4734-6-04 Preceptorships.

(A) In accordance with section 4734.27 of the Revised Code, the board may approve the limited practice of chiropractic in this state by a student intern of a board approved doctor of chiropractic degree program or institution that offers a preceptorship program.

(B) Definitions.

(1) Preceptorship program is a clinical program in which chiropractic interns participate under direct supervision of an Ohio licensed chiropractic physician who has been approved by a doctor of chiropractic degree program and the board to serve as a preceptor.

(2) Preceptor is an Ohio licensed chiropractic physician appointed to the extension faculty of a doctor of chiropractic degree program and approved by the board to provide direct supervision of the limited practice of chiropractic in this state by a student intern.

(3) Intern is an individual enrolled in a doctor of chiropractic degree program who has completed all requirements for the doctor of chiropractic degree except for the final clinical phase of the program and is approved by the board to practice chiropractic in Ohio in accordance with section 4734.27 of the Revised Code.

(4) Direct supervision of an intern means initial and ongoing direction, procedural guidance, observation, and evaluation by the approved preceptor who shall remain on the premises and shall supervise and monitor the intern's performance.

(C) Preceptorship program approval.

(1) The board shall consider the degree of consumer protection provided by the defined standards and practices of the preceptor program, as well as the degree of consumer protection demonstrated by the actual operation of the program.

(2) The board shall approve a preceptorship program that meets all of the following criteria:

(a) The program is conducted by a doctor of chiropractic degree program approved by the board.

(b) The program is an established component of the curriculum of the doctor of chiropractic degree program.

(c) The program operates in a setting where chiropractic services are typically and traditionally provided and where each preceptor's practice will provide the intern with an adequately diverse, broad, and extensive clinical experience utilizing practice procedures that include appropriate history, physical examinations and diagnostic procedures.

(d) The program is certified by the doctor of chiropractic degree program, on forms prescribed by the board, to meet all the following:

(i) All interns who participate in the preceptorship program are in the last semester, trimester or quarter of their education and have met all requirements for graduation from the doctor of chiropractic degree program except for the completion of the preceptorship period;

(ii) No preceptor shall supervise more than one intern simultaneously;

(iii) All preceptors are extension faculty of the doctor of chiropractic degree program; and

(iv) The preceptor and the intern have agreed on the goals of the preceptorship program to be completed by the intern.

(D) Preceptor approval.

(1) The board may approve a chiropractic physician to be a preceptor if the chiropractic physician certifies to the board, on forms prescribed by the board, that he or she meets all of the following conditions:

(a) The licensee has been continuously licensed and actively practicing in Ohio for seven years preceding the date of application ;

(b) The licensee has no pending disciplinary action;

(c) Within the seven years preceding the date of application there have been no malpractice payment reports and no disciplinary action in any jurisdiction against the licensee;

(d) The licensee is a member of the extension faculty of the doctor of chiropractic degree program from which the preceptor will accept an intern into a preceptorship program ;

(e) The licensee will assume responsibility for the practice of the intern ;

(f) The licensee shows proof of current valid malpractice insurance.

(2) The preceptor is approved by the intern's doctor of chiropractic degree program and subject to the board's approval.

(a) The board shall have the right to refuse to allow, or withdraw its approval of the preceptor at any time.

(E) Intern approval.

(1) Each intern shall apply for a special limited license to participate in a board approved preceptorship program and shall submit on board prescribed forms satisfactory evidence of his or her qualifications as prescribed by section 4734.27 of the Revised Code and this rule. Applications shall be signed by the applicant in his or her own handwriting and acknowledged before a notary public. Incomplete applications will not be considered and will be returned to the applicant with the notation application incomplete.

(2) It is the responsibility of the applicant to furnish the necessary credentials, facts and materials as the board deems necessary or as required by law. Submission of credentials does not guarantee approval.

(3) A complete application including a non-refundable application fee in the amount of seventy five dollars made payable to the treasurer, state of Ohio, and all required credentials must be filed with the board postmarked no later than fourteen days before the intended initiation of the scheduled preceptorship.

(4) An application for a special limited license shall include the following:

(a) An attestment from the academic dean that the applicant is in good academic standing at the doctor of chiropractic degree program and has completed all requirements for the doctor of chiropractic degree except for the clinical phase of the program;

(b) A passport type photograph taken within the preceding six months. The photo is to be signed by the applicant on the back of the photograph. All photographs shall be no smaller than two inches by two inches and no larger than three inches by five inches.

(5) Applicants have an ongoing obligation to update and supplement all information provided to the board in writing within ten days of any change.

(6) The board may refuse or deny an applicant for a limited license to participate in a board-authorized preceptorship program in this state if the applicant does not meet the licensure requirements as outlined in section 4734.27 of the Revised Code or this rule, or if the applicant has committed any act which indicates that the applicant does not possess the character and fitness to practice chiropractic, including any act that would be grounds for disciplinary action as outlined in section 4734.31 of the Revised Code. The burden of proof is on the applicant to prove by clear and convincing evidence to the board that he or she meets the conditions for licensure.

(7) Any applicant that the board proposes to refuse or deny limited licensure shall be entitled to a hearing on the question of such proposed refusal or denial. Notice and hearing requirements incident to such proposed refusal or denial shall be in compliance with the provisions of Chapter 119. of the Revised Code and Chapter 4734-4 of the Administrative Code.

(8) The board may take disciplinary action against any intern upon proof, satisfactory to the board, that the intern has engaged in practice in this state outside the scope of the preceptorship program for which he or she has been approved, or upon other proof, satisfactory to the board, that the intern has engaged in conduct that is grounds for action under Chapter 4734. of the Revised Code.

(9) Any violation of Chapter 4734. of the Revised Code or agency 4734 of the Administrative Code by the intern constitutes grounds for the board to:

(a) Prohibit the intern from taking the examination for licensure; and

(b) Take appropriate disciplinary action against the supervising preceptor.

(F) Preceptorship standards and procedures.

(1) The preceptor shall exercise direct on-premises supervision of the intern at all times during which the intern is engaged in any facet of patient care in the preceptorship program.

(2) The preceptor shall identify the intern to the patients of the preceptorship practice in such a way that no patient will be misled as to the status of the intern.

(3) At all times when an intern is providing direct chiropractic care to a patient the intern shall display a name badge identifying the intern's status as an intern.

(4) The preceptor must monitor and track the intern's activity and regularly evaluate the intern's performance.

(5) Interns may assist preceptors in the performance of those duties that are lawful and ethical under Chapter 4734. of the Revised Code and agency 4734 of the Administrative Code including but not limited to physical examinations, patient consultation, x-ray interpretation, specific chiropractic adjustment procedures and physical therapeutics. An intern shall not perform radiologic procedures without a valid general x-ray operator license issued by the Ohio department of health.

(6) Interns are required to document all patient encounters in a logbook. Entries shall be made for all patient encounters, including observation. These entries should accurately reflect patient identification, involvement, and services rendered.

(a) Copies of logbook entries may be requested by the board at any time.

(b) Failure to provide logbook copies upon request by the board or falsification of logbooks may result in punitive measures.

(7) The preceptor shall maintain copies of all logbook records for one year following conclusion of the preceptorship program.

(8) The board may conduct random inspections of a preceptor site, including inspection of all pertinent documents to determine whether the program maintains the minimum standards required by the board.

(G) Preceptorship prohibitions.

(1) In addition to the prohibitions set forth in Chapter 4734. of the Revised Code and agency 4734 of the Administrative Code, an intern shall not:

(a) Diagnose the condition of a patient;

(b) Establish a plan of treatment or prognosis for a patient;

(c) Perform any service, except at the direction and supervision of an approved preceptor;

(d) Bill independently of the supervising preceptor for any service rendered; or

(e) Sign insurance forms or any other forms which require a licensed chiropractic physician's signature.

(H) Preceptorship termination.

(1) A preceptorship shall terminate upon the occurrence of the earliest applicable of the following:

(2) An intern participating in a preceptorship program graduates from the doctor of chiropractic degree program;

(3) An intern is formally charged with a criminal offense, the circumstances of which substantially relate to the practice of chiropractic.

(4) An intern is found to have violated the statutes or administrative rules pertaining to the practice of chiropractic.

(5) An intern is formally named in a civil or malpractice action.

(I) Any change in preceptor must be pre-approved by the board in writing.

Effective: 05/25/2014
R.C. 119.032 review dates: 03/10/2014 and 05/25/2019
Promulgated Under: 119.03
Statutory Authority: 4734.10 , 4734.27
Rule Amplifies: 4734.27
Prior Effective Dates: 9/3/02, 8/1/07 , 4/5/09