2013.
Learners can expect text, images and schematics, dynamic video lectures and robust, customized, experiential, inter-activities in a thorough, 19-module program. Plus, an extensive note packet of nearly 200 pages is included and can be downloaded, printed and studied offline. Learners work at their own pace and can conveniently take programming around work hours to avoid disruption in the office. Questions? Visit our website or send us an email at [email protected]. 
Laurie Mueller, DC served in private practice in San Diego, California. She was the post-graduate director at Palmer College from 2000-2010, served as the ACC Post Graduate subcommittee chair for six years, peer reviewed for the Research Agenda Conference and wrote the informal role determination study that aided in the development of FCLB’s guidelines for chiropractic assistants. Dr. Mueller currently works as a private eLearning consultant with a focus on healthcare topics and functional medicine through her company, Impact Writing Solution and subsidiary She is a clinician, an educator and an expert in online educational pedagogy.

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