Thank you for the question.
You're absolutely right, chiropractors historically have spoken to wellness. It was not always initially well received, and they moved towards more specific roles as a “back doc”. However, now we're hearing our own words echoed back to us and are being asked what we know about it.
I think the role chiropractors initially and historically have played partially depends on the fact of where we enter a treatment regime. If you consider a patient's actions, when they have any particular failing that leads to a loss of capacity or function, they will make a decision about how they want to deal with it. Typically, a patient who is used to chiropractic care will come to a chiropractor before they go to their medical doctor. If the problem is not severe, this will be a very normal response. Then the chiropractor quite often may say this is not doing well; we need further diagnostic testing. It might progress to something for which you involve other practitioners.
Chiropractors are very often and for some segments of the population the only first contact. We all have patients who don't go to medical doctors—not that we advocate that; it's their choice. So we see patients at the initial stages of many problems.
We also see them in chronic situations. The area in which we see this role expanding is really all to do with access, and as the chiropractic profession expands its scope, access is dependent upon access to educational opportunities and to clinical opportunities. Chiropractors at the moment are still somewhat outside the tent. You don't see a chiropractor when you're in the hospital; you see a chiropractor independently. It's private funding in most of the provinces—in all but one. So there are problems of access.
There are educational opportunities that need to be capitalized on. We have chiropractors all across the country who are involved in very specialized projects, who pre-screen for orthopedic situations, who are doing marvellous research. We have 10 and almost now 12 research chairs across the country dealing in various aspects of health and wellness. These need to be developed and expanded. We might look across the pond to Denmark, Norway, and Sweden, where chiropractors and medical doctors go to school together until their fourth year, when they split up. They work together in hospitals and state clinics. They're reimbursed by the state, fully or partially, and very often moneys go directly to research.
Right now, in Denmark, there is a 9% clawback from the pay of the chiropractor; if they're employed in a state clinic, 9% of the payment from the state goes to a research fund for each profession. At the moment, that's generating $3 million Canadian in Denmark for chiropractic research. They're in the boat of looking for researchers. We in Canada fund our chiropractic research from the chiropractors' pockets alone, and we are looking for money—and we have piles of researchers.
So I think there are benefits in those examples to the whole field.
British Columbia's contingent made a very good point regarding collaborative care. It was also voiced by the cancer society. The chiropractic contingent, dealing primarily with neuromusculoskeletal, is a very important part of caloric consumption. Whereas you're looking after what's going in, we're hoping to help with what's going out. The utilization of our foodstuffs and how we act in our fun, in our leisure, in our jobs is very important, and chiropractors improve the capacity of an individual to function more fully.
