Forging our future.
Subject: Medical journals (Analysis)
Medical publishing (Management)
Trade and professional associations (Services)
Author: White, Eleanor
Pub Date: 10/01/2009
Publication: Name: Journal of the Canadian Chiropractic Association Publisher: Canadian Chiropractic Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Canadian Chiropractic Association ISSN: 0008-3194
Issue: Date: Oct, 2009 Source Volume: 53 Source Issue: 4
Topic: Event Code: 200 Management dynamics; 360 Services information Computer Subject: Company business management
Product: Product Code: 2721391 Medical Periodicals; 8620000 Professional Membership Assns NAICS Code: 51112 Periodical Publishers; 81392 Professional Organizations SIC Code: 8621 Professional organizations
Geographic: Geographic Scope: Canada Geographic Code: 1CANA Canada
Accession Number: 259590277
Full Text: It is an honour to be asked to make comments in this Journal regarding the chiropractic profession in Canada from the perspective of the CCA.

The association functions within an interesting and very typical Canadian duality. Although we represent the chiropractic profession on the national stage, health policy and delivery are primarily provincial in nature. Thus the CCA has two distinct member designations; Charter Members comprised of the provincial chiropractic associations, and individual registrants. This elastic web of national and provincial interests functions best, when viewed as interconnected and the CCA often has the privilege of exposure to differing perspectives, each addressing excellence in its own jurisdiction. The similarities far outweigh the differences and the opportunity to learn from one another cannot be ignored. Success hinges upon commonality in vision and commitment to excellence.

The national association is well suited to the art of fusion; working together to find the best answer or most appropriate policy as well as assuming a leadership role in pan-professional issues. A recent event in Canada is an excellent example of the coalescing of thought and action that I believe must take place.

In spring 2009, a Canadian Leadership Summit was held in Toronto, attended by all provincial advocacy and regulatory bodies, and all of our national chiropractic partners, comprising our educational and examining institutions, the specialty colleges, risk management, our research foundations and our national regulatory federation. The need to commit to a pan-Canadian professional approach to the advancement of chiropractic was addressed directly. The collective body unanimously agreed to adopt the identity statements developed by the WFC, positioning the chiropractic profession as "spinal health care experts" and to define this more colloquially as the 'Back Doc' in our business model. Secondly, the collective committed to formally pursuing an integrative role within mainstream health care.

This accomplishment cannot be trivialized. Many who have been involved in chiropractic leadership may view this as self-evident, but this stated commitment to a common direction is a big step for many within the profession. We, like other groups have a disparate membership, representing not only differing styles of practice, but adhering to diverse philosophies. Historically, the call has been made for "unity." Indeed, we have been united by goals of service to the public and our patients, and by our standards of practice, our education, our legislation, and our licensing requirements. However, as a goal unto itself, the value of unity may have been a veiled call to tolerance. We have often been told that there is room under the tent for all of us and that we are united by our name, and the nature of our two historic realities--the adjustment and the subluxation. As education has evolved, and health human resource issues have become important, inter-professional competencies are overlapping. The game has changed. We must change too.

We are now called upon, as a profession, to evolve and perhaps more quickly than we even now admit. Unity has taken on a new context and importance. Tolerance has become a liability at times. We are called upon now to understand our profession intimately, honestly and publicly. We must be committed in our endeavour to understand the mechanisms underlying the benefits of chiropractic care. This documented understanding will also compel us to trim away behaviours and practices that are not beneficial to the patient, irrelevant to practice, and quite frankly less than helpful in the advancement of the role of chiropractic in mainstream healthcare. In this context, unity becomes an ethical commitment to the pursuit of excellence and to the brave exploration of our own claims. As we work within our own profession and with other professions and jurisdictions to truly determine the uniqueness of chiropractic care, we will gain the knowledge to stake our ground.

So, what will that ground be? Where does our commitment to advancing integration within mainstream healthcare take us? Imagine pre-screening for orthopedic procedures, hospital privileges, working in the ER, multidisciplinary clinics, inter-professional continuing and post graduate education. Seeds are taking root, but it will take a pan-professional commitment to have these scenarios become common practice.

We have evolved greatly in the last decade, and the CCA has played a major role in this evolution. We have seen the development of excellent Clinical Practice Guidelines, soon to be housed within the new Research Chair at McGill University; and have established Research Chairs and Professorships in universities across the country. We have advanced federal government relations greatly and anticipate many more successes. We stand resolute in the support of our administrative members and partners in the profession. But we must think, and we must think creatively and well into the future and see where we need to know ourselves better, commit to excellence, and no longer tolerate unprofessional behaviour if we are to advance this profession as an integral partner in the health of Canadian citizens.

I am fortunate to have been involved in provincial, national and international chiropractic associations and I am always struck by the strength of the commitment of the volunteers and the administrators in this work. I have also been lucky to have been able to take these lessons to other areas of service in the provincial and federal community and I am convinced that the capacity of chiropractors to improve the health care of Canadians has not been even entertained by most. I like the word "capacity." It is a word widely used in the health human resources world. The best way to describe the benefit of chiropractic care is that it increases the capacity of function of its recipients. Patients experience an increase in their daily functional capacity, whether with respect to their working or recreational life. Our functional capacity as a profession is greatly untapped and I believe that as we understand the mechanism of our clinical success better, we can communicate it more confidently and effectively. This will ultimately result in a better understanding and acceptance of our contributions to general healthcare, leading to a greater use of our professional capacity.

We must move ahead with clarity and in a timely fashion as the healthcare world is evolving quickly, and each and every one of us has a responsibility to contribute to the success of the chiropractic profession. Our resolve this year to commit to this path was needed, but our next steps must follow quickly, surely and boldly.

Dr. Eleanor White, DC, MSc


Canadian Chiropractic Association
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