As the health industry moves forward, it is becoming evident to all that collaboration among the various health care professions will benefit the health care system as a whole. This collaboration encompasses decision-making, and the synergistic effect of teamwork between health care providers alike. Not only will this benefit the patients receiving this hybrid style of care, but it will also improve the interprofessional relationship among medical (MD) and naturopathic doctors, doctors of chiropractic (DC), and other alternative health care specialists. In this short narrative then, the discussion will focus on the role of chiropractic in health care, as well as the its role in public health.
Evidence from the January 2011 Chiropractic Report states that the collaboration between medical and chiropractic professionals is beginning to trend, not only in private practice, but also in hospitals for the treatment and management of individuals with neuro-musculoskeletal disorders (1). The report also explores the challenges this collaboration imposes on care providers, which are mostly due to the lack of understanding from individuals who still practice with the “old school” ideals (1). Here then, it is important to identify the boundaries of such collaboration, with respect to the role each profession plays in patient care, as well as to find opportunities that further progress the relationship between disciplines while also improving care (1). In the case of musculoskeletal health and care, the Chiropractic Report addresses the difference between collaboration and integration between MDs and DCs. Collaboration, in their perspective, relates to a formal partnership in which clinicians work together but maintain their individual roles in a patients care (1). Conversely, they see integration as being heavily built on trust (1). Integration is modeled by the unity of the professions in treatment centers like hospital or clinics, where the priority is patient care and not the gain of a specific discipline (1). These same factors were prevalent in the discussion of chiropractic as a complimentary and alternative medicine (CAM), which is another classification and label that promotes the separation of health care providers (2). Along with this, further barriers to integration include factors with the third party payors, which can occur if there are discrepancies between the policies of health coverage (2). To extrapolate on this, it is well known that chiropractic care is not covered under OHIP in Ontario. There are efforts to place chiropractic care under the umbrella of OHIP to make it more easily accessible to the public, yet until that occurs there will continue to be discrepancies between insurance companies for coverage of this care.
A step toward integration and collaboration includes identifying the role of chiropractic in health care and in public health, as this can assist in identifying the grey areas that require further focus and development as we strive to achieve the ideal health care system; one in which chiropractic is fully integrated. The role of chiropractors in health care include acting as primary health care providers in neuromusculoskeletal conditions, as well as specializing in the prevention and management of spinal health (2). Moreover, public health refers to the health of the general population and the measures that are taken to prevent disease, and assure the population’s overall satisfaction and health (2). These measures are maintained by the synergistic effect of the organized community efforts, and this includes chiropractic in its prevention and management of musculoskeletal conditions (2). Strategies that may aid in building trust between MDs, DCs, and patients include enhancing communication between all parties. Effective communication can be attained by adopting a common language that is easy to comprehend, and gaining a thorough understanding of each profession’s scope of practice, training and competencies (1).
In conclusion, the efforts made by health care providers to adopt a more integrative and collaborative interprofessional relationship has proven to be beneficial to the public. It has established a more cohesive approach to health care that emphasizes the patient, rather than the gain of the individual professions. Chiropractic itself has constructed a sound role in the health care system, and proven to be a great contributor to the need of public health. Indeed chiropractic maintains an active role in public health by educating patients and the population of the health measure they may take to actively participate in their own health. Despite the challenges that integration has presented in the past, professional relationships can continue to move forward as they build trust and maintain a common goal; a better health care system that promotes the strength of each profession.
1) The Chiropractic Report, Collaborative Practice – Challenges and Opportunities, https://chiropracticreport.com/index.php/past-issues/view_category/10-2011
Chapman-Smith, David. Collaborative Practice - Challenges And Opportunities. 2011. Print. The Chiropractic Report.
2) Haldeman S. Principles and practice of chiropractic. Norwalk, Conn.: Appleton & Lange; 1992.