What are the legal requirements of setting up a practice in a foreign country? That will depend on the legal status of the profession in that country. There are four scenarios:
- Full legal recognition of the chiropractic profession.
- No legislation protecting the DC title or defining the scope of practice; but, it is lawful to practice your profession once your title or degree is verified and you set up a lawful business.
- No requirements other than setting up a lawful business.
- Chiropractic is illegal and you are on your own.
(Note: All countries will require an approved resident or working visa first)
1) FULLY LEGAL
There only 37 countries which have gone through the legislative process to define the scope of practice and protect the title “chiropractor, DC, or it’s equivalent Bachelor degrees.” These countries are: Australia, Bahamas*, Belgium, Bolivia*, Canada, Cayman Islands, Costa Rica, Cyprus, Denmark, El Salvador*,Fiji*, Finland, France, Hong Kong, Iceland, Iran, Jamaica, Jordan*, Lebanon*, Liechtenstein, Mexico, Namibia, New Zealand, Netherlands*, Norway, Panama, Puerto Rico, Saint Kitts & Nevis, Saudi Arabia, South Africa, Sweden, Switzerland, Trinidad & Tobago, United Arab Emirates, United Kingdom, United States, Venezuela*, Virgin Islands-US, Zimbabwe. (*without full title protection) To practice in these countries you can obtain a license to practice by making application, passing boards and taking a practical exam. You will have to inquire as to the specific requirements of your country of interest.
2) SOMEWHAT LEGAL
The following countries have accepted the chiropractic diploma as qualification to practice chiropractic: Argentina, Botswana, Brazil, Chile, Columbia, Dominican Republic, Ecuador, Germany, Ghana, Greece, Israel, Italy, Jamaica, Japan, Libya, Malaysia, Morocco, Mozambique, Peru, Philippines, Singapore, Taiwan, Thailand, Uganda and Zambia. However, the actual license or certificate is not necessarily for chiropractic. It is more frequently issued for a natural healer, drugless practitioner or even a physical therapist or massage therapist.
3) NOT ILLEGAL
When it is otherwise not illegal to practice and there is no official recognition of the profession, there are no laws to prevent you from practicing chiropractic. In fact, the Commonwealth countries are governed by “Common Law” which makes it legal to practice your profession. Once you meet the resident or work visa requirements, meaning that you can legally live and work in the country, all that is required is that you set up your practice by meeting all the local laws that apply to any business. There are many countries that require citizenship in order to own a clinic; therefore you could only work in another D.C.’s office. There are disadvantages though. It is very difficult to run a regular practice. You have virtually no access to x-rays, ordering lab tests or other procedures that are under other providers’ regulations. This tends to be handled by establishing a close working relationship with a local medical doctor. In countries without an active National Association it is recommended that you visit every* chiropractor in the country to discover what he or she has learned about what is or is not permitted. (*Not everybody shares the same views.)
4) ILLEGAL (but somewhat tolerated)
When it is illegal to practice chiropractic, the laws usually prevent anyone other than an M.D. to treat people. countries like Swaziland state in their law that chiropractic is illegal but here are several countries (for example, in Eastern Europe) where MDs have become DCs and limit their practice to chiropractic. As Europe enters unprecedented economic cooperation, it will be interesting to see how antiquated medical dominated laws will crumble as new trade laws permit DCs equal access within the unified European nations. With France’s new law and the recent Korean cases being negotiated to bring official recognition, hopefully the days of oppression will be over and done with.
There are excellent opportunities for chiropractors to practice abroad. Begin the journey by taking an honest survey of yourself. Ask friends and family to help you get a realistic view of your strengths and weaknesses. Do you see yourself as a pioneer? Do you see yourself as a solid practitioner who can adapt in a foreign culture? Can you learn another language? Can you be happy living under different physical standards? The more you earn about yourself and about other cultures, the better of a decision you will make about setting up a foreign practice. Those of you who immigrated to North America, your questions are different. Why are you not back home, building the profession in the culture and language of your heritage? Are you going to leave it up to foreigners (well meaning, all be it) to decide how chiropractic is to develop in your homeland?
The future growth of chiropractic will be in non-English speaking countries. There are over 6 billion people on this planet. Taking into account economic and socio-cultural factors, there is an estimated 350,000 chiropractors needed to service those people who can afford the care, today. Right now we are only caring for 20% of our potential patients. If you practice in California or Florida, you know first hand what it is like to practice where there is a surplus of chiropractors. Think it’s getting crowded in America and harder to practice? Think again. Think differently. Think:” Do I have the right stuff to practice abroad?”