This series of blogs examines innovative healthcare models that include chiropractic expertise in treating spine, muscle, and nervous system conditions as part of team-based care. Evidence shows that team-based care with integrated chiropractic services can help improve outcomes and patient satisfaction. Several innovative approaches to healthcare delivery have been developed and introduced in Canada, with many more on the horizon, for all Canadians to have better access to appropriate care for spine, muscle, and nervous system conditions in their communities.
The benefits of interprofessional healthcare teams are too great to ignore. It’s been shown that patients do better when they are assessed, diagnosed and treated by practitioners with the most expertise in the area of concern, including chiropractors for patients suffering low back pain.1
Low back pain can be debilitating and statistics reveal that most of us will experience an episode at least once in our lifetime. Many of us will also experience a recurrence within one year without clinical intervention.
Back pain can impact many Canadians’ lives, so access to appropriate care can be crucial. In fact, access to interprofessional healthcare teams, including chiropractors, can help alleviate the burden of treating spine, muscle, and nervous system conditions, especially low back pain. Team-based care can help diminish demand on overworked general practitioners, reduce patient wait times and, as a result, provide better care for the 4.4 million Canadians without a family doctor.
Establishing team-based models of care has been a priority for many provincial and federal governments as they look to provide more efficient and sustainable healthcare delivery while managing the increase in demand for faster access to quality treatment. Spine, muscle, and nervous system conditions have been identified as an area of opportunity to advance healthcare delivery using standardized assessment criteria called pathway models in the treatment of low back pain.
This new spine pathway is a true win-win scenario for patients and providers.
—Dr. Joseph Buwembo, neurosurgeon
The province of Saskatchewan was one of the first Canadian jurisdictions to develop a comprehensive pathway to better manage low back pain and decrease wait times for surgical referrals. For many, the wait for a referral only delays access to care and decreases the likelihood of a prompt recovery.
The Spine Pathway in Saskatchewan was developed and introduced in 2011 to help patients access appropriate care faster and establish provincial guidelines for low back pain management. The Spine Pathway utilizes allied healthcare providers to assess and triage low back pain patients. Recommendations are made in terms of the appropriate type of treatment based on back pain patterns which increases consistency of care and appropriate follow-up if needed.
The province opened two Saskatchewan Spine Pathway Clinics where, upon referral by a family doctor, low back pain patients are reassessed and treated by an interprofessional healthcare team of allied healthcare providers.
“It changes the patient journey, by providing patients early access to assessment and support from their family physician, chiropractor or physiotherapist, using a standardized, simplified assessment and treatment process,” Dr. Joseph Buwembo told Yorkton This Week in 2011. “The spine clinics offer primary care providers and patients additional support and early access to diagnostics and consult if needed, resulting in earlier care and reduced wait lists.”
A parallel model was launched in Ontario in 2013. The Inter-professional Spine Assessment and Education Clinics (ISAEC) pilot was inspired by the Saskatchewan Spine Pathway Clinic model. Along with providing evidence-based triage, ISAEC emphasizes education and self-management strategies to manage back pain and decrease the likelihood of chronicity.
A 2011 report followed patients who were assessed using a spine pathway model from intake to discharge at Jordan Hospital in Massachusetts. The Back Pain Recognition Program that was used is different from the Canadian examples discussed above, however, it does show the efficacy of interprofessional healthcare teams in the context of low back pain. Patient outcomes were extraordinary:
- Of the 518 consecutive low back pain patients surveyed, 402 were treated exclusively by chiropractors.
- Cost $302 on average for total cost of care
- Pain rating at intake 6.2/10
- Pain rating at discharge 1.9/10
- Self-reported pain & disability scores reduced by about 70%
- More than 95% rated their care as “excellent”1
It is not uncommon to suffer from low back pain. Adding a chiropractor to your healthcare team makes sense! Canadian chiropractors, as spine, muscle, and nervous system experts, can be an asset in assessing and managing spine, muscle, and nervous system conditions, and help you prevent injuries to ensure that you can continue activities that you enjoy.
1. Paskowski I, Schneider M, Stevans J, Ventura JM, Justice BD. A hospital-based standardized spine care pathway: report of a multidisciplinary, evidence-based process. J Manipulative Physiol Ther. 2011 Feb;34(2):98-106. doi: 10.1016/j.jmpt.2010.12.004.