Mar 26, 2024

On March 14, 2024, the updated Canadian Guideline on Concussion in Sport, developed by Parachute Canada, was released by the Government of Canada. Despite chiropractors having the training and scope to diagnose concussions and having productive conversations with the Ministry of Sport and Physical Activity, the CCA was not consulted in the update of these guidelines.

The guidelines restrict the signing of the medical assessment (diagnosis) and medical clearance letters to physicians and nurse practitioners. Restricting the diagnosis and the authority to sign the letters, will only delay diagnosis and treatment. In addition, the letters provided by Parachute Canada states that “forms completed by other licensed healthcare professionals should not otherwise be accepted.” This is unacceptable as chiropractors have the training, expertise, and scope to diagnose a concussion and should be able to sign the forms. We believe that diagnosis should be done in a timely manner by a regulated healthcare professional with the scope to assess, diagnose, and treat a concussion.  Without timely diagnosis and access to assessments and treatments for concussion symptoms, there may be delays in recovery, potentially affecting Canadians’ ability to return to their sport, normal life, school, or work.

Although, the new guidelines do mention that if a licensed healthcare professional is present in a sporting event, that a sideline medical assessment using the Sport Concussion Assessment Tool 6 (SCAT6) or the Child SCAT6 be used by a licensed healthcare professional who has training and experience in using them. We believe that this will allow chiropractors to do an assessment on the field. However, medical assessment (diagnosis)/medical clearance letters can only be completed by a medical doctor or nurse practitioner.

The Canadian Chiropractic Association (CCA) met with Ministry officials from the Minister of Sport and Physical Activity on October 16th, 2023, to discuss the role chiropractors can play in the treatment, management, and diagnosis of concussions. We clearly communicated that the Canadian guidelines on concussion in sport, created by Parachute Canada, were not aligned with international guidelines. The old guidelines limited the assessment and diagnosis to physicians and nurse practitioners. This limitation creates a duplication of processes, and delays assessment and diagnosis in a timely manner. We communicated the need for all regulated healthcare professionals with the scope, to have the ability to assess and diagnose concussions, such as chiropractors. We also presented the position statement developed by the Canadian Chiropractic Guideline Initiative, the Royal College of Chiropractic Sports Sciences (Canada) and the CCA on the assessment/diagnosis of concussion. We also shared the joint submission by the Canadian Memorial Chiropractic College, the Canadian Chiropractic Guideline Initiative, the Royal College of Chiropractic Sports Sciences (Canada), and the CCA to the Parliamentary Standing Committee on Health on sports related concussions in Canada.

Recognizing that timely assessment and diagnosis of concussions lead to better outcomes, the CCA is calling on the Government of Canada to direct Parachute Canada to amend the guidelines to allow all qualified healthcare professionals, including chiropractors, to assess, diagnose, and treat symptoms of concussion. This is crucial, to avoid delayed diagnosis and treatment, as well as a delay in recovery and a return to normal life, sport, school, and work.

At a time when there is a health human resource crisis, all qualified licensed healthcare professionals who have the training, expertise, and scope should be able to complete the letters and deliver a diagnosis and should be allowed to complete the forms. Inter-professional collaboration is critical to reduce patient backlogs and address labour shortages in the medical profession, especially in rural and remote areas.

We will continue to fight for accessible concussion care for all Canadians.