Position Statements

Public Health

The chiropractic profession supports public health promotion and prevention efforts that are essential to the physical and mental health and well-being of world citizens.

As one of the largest primary care professions, chiropractors are leading providers of care that directly contribute to many important public health goals. Chiropractors provide effective treatment when low back pain and other neuromusculoskeletal conditions are limiting physical activity and mobility. Chiropractors are trained to take an active role in addressing risk factors related to preventing and managing a number of chronic non-communicable diseases. Further, they promote physical activity, educate patients on healthy lifestyles including nutrition, stress management and self-care.

The EBCN supports international public policies and initiatives that address the socioeconomic determinants of health, such as mental health programs, early childhood development, poverty, education, and safe, affordable communities.

Vaccination

The EBCN recognizes that vaccination is a safe and effective public health practice for the prevention of infectious diseases. Members are encouraged 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. Vaccination is not within the scope of chiropractors.

Neuromusculoskeletal Disorders

Neuromsculoskeletal injuries and disorders are a significant public health concern. Neuromusculoskeletal conditions, including low-back and neck pain, are significant health issues and a leading reason for disability. Neuromusculoskeletal conditions are also significant contributors to inactivity, which make it difficult to prevent and manage many chronic diseases. Internationally, citizens with a lower socioeconomic status, the prevalence of musculoskeletal conditions is higher, disproportionately impacting the group’s health and well-being. This population may face additional barriers to accessing needed care and challenges in securing or holding employment.

Public health authorities play an essential role in educating the public and healthcare professionals on the impact of musculoskeletal conditions. Public health initiatives can also help to promote access to evidence-based approaches to prevention and treatment, including where socioeconomic barriers exist.

The EBCN supports public health initiatives that recognize the burden of musculoskeletal conditions as a public health concern. The EBCN is committed to improving public health by promoting prevention, early intervention, and community-based programs that enhance the health of our population.

Women, Children and Adolescent Health

The EBCN recognizes that women, children, and adolescents face unique individual and societal health challenges, which differ between low, middle and high-income countries around the world. These challenges include, but are not limited to, health inequity, cultural and religious beliefs, violence against women and children, infant mortality, sanitation, access to services, and health literacy.

The EBCN supports the World Health Organization’s Global Strategy on Women’s, Children’s and Adolescents’ Health (2016-2030), which envisions a world in which every woman, child and adolescent can survive, thrive and reach their full potential. The EBCN recognizes that chiropractors can contribute to the goal of universal health coverage by providing equitable, accessible, affordable services that address health needs, promote physical activity and a healthy diet, and improve social and emotional wellbeing. The EBCNs committed to gender equality, empowering women to adequately address their and their children’s health needs, and reducing societal barriers that pose a threat to the health and wellbeing of women, children and adolescents around the world. (adopted from the World Federation of Chiropractic)

Diversity

Diversity encompasses, without limitation, race, colour, ethnicity, gender, sexual orientation, gender identity and expression, religion, nationality, age, disability, socioeconomic status, and marital or parental status.

A key component in addressing diversity and inclusion is cultural agility. EBCN acknowledges cultural readiness as a foundation for competent healthcare delivery to improve patient outcomes and engage in public health initiatives. EBCN defines cultural agility as having enhanced skills and knowledge of the needs of a multicultural society and requiring a commitment to inclusion that begins with broader concepts of diversity.

With greater cultural agility and a commitment to diversity, EBCN can bring varied perspectives, experiences, backgrounds, talents, and interests to its membership and the profession at large. The EBCN recognizes that achieving diversity goals and implementing inclusion strategies will be an evolutionary process that requires a continued renewal of commitment to diversity and opportunities for inclusion. (adopted from the American Chiropractic Association)

Clinical and Professional Chiropractic Education

The EBCN supports the ICEC education position statement, which reads:

Whereas, the welfare of the patient is paramount; and

Whereas, chiropractic education should be of the highest quality and be founded on the principles of evidence-based care; and

Whereas, curricula should be responsive to changing patient, societal and community needs and expectations within a modern health care system;

the evidence-based chiropractic network, state as follows:

1. Chiropractic education and training must acknowledge the biopsychosocial model of health care and be underpinned by biologically plausible theories and peer-reviewed research. It should embrace the value of clinical experience, shared decision-making, and a patient-centered approach to care.

2. Upon graduation, chiropractic students should be equipped to work effectively and collaboratively to deliver improved quality of life outcomes for patients with musculoskeletal disorders. This will, of necessity, incorporate:

a. An evidence-based approach to the case history, physical examination, diagnostic imaging, diagnosis, report of findings, and management plan that may include a range of clinical interventions

b. Effective communication in a language that is clearly understood by all stakeholders in healthcare, thereby facilitating inter-professional practice and promoting effective collaboration between health care teams

c. Knowledge of preventative measures including but not limited to musculoskeletal care, encompassing more comprehensive public health and health promotion initiatives for non-communicable diseases

3. Wherever possible, chiropractic educational programs should form or develop affiliations with established public and private universities, preferably within a medical or health science faculty. Such links may develop opportunities for inter-professional education and collaborative practice.

4. Chiropractic educational institutions should support their faculties in the provision of innovative models for the development of knowledge, learning, and skills. These should focus on facilitating scholarly activity including research, multi-disciplinary educational teaching within the context of emerging health care models.

5. Chiropractic education should reflect ethical practice and professional standards throughout the curriculum. Upon graduation, students must understand their responsibilities to their patients, their communities, and to the profession.

6. Practice styles that may contribute to inappropriate patient dependence, compromise patient confidentiality or require repeated exposure to ionizing radiation are not part of an undergraduate chiropractic curriculum. Students should be taught to recognize that such approaches are not acceptable in terms of the best interests of patients or the chiropractic profession.