While maybe not the norm, it’s not uncommon in chiropractic for practices to be set up with open or shared treatment spaces. While this is permitted, chiropractors should be aware that it isn’t without risk. Guild Insurance has managed claims relating to these treatment spaces with the complaints from patients commonly stating:

• They felt uncomfortable, both physically in a treatment space with others, and verbally when talking to the chiropractor and/or;
• After seeing how other patients were treated, they felt their treatment wasn’t tailored to their needs and was rushed so the chiropractor could get to other patients.

It’s therefore vital that if chiropractors are considering, or already are, running their practice in this way, they evaluate the following.

Professional requirements

There are two sections of the shared Code of conduct that relate to requirements for open treatment spaces.

Section 3.3 (b) Confidentiality and privacy states that practitioners must ‘provide surroundings to enable private and confidential consultations and discussions, particularly when working with multiple people at the same time, or in a shared space’.

Section 4.10 Working with multiple patients states ‘When you are considering treating multiple patients simultaneously in class or group work, or more than one patient at the same time, you should consider whether this mode of treatment is appropriate to the patients involved, including whether it could compromise the quality of care, whether it is culturally safe and whether confidentiality and privacy can be provided.’

So, while the Code of conduct doesn’t prohibit open treatment spaces, it does make it very clear that chiropractors need to meet maintain privacy and always provide appropriate treatment.

Considerations

Ensure practice set-up is understood – it’s important to be sure that before a new patient arrives for treatment, they understand what to expect. If a practice has an open plan set up, this should be made clear in advertising about the practice, allowing patients to decide if that suits them. Practices should also consider communicating information about the set up to new patients when they book in, to be sure they understand. Patients won’t want surprises at their first appointment!

Hold initial appointments in private – it’s recommended that initial appointments with new patients are held in a private consulting room. This allows for privacy during the initial assessment process and supports the patient and chiropractor to build rapport with open conversations. This process for the initial consultation should also be made clear to patients before they arrive, so they know what to expect.

Don’t make assumptions about patient comfort – there may be situations where a patient has found treatment different to what was expected and doesn’t feel as comfortable as they thought they might be. Therefore, while the practice policy may be for the second and future appointments to be in an open space, don’t assume the patient is comfortable with this. There should be a discussion about this, giving the patient an opportunity to agree and consent to the treatment location.

Keep up the communication – as with all aspects of your treatment and interactions with patients, ongoing professional communication is key. Continually talking to patients about their treatment, their response to treatment and their satisfaction (or not) with treatment is going to increase the likelihood of meeting their expectations and them being comfortable with how they’re being treated.