Weekly COVID-19 update
February 18, 2021
A message from the Registrar
Dear Colleagues,
The COVID-19 pandemic continues to test the resilience of all Albertans including Alberta chiropractors. The ACAC response to the pandemic, including the dedicated leadership of Alberta’s chiropractors in following Public Health guidelines, has been noticed. Your actions have built, and continues to build trust with the public, Public Health, and policy makers. Thank you.
With the continued roll out of the COVID-19 vaccine, patients may come to you asking questions related to the vaccine. How you respond to those questions will have a significant impact on your credibility and that of the chiropractic profession in the near and long term.
Webinars related to vaccine questions
To help you understand what the currently approved vaccines are, and to assist you in managing patient questions on the vaccines, the ACAC is pleased to offer all members with access to two upcoming webinars:
- February 24: "Information on the COVID-19 Vaccination for health-care professionals" webinar
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Join us for "Information on the COVID-19 Vaccination for health-care professionals" with Medical Officer of Health, Dr. Jia Hu and Infectious Disease Specialist Dr. Cora Constantinescu. Presented by 19 to Zero and hosted by the ACAC, this educational presentation provides an overview of COVID-19 vaccines and addresses common vaccine misconceptions.
The hour-long session will open with a 20 minute presentation, followed by a Q&A session. Please note that the presentation is intended for informing chiropractors in their personal vaccination decision, and not intended for chiropractors to discuss vaccine information with their patients. The ACAC directs members to refer all patient questions, consultation and education regarding immunization and vaccinations to the appropriate public health authorities and/or health professional whose scope of practice includes vaccination. Click here to register.
- March 4: “Managing patient questions on COVID-19 vaccines” webinar
- In addition to the information below, the ACAC will host a webinar on March 4 at 8:30 a.m. to discuss managing patient questions on the COVID-19 vaccines and to respond to your questions. Click here to register.
In preparation for the webinar you may have questions that you would like to have answered. If you can take a couple of minutes to fill out this survey and let us know your questions ahead of time, we can be more deliberate in providing information for your consideration and benefit.
Below are some possible patient COVID-19 vaccination questions and the ACAC’s suggested response. These are being provided to help you build trust with your patients, while staying within the chiropractic Scope of Practice. As stated before, it is entirely appropriate and recommended that you defer these conversations to Public Health and health-care practitioners whose Scope of Practice includes vaccines.
The ACAC is aware that chiropractor’s personal acceptance of immunization/vaccination occurs on a spectrum from affirmative to oppositional. Your personal decisions do not belong in the doctor-patient relationship and practitioners need to remove ego, beliefs, and values from vaccination conversations. Failing to avoid sharing your personal beliefs will damage the trust your patients have in you and with all Alberta chiropractors.
Regards,
Dr. Todd Halowski
ACAC Registrar
Steps to responding to questions and building trust
All health professionals must ensure clear and defined boundaries with patients. Once the doctor-patient boundary with our patients is established then all patient questions are professional questions. This clarity will ensure that we do not conflate a patient’s question with our personal beliefs and provide a personal response to a professional question.
Whether or not the patient was explicit with why they asked the question, their motive has no bearing on how you should respond. When patients ask you COVID-19 vaccination questions, you must reinforce the established doctor-patient relationship and the boundaries inherent in that relationship.
- Restate the question:
- Are you asking what I think about the COVID-19 vaccine?
- Are you asking if I am receiving the COVID-19 vaccination?
- Are you asking for what I think about the COVID-19 vaccination?
- What media are you asking about? Are you asking what I think about that media report, article, report, event etc.?
Restating the question is important because it ensures that the patient inquiry is heard and that you have a very clear understanding of their specific question. You will have completed restating once you hear the patient say yes to your question.
- Frame your position to build public trust:
The public has considerable belief and trust in vaccination programs, and in Public Health, who administer those programs. Challenging a patient’s trust in Public Health does not hurt the trust of your patients in Public Health. It hurts the trust the patient has in you as a health-care practitioner. There is no subtle or sophisticated way to challenge the trust your patients have for Public Health.
Further to damaging the trust the public has with you, contrarian and oppositional views can decrease the credibility of the chiropractic profession. This is because these views may be interpreted as oppositional to established Public Health practices supported by other health professions.
Here are some examples of ways you can answer the above questions:
- “As a chiropractor, vaccination is not within my Scope of Practice, so I am not the best person to ask professionally. Your family doctor or a Public Health nurse would be the best professionals to ask for information regarding the COVID-19 vaccination.”
- “Thank you for seeking my opinion as a member of your health care team, however, my personal decision to receive the vaccine (or my position on vaccination) should not be considered in your decision to receive the vaccination. It is best for you to ask members of your health care team who have vaccination in their scope of practice such as your physician or to contact a public health nurse.”
- “COVID-19 vaccination is receiving a lot of media coverage right now. I think that if you are looking for information on the vaccination you should get information from experts in vaccination such as public health officials or Alberta Health Services (and not Google).”
- Move on:
If you have understood the patient’s question and responded as indicated above, you do not need to say anything else. You will maintain patient trust by dealing with the healthcare issues and conditions they are seeking your care for. You damage patient trust by challenging other trusted members of their healthcare team, such as their family physician, by attempting to discredit the mandate and activities of public health.
Errors to avoid in your response
Sometimes your patients will ask you a question you are not prepared to answer. It is acceptable to indicate, after restating the question for clarification, that you do not have an answer. You can advise that you will get back to them at a later time. To maintain patient trust, you will want to get back to them promptly.
Examples, or errors, in responding and the reasons they diminish trust to avoid may include, but are not limited to the following:
- “My college told me I am not allowed to discuss vaccines, immunizations or vaccinations."
- This response is not compliant with the ACAC position statement on vaccination because you do not direct them to public health. The response diminishes trust by not answering the question and then hiding behind a policy or position statement. This will damage your patients’ trust in you and in Alberta chiropractors.
- “Chiropractors believe in informed consent so you should read everything you can. Have you thought of researching vaccine problems online?”
- This response breaches the ACAC position statement in multiple ways:
- The response directs your patient to search the web, where there is a high prevalence of vaccine misinformation.
- This direction undermines Public Health and if the patient tells another practitioner that “my chiropractor told me to Google vaccine information” it could damage the chiropractic profession’s reputation with other health care providers and with public health officials.
Managing vaccine questions and conversations with compliance to the principles advised in this communication will reinforce your position as trusted leaders on your patients’ health-care teams of your patients and with the other members of their health-care team.
The ACAC immunization/vaccination position statement
As you already know, ACAC Council has adopted a policy statement on vaccination.
Vaccination is not within the scope of chiropractic practice in Canada. Notwithstanding, the Alberta College and Association of Chiropractors recognizes that vaccination is a safe and effective public health practice for the prevention of infectious diseases. The ACAC directs members to refer all patient questions, consultation and education regarding immunization and vaccinations to the appropriate public health authorities and/or health professional whose scope of practice includes vaccination.
For your information, Alberta Health has created a Q&A for health-care practitioners on the COVID-19 vaccine.
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 February 25, 2021.
Alberta College and Association of Chiropractors
11203 - 70 Street NW
Edmonton, AB, T5B 1T1
P 780.420.0932 | F 780.425.6583
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