Conference speakers tout education as key to integrated, collaborative health care

VICTORIA, B.C. – Is your practice multidisciplinary or interprofessional? While many chiropractors practice in a multidisciplinary setting, very few are practicing “interprofessionally” – which is more than just multiple health disciplines in one clinic referring patients to one another.

True interprofessional health care happens when multiple health practitioners and disciplines collaborate on the care of one patient. And that, according to speakers at the 2015 B.C. Chiropractic Convention, starts in the education level.

Training future health-care practitioners to work alongside other health disciplines, in mutual respect of each other’s respective skills and knowledge, is a significant win for collaborative, patient-centred care.

“You cannot force collaborative practices, you have to build it from the ground up. You have to educate them on collaboration,” stressed Dr. Deborah Kopansky-Giles, a chiropractor and clinician-scientist on staff in the department of family and community medicine at St. Michael’s Hospital (St. Mike’s) in Toronto.

Giles oversees the chiropractic program at St. Mike’s and co-chairs the department’s interprofessional education committee with Dr. Judith Peranson, a family physician. Giles and Peranson discussed the St. Mike’s model of collaborative primary health care delivery at the BC chiropractic convention.

“Education helped drive our team forward,” said Peranson, referring to the collaborative health-care environment currently enforced at St. Michael’s Hospital. “Learning together as a team has been a major contributor to interprofessional collaboration.”

St. Mike’s department of family and community medicine has integrated 12 health-care professionals – including three chiropractors. These professionals look after the health care of more than 35,000 patients in a collaborative fashion.

Giles noted that St. Mike’s “interprofessional team” does not just mean a co-location or referral arrangement. The practitioners work on a “one patient, one chart” model, which provides the practitioners a universal view of a patient’s records, including notes of all practitioners involved with the patient’s care. This one-chart system also allows the health-care providers to message each other about patient progress, questions and comments.

Although there are only a handful of models of interprofessional primary health care in Canada – St. Mike’s being one of them – the trend towards creating new generations of collaborative health professionals is increasing. In 2009, the University of Toronto has declared it mandatory for all students in the health professions programs to fulfill a required number of credits on interprofessional education through its newly established Centre for Interprofessional Education.

The ultimate goal of the centre, according to the U of T’s website, is “to prepare healthcare providers with the skills and capacity to transform healthcare through collaborative practice, recognizing that a sustainable, innovative health system, effective health promotion, and good patient outcomes require the full, creative participation of all healthcare providers.”

Giles urged proponents of B.C.’s planned chiropractic educational institution to consider interprofessional education when developing its chiropractic education program for the proposed institute.

She also challenged current practitioners to consider attending a continuing education conference outside of chiropractic. “Get a little bit outside of your own comfort zone for your own professional development.”

Switzerland is one country that may have integrative health care collaboration figured out. Swiss chiropractors enjoy the same privileges, rights and responsibilities as medical doctors, according to Dr. Kim Humphreys, a professor in the medical faculty and head of the chiropractic medicine program at the University of Zurich.

The chiropractic medicine program is part of the university’s Faculty of Medicine. During the first three years of the nine-year doctor of chiropractic medicine program, chiropractic students are required to take medical courses, Humphreys said, noting medical and chiropractic students also have the same requirements for admission.

Such integrated education has “facilitated discussions and mutual respect” between the two professions, Humphreys said. “Medicine has not diminished our role. In fact, I found the opposite; they try to expand it.”

Humphreys, a Canadian born in B.C., was also a speaker at the chiropractic convention. The four-day event was held in Victoria, B.C., from Nov. 5 to 8 and hosted by the B.C. Chiropractic Association.