Thank you, Mr. Chair.
I would like to begin by thanking the members of the Standing Committee on National Defence for inviting me on behalf of the Canadian Chiropractic Association and the 9,000 doctors of chiropractic across Canada we represent.
I'm sorry I missed you in person on Tuesday, but I'm happy to join you virtually this morning.
I want to acknowledge that I'm joining you from the traditional lands of the Haudenosaunee, Huron-Wendat and Anishinabe nations, and it is my honour and privilege to be here.
It's takes eight years of education and 4,500 hours of clinical training to become a doctor of chiropractic. Chiropractors are trained to be primary care contact professionals with the ability to assess, diagnose and treat spinal, muscle, nerve and joint conditions, also known as musculoskeletal, or MSK, conditions. These conditions such as back pain, headaches and neck pain have a devastating impact on Canadians' health, quality of life, workforce participation and the economy. According to the World Health Organization, MSK conditions, specifically low back pain, are the leading causes of disability around the globe, and more than a 11 million Canadians suffer from musculoskeletal conditions every year.
Due to the physical demands put on active military personnel, MSK conditions like back and neck pain are double that of the general population. MSK injuries are also a major occupational risk for a military career and are responsible for 42% of medical releases. These conditions are a key issue for transition services, as 59% of Canadian Armed Forces veterans who report difficult adjustment to civilian life had chronic pain.
We are all here today because we want to help our women and men in uniform stay healthy and pain free. We feel chiropractors are part of the solution, but there are two barriers we want to bring to your attention, barriers to access to care and inadequate benefits coverage.
Yes, armed forces members do have access to some chiropractic care, but in order to receive treatment, they first need to get a referral from the on-base clinician. Most Canadians can simply walk into a chiropractor's office to get care. The requirement of a referral before accessing chiropractic care is not required in any provincial or national health regulation and is not best practice in the health insurance industry. Veterans in the RCMP can seek care when they are in pain without this requirement.
There's well-documented research that patient-centred care includes choice of provider. This results in improved outcomes. Some people respond well to physiotherapy. Some people respond well to chiropractic. Some may need both. It seems disrespectful that our brave Canadian Armed Forces members don't have the same choice and require a referral.
This requirement also takes time. It takes time to see a physician. They take a history. They have to perform their own assessment, and then usually the patient is required to first try a course of treatment with on-base staff. Then, when that doesn't work, they might get a referral to book an appointment with a chiropractor, who then has to go through their own processes. This causes significant delay in accessing care.
As a clinician and a chiropractor, I know the sooner I can see the patient, the shorter the recovery period and the better the outcomes. When care is delayed, acute cases become more complex and potentially chronic. We hear stories of Canadian Armed Forces members waiting weeks to get their required referral. Many are paying out of pocket so they don't need to jump through these hoops. At a time when health care human resources are spread thin in the armed forces and across Canada, we need to streamline and reduce duplication.
Secondly, the benefits offered through Medavie Blue Cross only cover 10 visits. This might be enough to cover an acute case of injury, but we know that MSK conditions like low back pain can reoccur, and there is a chronicity to them. Veterans, for example, get access to 20 visits.
Our chiropractors are ready and willing to follow the protocols and reporting requirements that are necessary to interface with the armed forces. We already have the training to do so. Culture change is hard and takes time, but we are asking this committee to encourage the removal of the barriers that are preventing Canadian Armed Forces members from getting the care they need. The prevalence of MSK conditions among active service members means chiropractic can play a role in improving health outcomes and quality of life.
We feel that the brave women and men of our armed forces deserve choice and the very best in health care.
Thank you again for inviting me to appear before the committee.