Chiropractors: Considerations in Providing “Emergency Care”

by Valerie Wise March 25, 2020 2 min read

Effective 11:59 p.m. on March 24, 2020, the Ontario government ordered the closure of “non-essential” workplaces.  The list of “essential” workplaces included “health care professionals providing emergency care including dentists, optometrists and physiotherapists”.

The College of Chiropractors of Ontario (“CCO”) interprets this list as including chiropractors, and we agree.

So the question becomes – what is “emergency care”?

The CCO’s website has helpful information and ongoing updates as to the CCO’s interpretation of what constitutes “emergency care”.  We expect that, within reason, the province would defer to the CCO in interpreting “emergency care” as it relates to chiropractic practice. 

Currently, the CCO has defined “emergency care” as including the following:

  • “Care for patients experiencing a sudden and debilitating change in functional abilities (understood as walking, standing, sitting, lifting floor-to-waist or waist-to-shoulder, stair climbing, ladder climbing) or significant restrictions (experienced during bending/twisting, repetitive movement, pushing/pulling with right/left arm) as well as injury to head/neck/back and extremities”; and/or
  • Treatment aimed at alleviating significant pain, understood as pain that is incapacitating for the patient and interferes with their ability to carry out normal functioning”.

The CCO also notes generally that the member needs to weigh the value of treatment against the risk when deciding to treat a patient.

In terms of risk assessment, you need to consider the risks of treatment not only to the patient and yourself, but also to other patients, staff and - at this time of collective physical distancing - the public at large.

Before deciding to treat, in addition to determining whether the proposed treatment constitutes “emergency care”, perform active screening of the patient for COVID-19 risk factors in advance and over the phone before scheduling the in-person treatment sessions.  Do not treat if you yourself have travelled in the previous 14 days, have symptoms of COVID-19, or have come into contact with individuals who have been diagnosed with or deemed to be a presumptive case of COVID-19.

If you do decide to treat, manage your risk by doing the following:

  • Take precautions including physical distancing as much as possible and observe the highest levels of hygiene protocols;
  • Stay within your scope of practice even if the patient is pressing for more due to the scarcity of other healthcare services;
  • Document not only your treatment, but also why you deemed this to be “emergency” treatment;
  • Don’t take shortcuts – even though this is a pandemic, unless expressly stated otherwise, the usual CCO standards of practice, policies and guidelines apply.

NOTE:  This blog was written on March 25, 2020, and was current as of that date.  A blog post is never a substitute for legal advice specific to your situation, and that is particularly so when circumstances are changing so rapidly. 

Wise Health Law is deemed by the province to be an “essential” service.  While we are working remotely, we are diligently monitoring email and voicemail, and remain available to assist our clients.


Also in Blog

Pandemic Exemptions for CPSO Registration

by Mina Karabit March 11, 2021 3 min read

It is no surprise that the COVID-19 pandemic continues to affect the delivery of health services and the regulation of various health professions.

In a welcomed move, the College of Physicians and Surgeons of Ontario (CPSO) Council recently approved a new registration policy allowing the Registration Committee to issue a Certificate of Registration authorizing Independent Practice to applicants who have not completed Part II of the Medical Council of Canada Qualifying Examination (MCCQE).

Supreme Court of Canada Confirms Test for Standard of Care

by Rozmin Mediratta February 08, 2021 4 min read

The test for the standard of care in medical negligence cases has remained untouched since the Supreme Court of Canada’s 1995 decision in ter Neuzen v. Korn.

On January 18, 2021, the Supreme Court of Canada heard the appeal in Armstrong v. Ward. Their unanimous decision maintains the status quo with respect to the standard of care in medical negligence cases.

Expanding the Pharmaceutical Scope of Practice (Again)

by Mina Karabit January 19, 2021 2 min read

Like other professionals, pharmacists have been adjusting to an expanded scope of practice as all health professionals work to combat the COVID-19 pandemic. We wrote about some of these changes in our previous blog posts.

Last week, the Minister of Health made additional changes to the Regulated Health Professions Act relevant to pharmacy professionals. Now, members of the Ontario College of Pharmacists — including pharmacists, interns, registered pharmacy students, or pharmacy technicians — can administer coronavirus vaccines by injection. These individuals must be certified to administer vaccines and must do so while being engaged by an organization that has an agreement with the Minister governing the administration of the vaccine (e.g., a hospital).