Blog: Navigating Professional Boundaries in Fractious Times

We live in difficult and fractious times. I cannot recall a moment in my career when political and social issues felt so charged - when disagreeing with a particular viewpoint could so quickly cast you as the enemy. In an age where opinion travels faster than reflection, public debate has become less about dialogue and more about division.

But how does this affect you as a chiropractor? and why am I, your registrar, blogging about it?

Last week, the Professional Standards Authority (PSA) published a letter addressing what is acceptable for health and care practitioners when expressing views on topical issues and global events. It affirms:

While preserving freedom of speech is important, hate crime and hate speech are unequivocally unacceptable. Such behaviours undermine professional standards and erode public confidence in healthcare practitioners.

Thankfully, such cases are rare in chiropractic. But when they do arise, I’m confident we respond appropriately and robustly.

The PSA’s letter coincides with the launch of our short consultation on the revised Guidance for Registrants on Professional Boundaries, which now includes a section on respect and dignity. This marks a significant expansion from the previous edition, which focused solely on sexual boundaries. The draft has benefitted enormously from input from the RCC, Professional Associations, and the GCC EDI working group.

Among the many updates, one stands out: for the first time we have included explicit guidance on your right to cease care.

Let me be clear - you are entitled to cease treating a patient if they persist in inappropriately crossing a professional boundary. We ask that you first attempt to resolve the situation, document your actions and reasoning, and, where possible, help the patient find alternative care. You are not expected to tolerate abuse or otherwise unacceptable behaviour.

And, to return to the PSA’s letter, aggressively asserting a political, religious or racial opinion can cross the professional boundary of respect. You and your patient may not agree on every topic, but we expect any discussion to remain respectful and not interfere with clinical care. This expectation applies both ways.

Issues such as conflicts in the Middle East, immigration, nationalism, and the Supreme Court ruling on sex and gender are complex and nuanced. They are ill-suited to the soundbite culture of today, where aggression and contempt for differing views are commonplace. In this climate, professionalism means maintaining respect, dignity, and focus - especially when others do not.