Council has been actively monitoring the pandemic and the province’s public health direction, advising members to adjust their practice as required. In addition to this formal public health communication and guidance, Council has been actively engaging with members across the profession to understand their perspectives in how the profession should serve patients at this time.
As of the writing of this notice, public health guidance remains the same regarding provision of patient care – that by actively pre-screening patients, strictly adhering to infection prevention controls and incorporating social distancing in clinic spaces, it remains safe to care for patients. However, there is significant and growing concern within the profession that providing any type of patient care beyond emergent care does not demonstrate the leadership characteristic of the profession.
Council met this morning to discuss the current situation and made the following decision:
The ACAC strongly recommends that chiropractors suspend all chiropractic services except those limited to emergent care only. The practice of mobile care (defined as in-person chiropractic care provided in locations other than a fixed, non-mobile clinic space) is completely suspended. The recommendation and suspension are effective starting Monday, March 23, 2020, and will remain in place until further notice.
Emergent care is defined as follows:
- The patient is in an acute condition where they would be severely physically limited from basic daily activities without chiropractic care.
- The patient is in a sub-acute condition that if left untreated would be vulnerable to an acute flare-up that could leave them severely physically limited from basic daily activities.
- Patients who are not experiencing an acute or sub-acute condition as described above, such as someone who has had a slight twinge after their run, are not considered emergent care.
The effective date of Monday, March 23, 2020, is to allow clinics time to communicate with their patients. However, clinics have the discretion to implement the above-noted recommendation and suspension immediately.
Understanding that continuity of care is a key priority for patients and chiropractors alike, Council approved a temporary Telehealth permission. This temporary permission allows chiropractors to maintain continuity of care with patients. As this temporary permission is a support to ensure continuity of care when in-person care is not possible, this is not a billable service.
We understand this decision has consequences for patients and members. It likely means that some patients with conditions that require care but don’t meet the threshold of emergent care may have to go to an emergency room to manage in the interim at a time when these systems are already overburdened. Some members may feel that this decision removes the ability to effectively provide continuity of care for their patients, creating guilt around the hardship this may cause patients. Finally, we understand members will interpret this decision on a spectrum, ranging from effectively demonstrating to sorely lacking leadership for patients and the profession.
Council’s role is to govern the profession in the public interest. In these unprecedented times it is more essential than ever for Council to be nimble in responding to the rapidly changing environment. Council will continue to actively monitor the situation and respond as appropriate.
A separate Notice to Members will be forthcoming to help provide guidance on how to manage this transition from a patient communication and business operations perspective.
Council commends chiropractors and their staff for their ongoing commitment to patient care and safety, especially in these extraordinary circumstances.