Changes to Chiropractic Practice in Response to COVID-19: a survey of all 50 United States

Abstract

Introduction: The COVID-19 pandemic led to unprecedented changes, as many individual state and local governments enacted stay-at-home orders and nonessential businesses were closed. State chiropractic licensing boards play an important role in protecting the public via regulation of licensure and provision of guidance regarding standards of practice, especially during times of change or uncertainty. Objective The purpose of this study was to summarize the guidance provided in each of the 50 United States, related to chiropractic practice during the COVID-19 pandemic. Methods A review of the public facing websites of Governors and state chiropractic licensing boards was conducted for each of the United States. Data was collected regarding the official guidance provided by each state’s chiropractic licensing board as well as the issuance of stay at home orders and designations of essential personnel by state Governors. Descriptive statistics were used to report the findings from this project. Results Each of the 50 state Governor’s websites and individual state chiropractic licensing board’s websites were surveyed. Stay-at-home or shelter-in-place orders were issued in 86% of all states. Chiropractors were classified as essential providers in 54% of states, non-essential in one state (2%), and no guidance was provided in the remaining 44% of all states. Fourteen states (28%) recommended restricting visits to only urgent cases and the remaining states (72%) provided no guidance. Twenty-seven states (54%) provided information regarding protecting against infectious disease and the remaining states (46%) provided no guidance. Twenty-two states (44%) provided recommendations regarding chiropractic telehealth and the remaining states (56%) provided no guidance. Seventeen states (34%) altered license renewal requirements and eight states (16%) issued warnings against advertising misleading or false information regarding spinal manipulation and protection from COVID-19. Conclusion Individual state guidance during the COVID-19 pandemic was heterogenous, widely variability in accessibility, and often no guidance was provided by state chiropractic licensing boards. Some state chiropractic licensing boards chose to assemble guidance for licensees into a single location, which we identified as a best practice for future situations where changes in chiropractic practice must be quickly communicated.

Interactive Governance Between and Within Governmental Levels and Functions: A Social Network Analysis of China's Case Against COVID-19

“…Indeed Tang and An (2020) suggest that while the US system allows local officials to warn early of an emergency, there is little coordination between government levels and agencies. As a result, various American states’ responses varied greatly ( Baccini & Brodeur, 2021 ; Neff et al, 2020 ). This uncoordinated response to the outbreak, particularly the premature relaxation of control in some states, has kept the overall outbreak in the US very severe ( Jalali et al, 2020 ).…”