The Healing Arts Radiation Protection Act
became law, and during the legislative
process the Minster told us we would
lose X-ray rights. A hard fought, grueling
political battle took place that we
eventually won.
The mid-80’s to mid-90’s also saw the
process which led to the RHPA and the
Chiropractic Act, establishing our place
among the health professions and putting
us on a level playing field with other
regulated health care professionals.
But on the other side of the coin, I vividly
remember to this day receiving a phone
call in the late evening, advising us that
we would not be granted the controlled
act of diagnosis. We very nearly lost one
of our most essential acts, and it took us
two years to get it back on the table.
The 90’s introduced the term “primary
care reform” and the idea of transitioning
physicians from fee-for-service funding,
with its perverse
incentives, to
capitated funding
models like Family
Health Teams; a
true paradigm shift
in health system
thinking, which is
still underway today.
I want to
share the
journey
I have
been on…
In the 2000’s that
new thinking led to
the understanding
that multidisciplinary care, chronic
disease management and prevention,
rather than just better illness care, were
the keys to better patient health and a
better health care system.
Today, with a profound understanding
of the burden of MSK disorders, these
principles are being implemented in
Ontario for improved conservative
management of back pain and other
MSK disorders.
In just over half a century, the chiropractic
profession moved from being a
disrespected alternative profession to a
thriving group of practitioners who are
valued by patients and increasingly seen
as essential partners in addressing our
province’s MSK challenges.
Speaking of MSK, now is a good
opportunity to clarify my thoughts on an
issue that can b e controversial. When I
graduated there was hardly any strong
evidence for basically anything to do with
MSK. Gray’s Anatomy said the S/I joints
were fixed, so the idea of a chiropractor
adjusting them was ridiculous.
But research finally caught up to practice,
and there is now solid evidence for
what we do for patients with back pain.
Yet there is less high level evidence for
neck pain and headaches, very little for
other MSK conditions and almost none
for non-MSK symptoms. As far as I’m
concerned, that is just the evolutionary
stage the research is at right now.
I remember in my first month as a
chiropractor, a 7-year-old boy visiting
from England came into the practice
having an asthma attack; he’d gone blue
around his lips and fingernails. I relied on
my training to examine and adjust him;
the boy turned pink and started breathing
normally, and said to his mother, as only
a British child can, “I’m weary. Can I go to
bed now?”
This dramatic experience is not easily
explained by evidence, but I am
absolutely confident that nearly every
chiropractor in the province has had
incredible clinical experiences where
remarkable and unexpected results
took place.
The point is, despite the fact that there
is currently a huge market opportunity
around MSK issues and pain management
that we absolutely must own, I believe
that the evidence for non-MSK symptoms
will eventually catch up to practice, just
as it did for spinal pain.
So for those of us who worry that
chiropractic is being put in an MSK box,
we are not. The story of chiropractic is
one of evolution, not revolution. It’s a
perilous story of hundreds of individuals
advocating and negotiating with those
in power over decades to carve out our
rightful place in this province, but it’s also a
happy tale of the thousands of patients that
have become our champions due to the
amazing care all of you have given them.
And this isn’t ancient history. The project
that led directly to the government’s
current Primary Care Low Back Pain Pilots
www.chiropractic.on.ca
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