Myth Busters: Common Questions About Regulation

Reality: CCOA provides a minimum of two weeks’ notice for practice visits.

This advance notice is intended to give chiropractors time to prepare, review the process, and understand what to expect. Practice visits are scheduled in advance and are administered in a fair, transparent, and organized way.

It is also important to clarify that practice visits and inspections are different processes. Practice visits are part of the Continuing Competence Program and are focused on supporting chiropractors in meeting minimum Standards of Practice.

Inspections are not part of the Continuing Competence Program and may occur for different regulatory reasons. Because they are separate processes, the timelines and expectations may differ.

CCOA recognizes that questions can arise when different regulatory processes are discussed together. We will continue to provide information to help chiropractors understand what each process involves and how they differ.

Reality: Practice visits do not involve a surprise exam. They are based on the Practice Visit Rubric, which is available to chiropractors in advance so they can understand what will be reviewed during the visit.

The Practice Visit Program assesses whether minimum standards are being met in practice. It does not use a grading system, and there is no “pass” or “fail” outcome.

If areas for improvement are identified, the Competence Committee works with the chiropractor to provide direction and support. The goal is to promote safe, competent practice and continuous improvement, not to penalize chiropractors.

Reality: CCOA has not revoked a chiropractor’s practice permit as a result of a practice visit, and the Practice Visit Program does not use a “pass” or “fail” outcome.

The purpose of a practice visit is to assess whether minimum professional standards are being met and to identify opportunities for improvement where needed.

Following a practice visit, the peer assessor and the chiropractor members of the Competence Committee provide direction to help the chiropractor address any areas requiring improvement. The focus is on education, support, and achieving compliance with minimum standards.

Where significant concerns are identified, the Competence Committee works with the chiropractor to develop an appropriate plan. This may include additional education, mentoring, or a follow up visit. The objective is to help chiropractors meet minimum professional standards in the public interest.

Reality: These roles are established under Alberta’s Health Professions Act. In smaller regulatory colleges, it is common for a CEO or Executive Director to also hold legislated roles such as Registrar or Complaints Director.

Each role must still be carried out according to legislation, regulatory requirements, and principles of fairness. CCOA will continue to provide information to help registrants understand how these roles function within the regulatory process.

Reality: CCOA’s preferred approach is to resolve concerns through accountability, education, remediation, and support wherever appropriate.

In approximately 95 percent of complaint files, CCOA has offered educational or supportive options to help chiropractors address concerns and take accountability without immediately proceeding to a formal hearing.

When matters do proceed to a disciplinary tribunal, the tribunal operates independently from the Complaints Director. In some cases, tribunal sanctions have been higher than what was proposed through earlier resolution efforts.

The Disciplinary Tribunal decision regarding Dr. Ernest Li provides one example of CCOA’s efforts to pursue informal, collaborative, and remedial resolution before a formal hearing.

This approach is not limited to discipline. In one recent matter involving multiple complaints, CCOA worked with the parties before opening formal complaint files, allowing approximately 80 percent of the matters to be resolved without a formal complaints process.

CCOA remains committed to fair, proportionate, and practical regulatory responses that support accountability, remediation, and resolution wherever possible.

Reality: Health profession colleges are not structured as member owned or shareholder organizations. Under the Health Professions Act, CCOA’s role is to regulate the profession in the public interest.

Because CCOA regulates chiropractors, registrants are not considered shareholders of the College. Decisions about College assets are made through the appropriate governance and oversight processes, consistent with CCOA’s public protection mandate.

Reality: As previously communicated to the profession, CCOA sold its office building because it was an aging and costly asset that was no longer being fully utilized.

The proceeds from the sale were placed in the College’s reserve accounts, consistent with Council’s responsibility to support the long-term financial sustainability of the organization.

CCOA communicated the rationale for the sale, the use of proceeds, and the financial impacts to registrants. The College also obtained an independent audit review of the sale to confirm the transaction was conducted appropriately, and those results were shared with registrants.

The College remains in a strong and stable financial position. Annual Reports and audited financial statements are publicly available on the CCOA website and provide a transparent account of the College’s financial position, stewardship of resources, and commitment to responsible governance.

Reality: CCOA is responsible for participating in professional conduct hearings in a prepared and timely manner. The length of a hearing can be affected by several factors, including the complexity of the matter, scheduling availability, motions, adjournment requests, extensions, and other procedural issues.

In some cases, delays may be caused by regulated members or their legal counsel being unprepared, requesting adjournments, seeking extensions, or making schedule changes. These factors can affect how long a hearing takes to complete.

Professional conduct hearings are generally open to the public, and those interested in understanding the process may attend and observe how proceedings unfold.

When adjournments or delays occur, they are often documented in publicly available tribunal decisions. CCOA also reports on hearing activity, including adjournment requests where appropriate, through professional conduct updates in the Public Interest Alignment newsletter. This helps registrants and the public better understand the process and the factors that can affect hearing timelines.

Reality: Alberta’s health professions moved from a self-regulatory model to a co regulatory model following legislative changes in 2019. Under this model, major governing bodies of health profession colleges must include at least 50 percent public members to ensure the public interest remains central to regulatory decision making.

This does not mean chiropractic expertise has been removed from the regulatory process. Chiropractors continue to play an important role in areas where professional knowledge and experience are essential.

For example, CCOA’s Practice Visit Program was developed by chiropractors, is conducted by chiropractors, and is overseen by a Competence Committee made up entirely of chiropractors.

More than 20 chiropractors currently contribute to the work of the College through committee appointments, peer assessment roles, and other volunteer or leadership positions. The College is also exploring additional opportunities for chiropractors to participate in committees, working groups, and other regulatory initiatives.

Reality: CCOA recognizes that regulatory requirements can feel challenging, especially during periods of change. At the same time, CCOA has taken several steps in recent years to reduce administrative burden and make compliance more accessible for chiropractors.

These include:

• Simplified registration and renewal processes
  • Digital submission of documents
  • Easier completion and reporting of continuing education requirements
  • Broader criteria for activities that qualify for continuing education credits
  • The ability to carry continuing education credits forward
  • Reduced yearly fees
  • Elimination of CCOA yearly fees for those on parental leave
  • Less frequent routine practice visits
  • Additional support through the Practice Advisor program, in clinic practice support visits, and career span competency resources

Preliminary information from CCOA’s renewal process also shows that the chiropractic profession continues to grow in Alberta.

As a single mandate regulator, CCOA’s role is to regulate the profession in the public interest. This includes supporting safe, ethical, and competent chiropractic care while continuing to provide clear information, practical resources, and transparent expectations for registrants.

Reality: CCOA is not pursuing, considering, or advocating for chiropractors to be regulated by a medical association or medical board.

A change of this nature could only be made by the Government of Alberta. CCOA’s role remains focused on regulating chiropractic practice in Alberta in the public interest.

Reality: Regulatory matters often involve different facts, circumstances, risks, and evidence. For that reason, decisions cannot always follow a single predetermined outcome for every complaint, assessment, or remedial process.

CCOA applies discretion, judgment, and right touch regulation when making decisions. When administrative decisions are made, reasons are provided so the affected person can understand the basis for the decision.

This supports fairness, transparency, and accountability. Where applicable, decisions may also be reviewed by appeal bodies or the courts.

Reality: Disciplinary hearings are governed by the Health Professions Act and follow a defined legal process intended to support fairness, independence, and public accountability.

CCOA does not decide the outcome of a hearing on its own. Hearings are conducted by an independent tribunal made up of 50 percent public members appointed by the Government of Alberta and 50 percent regulated members of the chiropractic profession.

Tribunals are supported by independent legal counsel, who provide advice on legal and procedural matters. Chiropractors who are the subject of a hearing are provided with notice of the allegations, an opportunity to respond, the option to be represented, and access to review and appeal processes established under legislation.

Tribunal decisions include written reasons, which support transparency and accountability. Registrants who want to better understand the process are encouraged to review published decisions, attend public hearings where available, and become familiar with the Health Professions Act.

The purpose of the discipline process is to protect the public, maintain professional standards, and uphold confidence in the profession.

Reality: Available data does not support this claim. CCOA continues to see steady interest in registration and practice in Alberta, including participation in the preceptorship program and ongoing growth in licensure.

Regulatory requirements exist to support public protection, patient safety, and professional accountability. These expectations are not unique to Alberta and are consistent with the responsibilities of regulated health professionals across Canada.

Registrants are encouraged to review CCOA’s Annual Reports, which provide information on registration trends, licensure statistics, preceptorship participation, professional conduct activity, and other key regulatory metrics.

While regulatory requirements may evolve over time to reflect changes in health care, legislation, and public expectations, the available data shows that Alberta continues to be a strong and active jurisdiction for chiropractic practice.

Reality: CCOA provided registrants with multiple ways to complete the mandatory criminal record check requirement. While an online portal was available as an efficient and cost-effective option, registrants were not required to use it.

More than 25 percent of registrants completed the requirement through other approved methods, including local police services or other recognized providers.

CCOA accepted all approved methods, provided advance notice, shared clear instructions, and sent multiple reminders before the deadline. There were no widespread portal issues that prevented registrants from meeting the requirement.

Mandatory criminal record checks are an important public protection measure. Registrants who were referred to conduct were referred because the requirement was not completed despite repeated communication and multiple available options for compliance.