For the purpose of this Chapter the following words and phrases shall have the meanings assigned to them, respectively, except where the context otherwise requires:

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(a) Disease means any blemish, defect, deformity, infirmity, disorder or injury of the human body or mind, or of pregnancy and the effects of any of them.

(b) The Healing Art means the art of prevention, detecting or attempting to detect the presence of any disease; of determining or attempting to determine the nature and state of any disease, if present; or preventing, relieving, correcting or curing of or attempting to prevent, relieve, correct or cure any disease; of safeguarding or attempting to safeguard the life of any woman or infant through pregnancy and parturition; and of doing or attempting to do any of the acts enumerated in this Subsection. The healing arts include, but are not limited to, acupuncture and oriental medicine, audiology, chiropractic, clinical psychology, licensed professional counseling, licensed mental health counseling, marriage and family therapy, cosmetology, dentistry, medicine, surgery, osteopathy, podiatry, physician assistants, nursing, nursing home administration, nutrition and dietetics, occupational therapy, optometry, pharmacy, physical therapy, respiratory therapy, speech-language pathology, and veterinary medicine.

(c) To Practice means to do or attempt to do, or to hold oneself out or to allow oneself to be held out as ready to do, any act enumerated in Subsection (b) of this Section as constituting a part of the healing art for a fee, gift, reward or in anticipation of any fee, gift or reward whether tangible or intangible.

(d) Commission means the Commission of Healing Arts created by this Chapter.

(e) Practice of Optometry means engaging in that primary healthcare profession, of which the members examine, diagnose, manage, and treat certain conditions and diseases of the human eye, visual systems and associated structures. It includes, but is not limited to, the use of any means or methods for the purpose of determining the refractive condition of the human eye or any muscular or visual anomalies thereof, and employing, adapting or prescribing of lenses, prisms, contact lenses or other

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ophthalmic appliances. Optometrists certified pursuant to § 12508 of this Title are authorized to make use of diagnostic or selected therapeutic pharmaceutical agents, based on the following conditions and limitations.

(1) Independent use of the following therapeutic pharmaceutical agents as topical preparations: non- steroidal anti-allergics, antibacterials and cycloplegics.

(2) Under a co-management arrangement with an ophthalmologist, the following additional agents may be utilized: oral anti-allergics, oral antibacterials, topical or oral anti-glaucoma agents, topical anti- inflammatories, topical anti-virals and oral analgesics.

(3) Co-management is an agreement by which an optometrist and an ophthalmologist share responsibility for patient care.

(4) Optometrists are prohibited from performing surgery. Surgery, as used in reference to the human eye and its appendages, means any procedure in which human tissue is cut or burned. Surgical procedures include the use of sharp-edged instruments or lasers to cut or burn tissue for therapeutic or photorefractive purposes, but do not include the removal of superficial foreign bodies. A superficial foreign body is defined as one that has not penetrated deeper than the epithelium.

(5) Optometrists utilizing pharmaceutical agents shall be held to the same standard of care as would a physician using the same agents.

(f) Practice of Nursing means:

(1) The Practice of Professional Nursing means the performance for compensation of any act in helping people cope with difficulties in daily living which are associated with their actual or potential health problems or illness problems, or the treatment thereof, which require a substantial amount of scientific knowledge in the biological, physical and social sciences and technical skills, and includes all of the following:

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(A) direct and indirect patient care services that insure the safety, comfort, personal hygiene and protection of patients, and the performance of disease prevention and restorative measures;

(B) direct and indirect patient care services including, but not limited to, the administration of medications and therapeutic agents necessary to implement a treatment, disease prevention or rehabilitative regime prescribed by a licensed physician or dentist;

(C) the performance, according to standardized procedures, of basic health care, testing and preventative procedures, including, but not limited to, skin tests, immunization techniques and the withdrawal of human blood from veins and arteries; or

(D) observation of signs and symptoms of illness, reactions to treatment, general behavior or general physical conditions; and:

(i) determination of whether such signs, symptoms, reactions, behavior or general appearance exhibit abnormal characteristics; and

(ii) implementation, based on observed abnormalities, appropriate reporting, referral, standardized procedures, changes in treatment regime in accordance with standardized procedures or the initiation of emergency procedures. Standardized procedures as used in this Section means policies and protocols developed through collaboration among administrators, physicians, nurses and other health professionals of an organized health care system.

(2) Practice of Practical Nursing means the performance for compensation of technical services requiring basic knowledge of the biological, physical,

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behavioral, psychological and sociological sciences of nursing procedures. These standardized procedures leading to predictable outcomes in the observation and care of the ill, injured and infirm, and in the administration of medication and treatments prescribed by any authorized person.

(g) Chiropractic means the science, art, and philosophy of things natural, the science of locating and removing interference with the transmissions or expression of nerve forces in the human body, by the correction of misalignments or subluxation of the articulations and adjacent structures, more especially those of the vertebral column and pelvis, for the purpose of restoring and maintaining health. It shall include the use of all natural agencies to assist in the healing art, such as food, water, heat, cold, electricity, mechanical appliances, and the ordering of laboratory tests. The use of imaging procedures shall be limited to skeletal imaging and shall exclude the therapeutic use of X-radiation, the use of contrast studies that introduce dyes, isotopes, or similar contrast media through the skin, orally, via catheterization, or retrograde into any body cavity. It shall exclude operative surgery and the prescription of scheduled drugs.

(h) Practice of Dentistry means:

(1) the diagnosis, treatment, correction, change, relief, prevention, prescription of remedy or surgical operation for any disease, pain, deformity, deficiency, injury, lesion or other physical condition of human teeth, gums, jaws, oral cavity or adjacent tissues by an individual or his agent or employee, including the prescription or administration of any drug, medicine, biological, prosthetic apparatus, brace, device, anesthetic or other therapeutic or diagnostic substance or technique;

(2) the representation, directly or indirectly, publicly or privately, of an ability or willingness to do any act mentioned in Paragraph (1) of this Subsection; or

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(3) with specific reference to the teeth, gums, jaws, oral cavity or adjacent tissues in living persons, for an individual, his agent or employee to do, propose, agree or attempt to do or make an examination, or give an estimate of cost with intent to:

(A) perform surgery, an extraction or any other operation, or to administer an anesthetic in connection therewith;

(B) diagnose or treat any condition, disease, pain, deformity, deficiency, injury, lesion or other physical condition;

(C) correct a malposition; (D) treat a fracture;
(E) remove calcareous deposits;

(F) replace missing anatomy with an artificial substitute;

(G) construct, make, furnish, supply, reproduce, alter or repair an artificial substitute, or restorative or corrective appliance, or take orders for such work from either a regularly licensed dentist, or place an artificial substitute or restorative or corrective appliance in the mouth or attempt to adjust it;

(H) give interpretations or readings of dental roentgenogram; or

(I) do any other remedial, corrective or restorative work.

(i) Practice of Medicine means the diagnosis, correction and treatment in any manner or by any means, methods, devices or instrumentalities of any disease, illness, pain, wound, fracture, infirmity, deformity, defect or abnormal, physical and mental condition, including podiatry and physician assistants under the supervision of a licensed physician of medicine, and podiatry, but does not include the practice of dentistry, nursing, optometry, psychology,

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chiropractic, or pharmacy by a person licensed under the provisions of this Chapter. (j) Practice of Podiatry means engaging in that primary health care profession, of which the members examine, diagnose, treat and prevent by medical, surgical and mechanical means ailments affecting the human foot and ankle, and the structures governing their functions, but does not include amputation of the foot or the personal administration of a general anesthetic. A podiatrist, under the laws of Guam, is defined as a foot or podiatric physician.

(k) Practice of Clinical Psychology means the assessing and alleviating of emotional and mental disorder in a hospital or clinical setting.

(l) Practice of Osteopathy means subscribing to, as a complete school of medicine and surgery, use of all methods of diagnosis and treatment in health and disease, including, without limitation, the prescribing and administration of drugs and biological of all kinds, operative surgery, obstetrics, radiological and other electro-magnetic emission, and placing special emphasis on the inter-relationship of musculoskeletal system to all of the body systems.

(m) Practice of Pharmacy means engaging in the preparation, compounding and dispensing of drugs and includes the identification, preservation, proper and safe storage, selection, combination, analysis, standardization, labeling and distribution of drugs, the proper maintenance of any records required by Federal or Guam law, and counseling with respect to pharmaceutical practices.

(n) Physical Therapy means the utilization of scientific principles for the evaluation and treatment of any disability, injury or disease by the use of physical, chemical or mechanical means, including, but not limited to, heat, cold, air, light, sound, electricity, water, massage, therapeutic exercise and rehabilitative procedures, with or without assistive devices, for the purpose of preventing, correcting or alleviating dysfunction resulting from such disability, injury or disease; the performance of tests and measurements of neuromuscular function as an aid to the diagnosis or treatment of human condition; performance of treatments on

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the basis of test findings; supervision of selective forms of treatment by trained supportive personnel; dry needling, also known as intramuscular stimulation or therapy, but only as provided in this Article and by Board rules and regulations; and the provision of consultative services for health, education and community agencies; provided, however, that physical therapy shall not include radiology or electrosurgery.

(o) Practice of Veterinary Medicine means:

(1) the diagnosis, treatment, correction, in any manner or by any means change, relief or prevention of animal disease, deformity, defect, injury or other physical or mental condition, including the prescription or administration of any drug, medicine, biologic, apparatus, application, surgery, anesthetic or other therapeutic or diagnostic substance or technique, and the use of any procedure for artificial insemination, testing for pregnancy, diagnosing and treating sterility or infertility, or rendering advice with regard to any of these;

(2) the representation, directly or indirectly, publicly or privately, of an ability and willingness to do any act mentioned in Paragraph (1) of this Subsection; or

(3) the use of any title, words, abbreviation or letters in a manner, or under circumstances, which includes the belief that the person using them is qualified to do any act mentioned in Paragraph (1) of this Subsection.

(p) Acupuncture and Oriental Medicine means the science and art of examination and diagnosis based on traditional oriental medicine, and treatment of symptoms and diseases by the insertion of needles into the respective three hundred sixty-five (365) major trigger points of twelve (12) meridians, eight (8) extra trigger points of extra meridians, Ashi (regional or local) points, as well as other extra points on the human body, by piercing the skin of the body to

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control and regulate the flow and balance of vital energy in the body and to treat ailments or diseases of the mind, body, any wound, bodily injury, or deformity. The term includes therapies that use manual, mechanical, thermal, electrical, or electromagnetic treatment based on the principles of oriental medicine to prevent or modify the perception of pain or to normalize physiological functions including pain control for the treatment of diseases or dysfunction of the Yin and Yang organic systems, and includes the application of acupuncture needles, electro-acupuncture, electrodynamics stimulation, i.e., electro-stimulation, neuromuscular stimulation, etc., ultrasound, or diathermy devices, cold lasers, magnets, cupping, moxibustion, heat and cold therapy, i.e., heat and cold pads, heat lamp, infrared heat, etc., hydrotherapy, acupressure, Tui Na, oriental massage, massage therapy, Chi- gong, breathing techniques, therapeutic exercise, manual traction, naturopathy and related natural medicine techniques, and nutrition including the incorporation of drugless substances and herbs as dietary supplements to promote health. Ordering blood and laboratory tests, x-rays, or image tests to assist in making a diagnosis and monitoring of a treatment plan is within the scope of practice of acupuncture and oriental medicine. The practice of acupuncture and oriental medicine does not include operative surgery and the prescription of scheduled drugs.
(q) Speech-Language Pathology and Audiology means: (1) Practice of Speech-Language Pathology means
the rendering or offering to render to individuals, groups, organizations or the public any service in speech
or language pathology involving the non-medical
application of principles, methods and procedures for the measurement, testing, diagnosis, prediction, counseling and instruction related to the development and disorders of speech, voice or language for the purpose of non-medical diagnosing, preventing, treating and ameliorating such disorders and conditions in individuals and groups of individuals; and

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(2) Practice of Audiology means the application of principles, methods and procedures of measurement, testing, appraisal, prediction, aural rehabilitation, aural habilitation, consultation, hearing-aid selection, counseling, instruction and research related to hearing, and disorders of hearing, for the purpose of non-medical diagnosis, prevention, identification, amelioration or the modification of communicative disorders, involving speech, language, auditory function or other aberrant behavior related to hearing disorders.

(r) Physician Assistants means a skilled individual nationally certified by examination, administered by the National Certifying Commission for Physician Assistants, as being qualified by practical and academic training to provide a specific medical service delegated to him by a licensed physician or group of physicians who is responsible for the performance of that physician assistant. Licensure requirements and scope and procedures of practice for such individuals are to be promulgated by the Board of Allied Health Professionals.

(s) Individual, Family and Marriage Therapist means a skilled individual qualified by practical and academic training to provide planned intervention to help the client(s) enlarge competencies, and increase problem solving skills and coping abilities. Licensure requirements and scope and procedures of practice for such individuals shall be promulgated by the Board of Allied Health Examiners.

(t) Practice of Occupational Therapy means the treatment provided to people whose lives have been disrupted by physical injury or illness, developmental problems, the aging process or psychosocial difficulties in order to assist each individual to achieve and/or return to an independent and productive life by teaching the individual techniques to prevent disability, by assisting the individual in recovery from illness or accident, and by promoting the development of functions which have been impaired or delayed. The treatment provided may include, but shall not be limited to, the adaptation of the environment and selection, design and

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fabrication or assistive and orthotic devices, and other technology to facilitate development and promote the acquisition of functional skills.

(u) Practice of Respiratory Therapy means the treatment and the management of pulmonary diseases with medications and machines provided to patients whose condition or illness is that of breathing.

(v) Practice of Dietetics and Nutrition means the integration and application of scientific principles derived from the study of food, nutrition, biochemistry, metabolism, nutrigenomics, physiology, food management, and from behavioral and social sciences in achieving and maintaining health throughout the life span and in providing nutrition care services, including medical nutrition therapy; assessing and evaluating the nutritional needs of individuals and groups, and determining resources and constraints in the practice setting, including ordering nutrition-related laboratory tests to check and track nutrition status and monitor effectiveness of dietary plans and orders; establishing priorities, goals and objectives that meet nutritional needs and are consistent with available resources and constraints; providing nutrition counseling in health and disease; developing, implementing, and managing nutrition care systems; evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition services; and ordering therapeutic diets, for the prevention, management, and treatment of disease. This term includes, but is not limited to, nutrition assessment; nutrition diagnosis; nutrition intervention, including the ordering of patient diets, nutritional supplements; monitoring and evaluation of nutrition care plans; nutrition support, including the ordering of enteral and parental nutrition, medical food; dietary and nutritional counseling and education regarding food, nutrient and prescription drug interactions; and the development and administration of nutrition care standards and systems. The practice of dietetics and nutrition does not include the medical differential diagnosis of the health status of an individual.

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(w) Practice of Cosmetology means any and all, or any combination of the following practices: arranging, dressing, curling, waving, machineless permanent waiving, permanent waving, cleansing, cutting, singeing, bleaching, tinting, coloring, straightening, dyeing, brushing, beautifying or otherwise treating by any means the hair of any person. The massaging, cleaning or stimulating the scalp, face, neck, arms, bust or upper part of the human body, by means of the hands, devices, apparatus or appliances, with or without the use of cosmetic preparations, antiseptics, tonics, lotions or creams. Beautifying the face, neck, arms, bust or upper part of the human body, by use of cosmetic preparations, antiseptics, tonics, lotions or creams. The removing of superfluous hair from the body of any person by the use of electrolysis, or by the use of depilatories or by the use of tweezers, chemicals, preparations or by the use of devices or appliances of any kind or description, except by the use of light waves, commonly known as rays. The cutting, trimming, polishing, tinting, coloring, cleansing or manicuring the nails of any person; and, the massaging, cleansing, treating or beautifying the hands of any person.

(x) Other Healing Arts Profession as allowed by Guam
Laws.

SOURCE: GC § 27000, as amended by P.L. 14-029 (May 27, 1977) and
16-123 (Dec. 28, 1982), added by P.L. 18-042:11 (Aug. 28, 1986), amended by P.L. 18-049:13 (Jan. 14, 1987). Subsections (b) and (i) were
amended by P.L. 18-042:9 (Aug. 28, 1986) and (r) was added by P.L. 18-
042:11 (Aug. 28, 1986) and subsection (s) was added by P.L. 19-019 (Sept.
5, 1988); subsection (g) amended by P.L. 20-107:1 (Oct. 17, 1989);
subsection (i) repealed and reenacted by P.L. 21-033:7 (May 17, 1991);
subsection (t) added by P.L. 22-140:IV;6(b) (Oct. 12, 1994). Subsection (e) repealed and reenacted by P.L. 23-009:1 (Apr. 22, 1995). Repealed and reenacted by P.L. 24-321:1 (Dec. 28, 1998). Subsections (b) and (i) amended and subsections (g), (n), (p), (v) repealed and reenacted by P.L.
36-138:2-7 (Dec. 28, 2022).

2013 NOTE: Pursuant to the authority granted by 1 Guam Code Ann. § 1606, numbers and/or letters were altered to adhere to the Compiler’s alpha-numeric scheme.

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