Chiropractic in the Health System

Involvement in Interprofessional Primary Care Teams 

Chiropractors are eligible to work in all primary care interprofessional teams in Ontario: Aboriginal Health Access Centres, Community Health Centres, Family Health Teams and Nurse Practitioner-Led Clinics. 

These interprofessional teams deliver comprehensive primary care services and programs through a team of health care professionals, which may include physicians, nurse practitioners, registered nurses, pharmacists, social workers, physiotherapists, chiropractors and other professionals. Collectively, these 294 primary care organizations are delivering team‐based, OHIP‐funded comprehensive care to more than 4 million Ontarians. In cases where funding is not available for chiropractic care within a primary care team, volunteer clinics have been established, such as the volunteer chiropractic program at Quest Community Health Centre.  

Chiropractors are also working collaboratively with other health professionals in two key government projects that the OCA has advocated for, and which will help inform the design of programs and services for MSK patients in Ontario: 


Rapid Access Clinics  

In December 2017, the Ontario government announced an investment of over $37 million over the next three years to establish Rapid Access Clinics (RACs) in every Local Health Integration Network (LHIN) across the province. The RACs are an expansion of the Interprofessional Spine Assessment and Education Clinics (ISAEC) and hip and knee Central Intake and Assessment Centres (CIACs). This model helps with the Ministry’s strategy of reducing surgical wait times and providing efficient triage for specialist referrals for patients with hip, knee and low back pain. Chiropractors are currently employed in ISAECs and CIACs, which have had significant outcomes, including wait times of less than two weeks, a patient satisfaction rate of 99%, and a rate of referrals for imaging or specialist consultation of just ~6.4% in the ISAEC pilots. 

For more information on the Rapid Access Clinic announcement click here. 


Primary Care Low Back Pain Program 

The Primary Care Low Back Pain (PCLBP) Program is funded by the Ontario government as part of Ontario’s Low Back Pain Strategy. There are currently seven PCLBP program sites in Ontario, all situated in primary care interprofessional teams. Patients with low back pain are referred by their primary care provider to the program, where a musculoskeletal (MSK) allied health provider, such as a chiropractor, physiotherapist or kinesiologist, assesses the patient, develops a care plan, and provides treatment such as manual therapy, therapeutic exercise prescription and education.  

In 2017, the Centre for Effective Practice evaluated the PCLBP program and the results illustrate positive patient outcomes, with significant improvements in mobility and quality of life as well as reductions in pain, use of opioids/prescription pain medications, emergency room utilization and referrals for diagnostic imaging. Of 146 patients surveyed at discharge of the program: 

  • 83% agreed or strongly agreed they now rely less on medication to help manage their low back pain 
  • 94% were satisfied or extremely satisfied with assessment and treatment received 
  • 87% agreed or strongly agreed the program gave them access to low back pain care they otherwise wouldn’t be able to access 
  • 93% agreed or strongly agreed their quality of life has improved 

Typical patients of this program have other conditions, such as diabetes, addictions, hypertension, and are of low income without extended health care. Many would be unable to access care for their low back pain without the program. In recognizing this, the OCA continues to advocate for a provincial roll out of the PCLBP program. To access our recent budget recommendation on Enhancing MSK Care for Ontarians Budget Submission to Ministry,  and a print-out poster with further details on the Primary Care Low Back Pain Program, please click the two thumbnails below:

 

Primary Care Low Back Pain Poster Enhancing MSK Care for Ontarians