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Never let a good crisis go to waste

– attributed to Rahm Emanuel but also Winston Churchill

Perhaps not surprisingly, as the COVID-19 pandemic has upended and disrupted society, there are those that are leveraging legitimate fears to sell dubious products and services. Jann Bellamy blogged last week about naturopathy, chiropractic, and COVID-19. Two days ago, CBC News profiled action being taken in Ontario:

There’s no scientific evidence that chiropractic care can boost your immune system, but that hasn’t stopped some chiropractors from touting the practice as a tool to prevent infection from the novel coronavirus that has caused the COVID-19 pandemic.

The problem is so widespread that one Ontario man has filed at least 34 complaints against chiropractic clinics in the province alone in the past few weeks.

“As soon as there is public fear to exploit, these practitioners are really quick to get on message and promote this type of misinformation for their own profit,” said Ryan Armstrong, who runs an independent non-profit called Bad Science Watch.

Multiple organization have made statements regarding inappropriate marketing, the CBC reports:

Across the country, provincial governing bodies have issued warnings to their members not to spread misinformation about chiropractic care and COVID-19.

The College of Chiropractors of B.C., the Alberta College and Association of Chiropractors, the Manitoba Chiropractors Association and L’Ordre des chiropraticiens du Quebec have all put out statements in the last week or so.

Nationally, the Canadian Chiropractic Association has also warned members about making unsubstantiated claims.

Provincial governments are curtailing access to chiropractic. The Alberta government has ordered chiropractors to not provide services unless it is felt to be emergency or critical. Alberta’s chiropractic regulator has stated the following:

The Alberta government ordered chiropractors to cease normal operations and limit care to urgent, critical and emergency cases only. Chiropractors are not permitted to provide any service that does not constitute urgent, critical or emergency care.

The ACAC was asked by some members to clarify what urgent, critical and emergency chiropractic care means.

This is defined for all chiropractors as follows:

Urgent neurological chiropractic care:

  • This is defined as a pathology that could reasonably lead to a neurological deficit. The patient must be a demonstratable candidate for response to manual treatment, as delivered by a chiropractor; and if left untreated would result in the patient seeking urgent or emergency care at a medical facility. This must be established with a complete neuro/ortho/biomechanical assessment. No other form of assessment may be used to establish the need for care. Subluxation, wellness or functional care does not meet the criteria for urgent neurological chiropractic care in the context of what has been communicated by Alberta Health.

Urgent musculoskeletal chiropractic care:

  • This is defined as a pathology that could reasonably be a musculoskeletal condition for the patient that does, or would incapacitate the patient’s ability to function in performing daily activities without immediate intervention; and if left untreated would result in the patient seeking urgent or emergency care at a medical facility. This must be established with a complete neuro/ortho/biomechanical assessment. No other form of assessment may be used to establish the need for care. Subluxation, wellness or functional care does not meet the criteria for urgent musculoskeletal chiropractic care in the context of what has been communicated by Alberta Health.

Relying on patient preference to receive chiropractic care is not currently acceptable in establishing the need for urgent, critical or emergency care. Any consideration for in-person care should begin with the assumption that in-person care is not necessary.

While many will argue that all chiropractic is unnecessary, given this is coming from the chiropractic regulator, it leave only a very small number of patients eligible for treatment, if this order is followed. If chiropractors are following orders to offer noting but the most urgent/critical cases, then touting unproven benefits related to coronavirus should, hopefully, cease. We will keep monitoring.

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Posted by Scott Gavura