Thank you, Mr. Chair.
Respected members of the House, I am honoured to be here with you this evening. Thank you for the invitation to be a witness, and thank you to the committee and subcommittee for giving attention to such an important topic.
I will briefly introduce myself. My name is Dr. Shannon Bauman. I'm a primary care sports medicine physician and have a dedicated practice to the care of athletes of all ages and all ranges of participation, from recreational level to professional athletes. I've been a team physician for lacrosse, hockey and sledge hockey. I currently hold medical privileges within the department of family medicine and department of surgery at the Royal Victoria Regional Health Centre in Barrie, Ontario, and I am associated with the University of Toronto.
I am the medical director and founder of Concussion North, a physician-led interdisciplinary team dedicated to the medical management and rehabilitation of sports- and exercise-related concussions. Concussion North has been recognized as a world leader in the management of concussions, and I've been asked to present at various meetings, such as in Berlin, in Croatia and across the United States, on our model and our research in the recovery of sports-related concussions. We see Olympic athletes, world junior hockey players, professional athletes, as well as local athletes and those who travel far distances across Canada and the United States to receive care at our clinic.
Most recently, Concussion North has been recognized provincially on the Minister's Medal honour roll for our dedication to excellence in concussion care in Ontario.
I'm proud to be an expert adviser and committee member at Parachute Canada, Ontario Neurotrauma Foundation, the Canadian Concussion Collaborative and MomsTeam, working with the NCAA and U.S. Department of Defense. Through my work on these committees, I've also co-authored five of our leading provincial and federal guidelines on concussion, including the “Canadian Guideline on Concussion in Sport”, our “Statement on Concussion Baseline Testing in Canada”, and Ontario Neurotrauma Foundation's provincial “Standards for Post-Concussion Care”.
First and foremost, I'm a clinician who provides care to my patients in the focused area of sports-related concussions. I'm also a clinician scientist. My area of research is in the management of concussion within an interdisciplinary team model, the recovery of sports-related concussions and factors contributing to the risk of prolonged recovery, and sex differences in the recovery of concussion.
Based on my professional experience in concussions, I have two primary recommendations that can inform this subcommittee's work.
The first is national uptake and implementation of the best practice guidelines. Through the leadership of our federal government and the Public Health Agency of Canada, as well as the work of our nationally recognized researchers, expert clinicians, knowledge translation specialists in Parachute Canada and the Ontario Neurotrauma Foundation, we've produced strong guidelines that set a high standard of care for concussions, both provincially and nationally.
Working with the majority of Canada's national sports organizations, these guidelines have now been translated into harmonized sport-specific concussion protocols that allow all sports stakeholders to work together to optimize the recognition and management of concussion in Canada. However, we need all health care professional organizations, provincial and municipal sports organizations, as well as school divisions to widely adopt these protocols to ensure the messaging is consistent across all school and sports settings. This isn't happening currently across all provinces in Canada and we're often confronted by the mixed messages that sport and school stakeholders are receiving from other sources outside of our guidelines.
Second, we need the government to fund and support physician-led interdisciplinary concussion centres of excellence across Canada. These centres need to be geographically located and funded appropriately to ensure everyone has access to the interdisciplinary expertise needed to successfully treat concussions.
We know that most individuals recover from concussions within two weeks of injury, but for those 25% of individuals who continue to experience prolonged symptoms, finding clinics that uphold the current stated standard of care for persistent symptoms is a challenge.
Our federal guidelines are clear in stating that people suffering a concussion require assessment by a physician and some may require a multidisciplinary clinic with a physician with extra experience in concussion care, together with an interdisciplinary team of health care professionals.
Caring for athletes and patients with persistent symptoms of concussion is challenging. As a physician, my licensing and training enables me to assess the complex medical issues, including migraine, sleep, cognitive difficulties, depression and exacerbation of other co-existing medical conditions that all need to be recognized by the physician providing an initial assessment. Only physicians can provide this type of care.
These conditions such as concussion are becoming more common. There are also aspects that will require rehabilitation by allied health care professionals with experience in managing the nuances of this injury, which may include physiotherapy, athletic therapy, occupational therapy, neuropsychology and optometry, all of which exist in clinics under one roof.
Unfortunately, we need to be wary of large concussion businesses that are falsely promoting expertise and are falling short of providing the necessary standard of care that we see in our guidelines. Despite marketing or certification of concussion expertise, it's a challenge when these clinics are not meeting their current guidelines.
Like conditions such as cancer that are medically complex, concussion care requires physicians in addition to other allied health providers to work collaboratively in an interdisciplinary fashion. In short, we need to establish regional centres of excellence that are able to uphold the high standard of multidisciplinary care set out by our guidelines.
We currently do this at Concussion North. I am quite confident that with federal support and funding, we will be able to offer this high standard of care in centres across Canada.
Thank you very much. I look forward to your questions.