The Global Journey

If one tries to form a snapshot of the profession of chiropractic, here
in Canada and around the world, one quickly discovers it is a difficult
proposition.

If one tries to form a snapshot of the profession of chiropractic, here in Canada and around the world, one quickly discovers it is a difficult proposition. The progress that the profession has made does not lend itself to a still-life composition, but rather is best captured as an evolution, looking back on its distant, as well as recent, past to understand its present progress into a very promising future. One would almost rate this flurry of activity within the profession, on a global scale, as fairly random and/or judge its efforts in each distinct country as relatively detached, if not distant, in their purpose, from that in other regions. But, in fact, if one examines the profession globally, the efforts on behalf of its members begin to appear quite systematic with goals converging on many fronts, such as scope of practice, regulation, education, research, leadership and identity.

At home – across our Canadian provinces that, while united in their vision to bring chiropractic to as many as possible, vary in their approach to and execution of this goal – we witness chiropractic milestones on a frequent basis. The products of many of these milestones can be seen to fan out and influence the process of establishing chiropractic – helping it to grow – in many other countries around the world. Furthermore, Canadian DCs are quite active in assisting other nations in their efforts to achieve recognition with their governments and establish regulatory frameworks that allow chiropractors to practise within established guidelines and local laws.

One of the most active international agents in this respect is the World Federation of Chiropractic (WFC). Based in Toronto, the WFC is made up of an ever-growing number of member states from around the world. The executive council of the WFC comprises chiropractors from a variety of countries, including Canada, an arrangement that coalesces experiences from a broad range of locations in order to bring a balance of perspectives to the federation’s work.

This article features interviews with current WFC president, Dr. Michael Flynn (from Louisiana, United States) and second vice-president Dr. Gregory Stewart (from Manitoba, Canada).  Dr. Flynn will discuss the role of the WFC and some recent developments around the world, while Dr. Stewart will tie in Canada’s significant contributions to the profession as well as provide some insight on the basis of this success.

INTERVIEW WITH DR. MICHAEL FLYNN

Dr. Flynn is a second-generation DC born in Davenport, Iowa, and a graduate of Texas Chiropractic College. He has represented the ACA and the North American Region on the WFC Council since 2001 and currently serves as WFC president.

Dr. Flynn is a second-generation DC born in Davenport, Iowa, and a graduate of Texas Chiropractic College. Dr. Flynn has represented the ACA and the North American Region on the WFC Council since 2001 and currently serves as WFC president.
Canadian Chiropractor: What are some ways in which the WFC is evolving to better serve and represent the profession around the world?

Michael Flynn: As chiropractic grows internationally, the WFC is positioned to provide a representative forum to discuss the major issues facing the profession, including capturing the profession’s identity in a way the public can relate to, and provide important data on the profession such as the recent comprehensive survey of the legal status of the practice of chiropractic worldwide.

CC: What is the WFC’s role in the development of chiropractic education around the world?

MF: This is a large and significant part of the WFC’s work and one of the priorities that our member associations ask for. There is great interest in many regions of the world for formal chiropractic education. It is essential that high standards are met in all educational programs. The Council of Chiropractic Education and the National Board of Chiropractic Examiners now have international branches and are making great progress. The WFC stands strongly for a consistent level of education and legislation internationally.

In individual countries the WFC brings together the national associations, a local university and a partner accredited college from another country to commence chiropractic education. The WFC has assisted this way in Brazil and Chile, for example, and is
currently working in Asia, Eastern Europe and the Middle East.

Every two years the WFC partners with the Association of Chiropractic Colleges and other educational organizations to put on an international meeting to address specific educational issues. Most recently, at RCU Maria Cristina in Spain in October 2010, the conference focused on clinical training. The next conference will be at Murdoch University in Perth, Australia in September 2012.

CC: How is chiropractic evolving on a global scale?

MF: I am convinced that the science, philosophy and art of chiropractic will continue to make great strides in recognition and accessibility. On the shoulders of many in the profession, we have overcome scores of challenges. Although there are still battles to be fought, the naturally right values of a chiropractic influence on health care are making progress that will be of benefit to mankind.

From an international perspective there is impressive growth. The profession is now recognized by legislation in 46 countries, most recently in France, Italy and Israel. There are new educational programs in many countries and more being developed.

Approximately 10 years ago in Brazil, where the WFC just held its Biennial Congress, there were two schools just getting started and less than 40 DCs in the country. Today in Brazil, there are more than 700 students and 600 doctors of chiropractic. A third school will be welcoming its first class soon.

There is a serious research capacity and a level of research output that is building a secure foundation for the future.  In Canada you are playing a very senior role in research that is most respected. In the USA a recent research grant of almost $8 million to RAND and Palmer College will measure chiropractic services in the military and with Veterans hospitals.

Progress is at different stages in different countries. Chiropractic is fully integrated into mainstream health-care systems in diverse countries such as the Cayman Islands, Denmark, Iran and Switzerland, while there is still the risk of prosecution in South Korea, Taiwan, Hungary and Turkey.

Sports chiropractic is flourishing and is a source of great pride for professional achievements. The WFC has put forth great effort in the growth of the Federation of International Sports Chiropractic (FICS) in recent years.

A united and consistent market identity, supported by uniform international standards in education and legislative scope of practice, are essential.  The profession is on the right road to accomplishing these, much more so than some other professions.

INTERVIEW WITH DR. GREGORY STEWART

Dr. Stewart has served as president of the Manitoba Chiropractic Association and the Canadian Chiropractic Association. He is a graduate of CMCC and currently serves as second vice-president of the WFC.

Dr. Stewart has been an active member of the profession in Manitoba, and nationally, for a number of years. He has been involved in many political battles for, and within, the profession in Canada and has also had the opportunity to listen to the concerns of DCs across the country.  He brings this experience to his office as second vice-president of the WFC executive board, but perhaps even more significant is that, over the years, he has seen the fruits of chiropractors’ labours in the form of a number of successes for the profession. 

Dr. Gregory Stewart:  What I have learned from experience, and see in the WFC, is that strong leadership and clear vision can accomplish much, and in a surprisingly short period of time.  As well, I have seen first hand the significance of sound legislation and a high level of education in furthering the profession and the importance of a commitment to bringing patient-centred chiropractic care to as many as possible.

Canadian Chiropractor:  What does the profession in Canada offer to chiropractic around the world?

GS: In Canada, dedicated leadership of international significance has been demonstrated by the CCA, as well as by individual members of the CCA such as Dr. Deborah Kopanski-Giles and Dr. Allan Gotlib.  Dr. Kopanski-Giles, one of the two CCA/WFC representatives, is a leader in her efforts for interprofessional bridge-building, in educational development, and as an ambassador for the profession. Her international involvement is further demonstrated through her work with the Bone and Joint Decade (BJD), a UN global health initiative.

Dr. Allan Gotlib, along with the CCA board of governors and on an initiative started some years ago by CCA Past President Dr. David Peterson, has led a program to establish chiropractic research chairs in major universities across the country. This is raising research standards and capacity and concomitantly increasing the credibility of the profession. This program is known and admired worldwide in the profession.

The CCA is acutely aware that the profession is evolving, while the dynamics of health care  delivery have altered. The determinates of success for health care professionals have shifted and, if chiropractic is serious about attracting bright minds and strong leaders, the profession needs to help open doors for its young members so that they can realize fulfilling and rewarding careers.  In this, the CCA shows strong leadership, supporting and developing a framework for evidence-informed practice, creating opportunities in health care research and policy development and building a public health persona for chiropractic so that DCs are trained and recognized not only as spinal experts but also as qualified and active participants in improving population health.

It is this brand of leadership that will benefit the profession on a global scale, and Canadians certainly can – and do – take a lead role in bringing this about.  Canadian organizations and their leaders are very cognizant of their responsibilities in the world of chiropractic and are also well positioned to propagate the message that the profession’s growth should be centred on bringing effective and safe patient care, as well as propagating healthy living choices, not only to Canadians but also to people around the world.

Finally, in the area of research, Canadian chiropractic scientists are uncontested leaders, and it is exciting to see that DCs not only in Canada but internationally are understanding and responding to this leadership. That was clearly seen when there was standing-room only attendance at the research forums at the WFC Congress in Montreal in 2009. An audience of that size and enthusiasm would never have been seen at a chiropractic research session even 10 years ago – there just wasn’t the awareness of the importance of research to chiropractic.  This awareness is now alive and well across the profession all over the world.

CC: What can the profession in Canada learn from chiropractors in other areas of the world?

GS:  At the WFC’s 12th Biennial Congress recently held in Brazil, a session was held that focused on the question of whether chiropractors should make any use of prescription drugs with their patients. Although a change in the WFC policy against the use of prescription medications was not an objective, one of the significant features of this discussion was that the profession, locally and globally, has reached an assured level of maturity. The WFC was able to engage chiropractors in a discussion that was politically charged but respectful to all points of view– there was no grandstanding but all who were present were engaged. It, once again, spoke highly of strong leadership such as that offered by the WFC, but it also spoke volumes about how the profession can now participate in a sophisticated, critical-thinking environment. Chiropractic is not threatened by this type of dialogue and ultimately it strengthens our core values.

Another thing we can learn from chiropractors elsewhere is that we in Canada must never be self-righteous. In Canada we come from very humble roots – DCs who went before us and made many sacrifices  on behalf of the profession. To this day there are similar pioneers are out there in other countries, taking the road less traveled. We need to be thankful for what we have, and ready to help the pioneers in other countries.

We can help in the advancement of the profession globally by participating financially in strategic and supportive work of the WFC as individual members. Doing this through the WFC is the best option. The WFC could not accomplish its mission without the support, especially financial, of the major Canadian organizations, first and foremost the Canadian Chiropractic Association.

Finally, we can help by working with, and supporting, chiropractic students. Chiropractic students as well should not hesitate to share input and ideas with student leadership groups as well as the WFC. The WFC does much work within chiropractic education but has also partnered with the World Congress of Chiropractic Students (WCCS) in order to learn from students, absorbing and being influenced by their optimism regarding growth for a patient-centred profession, and developing a synergy that will result in today’s student leaders becoming the profession’s leaders tomorrow.

In conclusion, I stress again that the profession can realize rapid progress and huge results if we have strong leadership and a clear vision in mind. More than ever before, that vision must begin with patient-centred care – there is no other way forward in this era. Without losing its principles and values, chiropractic must be known as science- based, collaborative and mainstream.

I have fought many battles over the years, but I have enjoyed the challenges and seen many successes when we have the right people all pulling the rope in the same direction. And, increasingly, I have seen that Canadians can and must be leaders in the profession internationally.