It has come to my attention that some licensed members have been sharing their personal views publicly, or with patients, about COVID-19 and/or the public health orders that are in effect in Alberta.

Under the Health Professions Act, all regulated health professions, which includes chiropractors, have a fiduciary responsibility to support public health efforts and abide by all public health orders.

Sharing personally-held opposition to the disease, the pandemic response, public health directives, or legislated requirements from any government entity with patients or with others, diminishes public health efforts, the same as violating public health orders would.

Your patients are seeking your care because of your professional expertise. Your personal beliefs and professional expertise may not always align, and there may be situations where your personal views on COVID-19 contravene, or are not aligned with, public health orders or legislated requirements from any government entity. As Registrar of the Alberta College and Association of Chiropractors, my professional advice is to remember your professional obligation to keep your personal views private.

Patients may ask you questions about COVID-19 as they see you as an important part of their health-care team. Chiropractors that demonstrate leadership in aligning with public health efforts will strengthen these efforts as well as strengthen the trust that patients, and other Albertans, have in your expertise and treatment recommendations.

It is reasonable to be empathetic to the personal or societal impact of these restrictions. However, as a regulated health professional, you are required by law to publicly abide by, and act in accordance with, public health orders and other efforts. This includes conversations with your patients, staff, or others.

The College has a responsibility to protect the public and ensure competence. Regulated members who undermine the efforts of, or breach, public health orders will be referred to the Complaints Director.

What to do if 811 provides close contact information that contradicts that provided by the ACAC

The ACAC has communicated with some members regarding COVID-19 exposure who have received guidance from 811 that contradicts the ACAC guidance on being a close contact provided on December 10, 2020. The ACAC continues to consult with the Emergency Operation Center (EOC) and the Center for Disease Control (CDC) to ensure that you have the most up-to-date information, and that the information provided is correct.

There is a discrepancy between the information that 811 and CDC use regarding the use of eye protection and the determination of COVID-19 close contact. They are aware of this discrepancy and are working to correct the information so that 811 and the CDC are aligned.

The algorithm that 811 follows screens for eye protection use, and if the practitioner was not wearing it, then you are deemed a close contact. The EOC and CDC have communicated that eye protection is not required. A decision by the CDC takes precedence over a decision by 811.

In a situation where 811 has told you to isolate despite adhering to the ACAC COVID-19 Pandemic Practice Directive you may seek further clarification from the CDC who may make a determination that you are not a close contact and therefore will not need to isolate.

The ACAC continues to strongly recommend using eye protection as a precaution when working with patients, though it is not required. Following the ACAC COVID-19 Pandemic Practice Directive is also essential to ensure that you minimize your risk of being a close contact.

What the changed orders for massage therapy mean for chiropractors

Following the December 21 news conference with the Chief Medical Officer of Health and the Minister of Health, the ACAC has received many member inquiries related to the CMOH allowance for massage therapy services to re-commence operations under certain circumstances.

We recognize the business and professional relationship between chiropractors and massage therapists as part of the team approach to patient-centred care.

The announcement means that massage therapists are entitled to work under their own license.

As regulated health professionals, chiropractors may refer patients or clients to receive massage therapy services as part of a written treatment plan.

This is not a blanket referral for massage therapy, but a specific prescription as part of a care plan to address their health status.

This is no different than the way referrals were made prior to the closure, as outlined in Standard of Practice 3.2 (Treatment Recommendations and Referrals) and 5.2 (Clinical Relevance of Treatment Recommendations).

For information:

What "by appointment only" means for chiropractic clinics

This term, “by appointment only”, was meant to give additional options to health-care professionals for controlling patient numbers in their health-care clinics.

Chiropractic clinics are not bound by the 15 per cent fire code maximum occupancy rule that was set for retail establishments in recent public health orders. Chiropractic clinics are required to ensure that all patients have a minimum of six feet of social distancing at all times in the clinic. Therefore, each clinic will have a different maximum occupancy depending on its size.

This means that if a patient walks into your clinic without an appointment, you can:

Consult with the patient right at that moment if your clinic is not full.
You must still perform your normal and customary COVID-19 screening. Offer to consult (examine or treat) at some future time that you book the patient in – depending on what is convenient for the patient and when you can schedule that appointment in your clinic.
Obviously, patients who present with urgent, critical, or emergency issues should be triaged and dealt with as quickly as possible. Research shows that the provision of quicker diagnosis and treatment services improves the final patient health outcome.

Other notes

The ACAC is operating with limited in-office staff due to current COVID-19 restrictions. This means the ACAC phone line will not be answered personally, so callers will need to use the internal directory to direct your call to a staff member. Response times to your enquiry by phone or email will be responded to within 24-48 hours.

The ACAC office will be fully closed for the holiday break starting 12 p.m. on December 24. We will re-open at 8 a.m. on January 4, 2021.

If you experience a COVID-19 emergency and you cannot obtain guidance from public health, you can email registrar@albertachiro.com and the regulatory team will aim to get back to you within 24 hours.

This weekly, Thursday morning COVID-19 update provides non-urgent, yet important, information and answers questions posed by members as part of the ACAC’s ongoing efforts to keep members informed about public health responses to the pandemic. If you have questions related to policy, procedures, control measures, safety, or any other topic pertaining to effectively responding to COVID-19 in your practice, please send them to registrar@albertachiro.com.

The next update will be January 7, 2021, as the ACAC office is closed on December 31.