Public health reporting and infection control
Public-health questions test mandatory reporting and day-to-day infection control. Both are independent of clinical scope: a chiropractor may not treat a reportable disease but must recognize and report it.
Core rules
- Report child abuse or neglect, elder or vulnerable adult abuse, and specified communicable diseases to the designated authority as required by Montana law; HIPAA permits many public-health disclosures.
- Do not delay emergency medical referral to protect confidentiality; minimum necessary disclosure applies.
- Use standard precautions with every patient: hand hygiene, gloves and PPE when exposure is likely, safe sharps handling, and clean or sterile technique for invasive procedures.
- Clean and disinfect tables, equipment, and toys; use appropriate sterilization for reusable instruments; single-use items are not reused.
- Maintain an infection-control plan, train staff, and document exposures and corrective actions.
Worked example
A patient discloses active tuberculosis and asks for an adjustment. The chiropractor should not simply adjust and keep the disclosure confidential. The correct response is to defer nonurgent care per public-health guidance, refer for medical management, and report as required; document the advice.
Traps
- Treating confidential as never report.
- Using disinfectant without contact time.
- Reusing single-use needles or gloves.
- Failing to report suspected abuse because the patient asks you not to.