I'd like to start with an appreciation of the question. You finished your question with how could we prevent chronic disease. I'd like to first make clear that as one of the primary care practices, it would always be a collaborative approach.
We've all spoken to essentially the same topics. The common points have been collaboration; having a medical home, or a health home; integrated services and research; and primary care reform. So taking those points into account and answering your question, I would suggest that we don't perhaps need any further numbers of chiropractors to assist in the job. What we need is better access to the patients and them to us.
We also need to disseminate information in a manner that is much more imaginative. For every practitioner who is successful in his or her office, whether it is medical, psychiatric, chiropractic.... For nurse practitioners, the problem is time management. To educate patients on what they may need to know is no longer always possible to do, need to need. Often you can. Often extra time is set up. But we have to be much more imaginative in how we deliver material.
First, I would think, is that material is consistent, not only within a profession but inter- and intra-professional. Second, the use of social media, of having things on our websites, of having things on Facebook, is very appropriate.
I'd like to suggest another small program that might be of use, particularly to a federal audience. All our patients now come to us with what they have read on the Internet: I have such and such a condition. I have read this. Is it of use? I'm aging. I have a husband with such and such, or a mother. How do I deal with this? So they're researching information.
The federal health minister has brought the importance of clinical guidelines to mind, and so have the provincial premiers. Those guidelines are currently geared toward practitioners finding treatment for chronic disease as one of many things. Perhaps what the federal government could do very well is take those clinical guidelines and turn them on their sides and find an adjudicated, authorized manner of taking the successful approaches to treating a disease and make that accessible to people for self-care.
If you have diabetes and you look online to see what you can do, instead of finding some sort of approach that you wonder about in terms of validity or usefulness or safety, have an authorized report so that when you look at diabetes you would see this is what the following practitioners all do--they have been shown, through the research, to be effective to the following degree, particularly when done in conjunction with so and so's approach.
We know that all our patients are doing a lot of self-care. I think we have a role. If we all do our clinical guidelines properly, and compare them and find common points on the side instead of silos, we could serve in a capacity that way as well as our treatment and education of patients in the office.