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

Health Care Professionals in Ontario Begin the Restart

by Valerie Wise May 28, 2020 3 min read

The Chief Medical Officer of Health for Ontario has issued an updated Directive #2 (dated May 26, 2020) for Regulated Health Professionals in the province. 

Pursuant to the updated Directive #2, all deferred non-essential and elective services by health care providers may be gradually restarted – subject to the rest of the requirements set out in the Directive.

The updated Directive #2 does not provide particularly detailed guidance to health professionals on how to proceed, likely because it applies to such a broad spectrum of health care and health professionals. It does, however, provide some principles to assist health care providers in making decisions as we enter this transitional period.

International Medical Graduates Reinforcing the Healthcare Frontlines

by Mina Karabit May 25, 2020 2 min read

In addition to the mask and hand sanitizer shortages, Ontario’s response to COVID-19 highlights the need for more frontline health care workers. Each regulated health profession’s college responded differently, and we have discussed some of those changes in other posts to keep you apprised.

Today, we focus on the College of Physicians and Surgeons of Ontario (CPSO), who set out to increase the number of available and licenced physicians out on the frontlines through certificates of registration that authorize supervised practice of short duration. The temporary licences authorize practice for 30 days.  

Pharmacists’ Time-Limited Change in Scope of Practice During COVID-19

by Mina Karabit May 05, 2020 4 min read

Undoubtedly, COVID-19 has affected how health professionals practice. Pharmacists across the country are not only experiencing changes in how they practice (for example, accepting emailed prescriptions, where appropriate) but the scope of their practice as well. The latter change is not permanent, although the disruptions in practice may be felt long after the COVID-19 emergency subsides.

On March 19, 2020, Health Canada issued a short-term section 56(1) exemption under the Controlled Drugs and Substances Act (CDSA) that would authorize pharmacists to prescribe, sell, or provide controlled substances in limited circumstances, or transfer prescriptions for controlled substances (the CDSA Exemption).