Recently NYS issued an update for guidance for essential and non-essential business’. For essential health care operations chiropractic was included for emergency chiropractic services. The Council Executive Board has sought the advice of our attorneys and malpractice carriers who have all studied the language of the governor’s office clarification. For the protection of our members, our patients and the profession, the definition of emergency care has been described as care of an “urgent and necessary” nature. Here is the lens through which to view that process of triage and the related language:
- Your patient management and triage at this point, where these orders have been enacted, should be ensuring there is no interruption in care plans in cases where doing so would lead the patient to suffer from permanent disability, a deterioration in their condition or place them at undue risk for their current and future health. Your triage and clinical decision making should not delay patient care that would put their immediate health and wellbeing at risk and contribute to the worsening of their condition.
- Supportive care should be provided when if not rendered, could lead to a deterioration of a patient's health status and cause undo harm.
You will notice that there is no mention of WELLNESS. See supportive care.
If one wants to get into an argument with the public health authorities about that right now you are welcome to. Our advice would be to:
1. Follow the orders
2. Document everything like you have never documented in your entire career to support your clinical rationale.
In summary, as previously directed, all care should be medically necessary during this crisis. Necessary chiropractic care for workers functioning in essential business capacities may also be considered essential. Tele-Health services can be used to determine what care is essential and an emergency, remember to document your rationale. Please continue to use your best clinical judgment and decision making on what care is urgent and represents an emergency chiropractic service.
In closing we repeat, “remember to document your rationale. Please continue to use your best clinical judgment and decision making on what care is urgent and represents an emergency chiropractic service.” The Council is here to assist in any way we can please, feel free to email any additional questions you have or to share any insight and information if your practice has had similar experience. Banding together makes us all stronger.