Chiropractic scores in new Ontario health ministry initiatives

Oct. 17, 2013 — The Ontario Ministry of Health and Long-Term Care will soon be releasing a call for proposals for a primary care low back pain (PCLBP) pilot program that will support interprofessional health-care teams in providing more effective management of low back pain.

Minister Deb Matthews made the announcement in a video message to
the Ontario Chiropractic Association (OCA) during its annual general
meeting on Oct. 5.

“You’re an important part of our efforts to deliver the right care in the right place at the right time,” said Matthews.

“This
pilot program is aimed at improving lower back pain management in
primary care setting. Interdisciplinary teams will be funded to design,
plan and implement a lower back pain program,” the minister explained.

The
model for primary care low back pain management will be geared towards
family health teams, nurse-practitioner-led clinics, community health
centres and aboriginal access health centres, according to Matthews.

In
addition, Matthews announced that within the year, chiropractic will be
added to the list of professions eligible to work in family health teams
and nurse-practitioner-led clinics.

“Combined with the lower
back pain program, these are important first steps in exploring the ways
in which chiropractors can be integrated into interdisciplinary primary
health-care teams,” Matthews said.

The OCA welcomed Matthews’ announcements saying this
development is “unique” in the history of chiropractic in Ontario and
presents a significant shift in government policy.

“The two announcements represent a significant shift in government policy, with chiropractors being viewed by the Ministry of Health and Long-Term Care as important partners in the health-care system. This is a formal recognition of the value of chiropractic to the health of Ontarians, which stands to benefit all chiropractors across the province, whether they participate in these new opportunities or not,” the OCA
said in a statement sent to Canadian Chiropractor Magazine.

Taking its cue from these announcements, the OCA said it
will now focus on how family health teams, nurse-practitioner-led
clinics, community health centres and aboriginal access health centres
will take advantage of the opportunity.

“Our member driven Local
Health Integration Network liaison program, which exists for promoting
opportunities like these throughout all regions of the province, will be
an integral part of this effort,” the OCA said in a statement issued on its website.

According to
David Jensen, spokesperson for the Ministry of Health and Long-Term
Care, the PCLBP pilot is in line with the ministry’s low back pain (LBP)
strategy, by promoting better patient outcomes and satisfaction,
improving quality and efficiency in LBP management and supporting the
adoption of clinical best practices in the treatment of LBP.
 
To
date, the ministry’s LBP strategy has seen reductions of almost 20 per
cent in diagnostic imaging, resulting in cost savings of $13 million,
Jensen told Canadian Chiropractor.

“The PCLBP pilot will see the
integration of inter-professional allied health provider services into
primary care teams to provide treatment, assessment, patient education
and referral for LBP patients,” Jensen explained. “Through the pilot,
the above-noted primary care settings will recruit allied health
providers with the appropriate skills and fit to deliver services, with
any combination of chiropractor, physiotherapist, occupational therapist
and kinesiologist eligible for inclusion.”

The addition of
chiropractic in the list of eligible professions in primary health-care
setting means chiropractors are now eligible to work in Ontario’s
family health teams (FHTs) and nurse-practitioner-led clinics (NPLCs).

“Both
FHTs and NPLCs are interprofessional primary health-care models
delivering team-based programs and services in chronic disease
management, health promotion and disease prevention to communities
across Ontario,” said Jensen.

He added the need for
chiropractors in these primary care settings would be determined by each
organization based on the health needs of their patient population and
their ability to integrate new professionals into their team.

Despite
these positive developments for the chiropractic profession, the OCA
said it will not likely generate a huge number of new positions for
chiropractors in primary care team settings in the immediate future.

“The
full impact of this on the profession and our patients will be seen
over the next decade. However there will be new opportunities for
chiropractors to be funded through both the ministry’s new low back pain
project and through the FHT/Nurse Led Practitioner Clinic budget lines.
On a broader basis, the inclusion of our profession in a funded primary
care system will enhance the reputation and brand of the profession
across the province,” the OCA said.

The Ministry of Health and
Long-Term Care is expected to provide more details about the PCLBP pilot
program when the call for proposals released “in the next few weeks.”