Code and Standard

International Veterinary Chiropractic Association (IVCA)
Code of Practice
and
Standard of Proficiency

General Introduction
Purpose of the IVCA Code of Practice and Standard of Proficiency:

Accessibility, accountability and transparency are expected of every self regulating profession. The IVCA Code of Practice and Standard of Proficiency set out the behaviour and standards which are reasonable to expect from a professional member observing and indicating to patients and clients the quality of care that they can expect from an IVCA member.

The Code of Practice and Standard of Proficiency can be used as a point of reference when dealing with disciplinary procedures against members. This is intended to protect the profession, individual practitioners, their clients and patients and the general public.

The IVCA aims to promote veterinary chiropractic so its contribution to the health of animals is understood and recognised by other health care professions and the general public, both nationally and internationally.

Education and training of IVCA members:

Membership to the IVCA is only granted to qualified veterinarians or chiropractors (or individuals qualified in both professions) upon successful completion of approved veterinary chiropractic postgraduate training and adherence to membership rules and regulations.

Once individuals are accepted onto the IVCA Register, they are required to maintain and update their knowledge and skills through undertaking Continuing Professional Development (CPD). This is monitored by the IVCA and failure to comply can result in removal from the Register.

To ensure the development of the veterinary chiropractic profession the IVCA requires members to undertake regular continuing professional development (CPD) and supports and encourages research.

The IVCA attempts to protect animals by providing the general public and other professionals with access to the IVCA register of members.

The IVCA has members in many countries and strives to coordinate Veterinary Chiropractic on an international basis. It is expected that each country, province or principality will eventually develop regional veterinary chiropractic groups to respond to local issues, as has already happened in several countries.

IVCA member veterinarians and chiropractors should ensure that they adhere to the IVCA (and their respective professional veterinary and chiropractic) codes of practice and standards of proficiency.

These are not an exhaustive set of rules and members must comply with national legislation. If there is any conflict, national legislation takes precedence. An allegation that an IVCA member has failed to comply with any component of the Code or the Standard does not, of itself, constitute unacceptable professional conduct but will be taken into account in any proceedings against that person.

IVCA Committees:

The IVCA will establish two committees concerned with the maintenance of standards of proficiency and conduct:

The Investigating Committee investigates any complaints made to the IVCA about an IVCA member’s proficiency or conduct (essentially it establishes whether there is a case to answer).
The Professional Conduct Committee considers and makes judgments on any cases of concern about an IVCA member’s conduct or proficiency referred to it by the Investigating Committee.

CODE OF PRACTICE

IVCA members must meet high standards of conduct and practice. The Code of Practice explains the standard of personal and professional conduct that is expected of all IVCA members worldwide and gives advice in relation to the practice of veterinary chiropractic.

In the IVCA Code of Practice, “Patient” in this context means any animal under the veterinary chiropractic care of an IVCA member and “Client” in this context is the person who requests the IVCA member’s veterinary chiropractic services for an animal.

The Principles

All IVCA members are personally accountable for their actions and must be able to explain and justify their decisions. All IVCA members have a duty to protect and promote the needs of their patients. To do this, members must act in accordance with the following 10 guiding principles:

I. Make animal welfare your first consideration, ensure that all animals under
your care are treated humanely and with respect

II. Provide a good standard of practice and care

III. Protect patients, clients and colleagues from risk of harm

IV. Justify public trust and confidence by being honest and trustworthy

V. Promote and maintain a good relationship with your clients, earning their trust,
respecting their views and protecting client confidentiality

VI. Promote and endeavour to maintain good relationships with your professional
colleagues

VII. Maintain and continue to develop your professional knowledge and skills

VIII. Uphold the good reputation of the veterinary chiropractic profession

IX. Respond promptly, fully and courteously to complaints and criticism

X. Understand and comply with your legal obligations

IVCA member’s responsibilities to patients

All IVCA members must:

Treat all patients, of whatever species, humanely, with respect and with welfare as the primary consideration.
Protect patients from risk of harm.

IVCA member’s responsibilities to clients

When providing veterinary chiropractic services the IVCA member should:

Provide a good standard of practice and care. (The Standard of Proficiency sets out the requirements for the competent and safe practice of veterinary chiropractic.)
Ensure that information regarding veterinary chiropractic care is clearly communicated in a way that clients understand (including explanation of what veterinary chiropractic care entails, patient’s health needs, care options, possible side effects etc.)
Obtain the appropriate consent before examination and treatment of the patient.
Take all reasonable care in using their professional skills to treat patients.
Maintain their skills and keep their knowledge up to date andmeet the minimal requirements for Continuing Professional Development (CPD) set out by the IVCA.
Recognise and work within the limits of their knowledge, skills and experience, keeping within their own areas of competence (IVCA members should refer patients to other healthcare practitioners when the needs of the patient are beyond the knowledge and skills of the IVCA member.)
Maintain clear, accurate and comprehensive case records and accounts.
Protect clients from risk of harm.
Recognise that the client has freedom of choice.

The professional/client relationship is one of mutual trust and respect, under which an IVCA member should:

Act with integrity and not abuse their professional standing. The relationship between IVCA members and their clients is based on trust and on the principle that the welfare of the patient is paramount.
Be polite and considerate, treating the client with respect, and observing professional courtesies.
Maintain client confidentiality.
Avoid conflicts of interest.
Give due consideration to the client's concerns and wishes where these do not conflict with the patient's welfare.
Provide access to patient health records and fully itemised accounts if requested.
Have a complaints procedure in place within their practice and deal promptly and fairly with any complaint or claim made against them by a client.
Notify patients of their right to refer any unresolved complaint to the IVCA, giving the client the IVCA’s address.

IVCA member’s responsibilities to the general public

IVCA members must:

Use their professional status to provide only factual information to the general public about veterinary chiropractic services.
Protect the general public from risk of harm.
Ensure that all their professional activities are covered by professional indemnity insurance or equivalent arrangements.
Never ask for, nor accept, any inducement, gift, hospitality or referral which may affect, or be seen to affect, their judgment.
Recommend the use of particular products or services only on the basis of clinical judgment and not commercial gain.
Declare any personal interests to those who may be affected (For example, if an IVCA member is involved in research that might affect a patient, then the client has the right to know of the IVCA member’s involvement and the IVCA member must inform the client of his/her research.)

An IVCA member who has concerns about the competence of a colleague is encouraged to discuss the matter with the senior veterinarian or chiropractor of the practice. If the matter cannot be resolved with such an approach, any concerns should be brought to the attention of the IVCA investigation committee.

An IVCA member must seek and follow proper advice as to whether or how they should modify their own practice when patients may be at risk due to the IVCA member’s own mental or physical health.

IVCA member’s responsibilities to professional colleagues

Overtly poor relationships between veterinary chiropractors undermine public confidence in the whole profession.

IVCA members must:

Co-operate with colleagues from their own and other health professions when appropriate.
Respect and encourage the skills and contributions which others can bring to the care of patients.
Provide all relevant clinical information promptly to colleagues taking over responsibility for a case.
Provide documentation for all referral or re-directed cases.
Refer cases responsibly.
If advertising, do so in a professional manner and only in accordance with the relevant legislation. The information used must be factual and verifiable. The information must not be misleading or inaccurate in any way. It must not, in any way, abuse the trust of members of the public nor exploit their lack of experience or knowledge about either health or veterinary chiropractic matters. It must not put pressure on clients to use veterinary chiropractic.

IVCA members must not:

Speak or write disparagingly about another IVCA member.
Discriminate against, or unjustly criticise, a colleague or other health professional.
Obstruct a client from changing to another veterinary chiropractic practice.
Discourage a client from seeking a second opinion.
Knowingly approach someone who is the client of another veterinary chiropractor, or a related health professional (e.g. osteopath, physiotherapist or similar) with the specific intention of persuading that client to become the IVCA member’s client.
Use any title or qualification in such a way that the public may be misled as to its meaning or significance. In particular, IVCA members should make clear that they are either registered chiropractors NOT veterinarians or registered veterinarians NOT chiropractors (unless they hold both qualifications).
Conduct themselves in a way which may undermine the public confidence in the veterinary chiropractic profession or bring the profession into disrepute whether or not such conduct is directly concerned with professional practice.
Attract publicity about him/herself or the practice which arises from interviews with representatives of the media, that may be regarded as bringing the profession into disrepute.

IVCA member’s responsibilities under the law
Laws vary internationally. It is the IVCA member’s responsibility to ensure that they are sufficiently familiar with and comply with relevant legislation.

This also includes Advertising, Health and Safety, Data Protection, Employment, Tax and Social Security legislation as it applies to veterinary chiropractic practice and any other relevant animal health or welfare legislation relating to animal health.

IVCA members should also have third party insurance for the protection of the public.

STANDARD OF PROFICIENCY

The Standard of Proficiency details what is expected in the competent and safe practice of veterinary chiropractic. All IVCA members are expected to reach this standard of proficiency. Clients can expect IVCA members to work to this standard.

The fundamental basis for the Standard of Proficiency is the principle that every IVCA member must at all times adopt the current sound practice of a reasonable practitioner.

Achievement of the requirements set out in the Standard will deliver a standard of veterinary chiropractic care that will benefit the patient and protect them from harm.

The Standard of Proficiency has been divided into the following sections:
I. Patient management
ÍI. Practice management
III. Effective communication.

In the IVCA “Patient” in this context means any animal under the veterinary chiropractic care of an IVCA member and “Client” in this context is the person who requests the IVCA member’s veterinary chiropractic services for an animal.

I. Patient management

Assessing the health and health needs of patients

Examination

IVCA members should use appropriate methods to physically examine the patient
and be able to identify when a referral for further investigations is required.

Obtaining further information

When IVCA members have identified a need to obtain more information on patients,
they should make appropriate arrangements without delay.

Cessation of assessment

IVCA members should stop assessments at the request of the client or when the
information obtained indicates that it is inadvisable to proceed.

Evaluation

     IVCA members should evaluate the patient’s health and health needs from the
     information gained and formulate a veterinary chiropractic clinical impression or
     rationale for care, based on the evaluation of the information. This should be kept
     under review while caring for the patient.

Veterinary Chiropractic clinical decision making

     IVCA members should interpret all of the information available about a patient
     and then make (and record where appropriate) decisions with regards to:
   - How the patient’s health and health needs are likely to change over time with
     and without veterinary chiropractic care.
   - The benefits and risks of providing care for the patient, including any contra-
     indications.
    - The natural history and likely outcome of any presenting veterinary chiropractic
     complaint.
    - Identifying emergency situations that need immediate action.
    - The likelihood of preventing recurrences or managing any long-term health
     needs and the severity of those health needs.
    - Patients whose health needs would be better met through the care offered by
     another healthcare professional.
    - Any other care, which the patient is receiving, where there is evidence that it is
     having an adverse effect on the patient’s health.

Advice on medication

     IVCA members must not advise clients to stop prescribed patients medication. If an
     IVCA member has concerns about the effects of prescribed medication on a
     patient’s health, he/she should advise the client to discuss the issue with the health
     professional who prescribed the medication.

Planning, implementing and reviewing care to improve patients’ health and address patients’ health needs

Planning care - IVCA members should develop a plan of care for a patient and should do this in discussion with the client and primary carer where necessary. IVCA members should continually review a patient’s health and health needs as they provide care for the patient and should modify the plan of care accordingly.
Selecting appropriate care - IVCA members should choose care that is safe and suitable for; the patient concerned, their health and their health needs.
Applying appropriate care - IVCA members should be educated about the underlying theories of the care they provide. They should be competent, proficient and qualified to apply such care in practice.

    For example:
    - To perform Applied Kinesiology the IVCA member should have successfully
       completed an IVCA approved (or equivalent) course in Applied Kinesiology.
    - Treatment by acupuncture, aromatherapy, homeopathy, herbal medicine or other
       complementary therapy may only be administered by an IVCA member who is a
       veterinary surgeon who has undergone specific training in these procedures.

The care provided should be appropriate for the patient’s health and health needs.

The client must have consented to the form of care.

IVCA members should care for the patient in such a way, that risk to the patient
is minimised.

Review - IVCA members should review and evaluate the benefit of care to the patient. Any modifications to the original care plan should be identified and acted on accordingly.

II. Practice management

Insurance

     While in practice IVCA members should secure and maintain professional
     indemnity insurance (and ensure that their insurance covers them if a complaint is
     made when they have ceased practising).
     If an IVCA member employs other health professionals, these individuals should
     have the necessary professional indemnity insurance too.
     IVCA members should obtain and maintain any other relevant insurance that is
     required by legislation.

Financial records

IVCA members should keep sound financial records and comply with relevant
legislation

Effective communication

Effective communication is an integral part of both client and practice management

Communication with clients

Information on assessment and care

     With regards to assessment and care, IVCA members should clearly explain to
     clients
    - What will happen during assessment and care.
    - When the care will be reviewed.
    - Any known risks.
    - The expected outcomes.
    - The need to refer the patient to another health professional to meet the patient’s
      health needs if appropriate.
    - Required communication with the primary carer to pass on information.

Information on practice matters

     IVCA members should communicate clearly with clients with regards to:
    - Fees structures.
    - The type of information that will be recorded.
    - The procedures for making a complaint (if the patient wishes to do this)

Communication with other healthcare professionals

Responding to referrals

     When patients have been formally referred in writing to an IVCA member as a
     named healthcare professional, the IVCA member should produce clear follow-up
     reports.

IVCA members must seek the consent of the client for this information being
provided.

     In compiling such reports IVCA members are encouraged to consider the following:
    - The initial findings.
    - The number of times that care has been provided.
    - The form that care took.
    - Changes in a patient’s health and health needs.
    - A review of treatment plans following care (including if applicable any
     arrangements for further contact with the patient).
    - Any requests for additional involvement of the referring party or other healthcare
     practitioners.

Contributing to the completeness of patients’ health records

     IVCA members are encouraged to produce clear, concise reports for the patient’s
     primary health care provider as the custodian of patients’ complete health records
     (if the client/caretaker consents to this happening).
     The reports should identify the:
    - Reason for the information being sent.
    - Evaluation of the patient’s health and health needs before and after the provision
     of care.
    - Type of care provided.
    - Client's consent to the information being sent.

Reports for third parties

     IVCA members should respond promptly and courteously to requests for IVCA
     information from other health professionals and third parties. IVCA members
     should get consent from the client for any information to be provided. IVCA
     members should produce clear, concise reports for third parties. IVCA members
     may make a reasonable charge for the provision of such information.

Facilitating access to care

IVCA members should act in the interests of patients through facilitating access to
the investigations and other forms of healthcare that patients may need.

     The IVCA code of conduct and standard of proficiency have been based on the
     Royal Veterinary College of Surgeons (2004) and the General Chiropractic
     Council (2005) professional conduct and standard documents.