New measures aim to boost MD-chiropractor collaboration in tackling low back pain

When it comes to managing low back pain (LBP), Dr. Mike Kates says the goal of all health-care professionals is to resolve issues with patients and get them comfortable, safe and back to work as soon as possible. “Whether you’re a physician, a chiropractor, a homeopath or a physio-therapist, everyone needs to be on the same page,” said Dr. Kates, a family physician in Mississauga, Ont., and lecturer at the University of Toronto.That’s why he welcomes two new measures under Ontario’s LBP Strategy that aim to integrate chiropractors into primary-care settings in Ontario in an effort to cut costs, referrals and wait times.One of the measures was announced by health minister Deb Matthews via a two-minute video presented at the Ontario Chiropractic Association’s (OCA) annual meeting last fall. It is a pilot funding offer to support Family Health Teams (FHTs) and other types of clinics that design, plan and implement new or existing LBP programs that integrate allied health providers.The minister also said chiropractors had been added to the list of professions that are eligible to work in FHT and nurse-practitioner-led clinics in Ontario. “These are important first new steps in exploring the ways that chiropractors can be integrated into interdisciplinary primary health-care teams,” added Matthews.For the OCA’s chief executive officer, the new measures are less revolutionary than an acknowledgement of the collaborative clinical efforts that already exist between chiropractors and many health-care professionals. “Chiropractors are widely recognized for their great core skills in musculoskeletal injuries, and LBP specifically,” said Dr. Robert Haig (DC).“It’s much better to manage LBP at the primary-care level rather than escalating it to emergency or second-level care,” he said. He called the new measures “a tangible opportunity” for FHTs to add the expertise of one of Ontario’s 4,000 chiropractors to their collaborative teams.Dr. Kates agreed. A member of an FHT with five sites and the primary-care lead for a Local Health Integration Network that includes some 1,000 physicians in Mississauga and other nearby communities, he said he enjoys working with chiropractors to manage patient LBP issues.“I like the fact that I can communicate with them in an interactive and collaborative model,” said Dr. Kates. “I get timely notes back about treatment, which is more patient-centred and efficient.”More important, he added, is that referrals to specialists take time, and LBP issues can worsen during the wait.Similarly, Dr. Kates said MRIs “can sometimes complicate things unnecessarily” because they can show abnormalities that are really normal and minor degenerative changes. “That causes delays and additional angst for patients,” added Dr. Kates. MP

New measures aim to boost MD-chiropractor collaboration in tackling low back pain

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