Shopping Mall Screenings
- The Chiropractic Association (Singapore) does not seek to restrict the rights of its members to market their practices to increase awareness of chiropractic in Singapore.
- It is concerned, however, that any marketing or advertising undertaken in association with these rights is consistent with its code of ethics and existing codes of advertising practice prevailing in Singapore.
- Particular issues have been raised by members of both the association and the general public in relation to marketing activities undertaken by chiropractors in shopping malls and similar venues. In these situations, chiropractors or their representatives offer screening to members of the public whereby analysis is undertaken, either by reference to posture or readings obtained by surface EMG/thermography.
- Pending the results of these analyses, potential patients are often encouraged to book an appointment at the chiropractor’s clinic for a more comprehensive assessment including x-rays and physical examination.
- The association takes the view that the welfare of the patient is paramount. No activity should be undertaken by a chiropractor that in any way may breach this principle.
- The association does not consider that assessment by means of examination within the situation of a shopping mall is appropriate. Important duties are owed to patients in terms of privacy and confidentiality and the association does not consider that such duties can be discharged under the circumstances of assessing patients at a mall screening.
- The use of SEMG is controversial. Its lack of evidence regarding its efficacy makes it inappropriate to use in a non-clinical setting for diagnostic purposes. Furthermore, any statement by a chiropractor which may be seen to create an impression of gravity in the mind of a patient must be avoided. No programme of treatment should be recommended solely on the basis of a shopping mall screening.
- Chiropractors should not take any fees from a patient at a shopping mall screening either in respect of that screening or any future appointment.
- The provision of a diagnosis or clinical impression should only be following a full assessment involving a case history and physical examination plus any other diagnostic tests deemed necessary by the chiropractor. Such provision in a shopping mall on the basis of only a cursory examination is inappropriate.
- Express or implied suggestions that a condition might be cured by chiropractic treatment must not be made by a chiropractor under any circumstances and particularly in a shopping mall environment.
The association does not seek to prohibit chiropractors (or their representatives) from marketing their services, whether in shopping malls or elsewhere. To do so would restrict the rights of chiropractors to fair trade and competition.
- Stalls in shopping malls should be purely designed to provide information about chiropractic. Distribution of written information, business cards, or electronic/multimedia is accepted provided the information complies with the TCA(S) code of ethics and Singapore Code of Advertising Practice.
- Patients should be able to approach the stall of their own free will; no undue pressure should be placed on a patient to approach the stall.
- Chiropractors are permitted to talk to patients about conditions in general terms and answer questions relating to chiropractic treatment. No information or advice specific to any individual should be given outside of a formal clinical assessment to be conducted in the chiropractor’s clinic.
- Patients should not be examined or assessed at a shopping mall marketing stand. In particular, SEMG screening should not be used as a diagnostic tool and can only be used as a measure of muscular activity. All screening with SEMG devices must be accompanied by a disclaimer translated into English and Chinese stating:
“The use of SEMG is for measuring muscular activity and a screening tool only. The results will vary somewhat from what is expected in a clinical setting. Due to numerous environmental conditions, the level of the floor, the lack of skin preparation (including the use of alcohol) allowed at a screening and electrical noise at the location of the screening, readings may not accurately reflect the true muscle activity as found in a complete exam.”
- No information should be given to a patient that might be seen to give the impression of a promise of cure.
- No payment should be received for information or assessment provided at the stand or in advance of appointments at the chiropractor’s clinic.
- No impression should be given that x-rays will be automatically taken at every new patient appointment. X-rays should be ordered only on the basis of individual clinical justification and should take account of the adverse effects of ionising radiation.
- The appearance and demeanour of the stand in general and the chiropractor in particular should reflect a professional approach to care and high standards within the profession