Medavie Blue Cross Presenter Canadian Chiropractic Association Canadian

Medavie Blue Cross Presenter: Canadian Chiropractic Association

Canadian Chiropractic Association • CCA represents Canada’s 8, 400 chiropractors • More central role as experts in MSK health • Promoting high standards of practice • National leadership on insurance issues 2 The Role of Chiropractors in EHC: Example of Orthotics

Canada’s Chiropractors 3 • Assessment, diagnosis, treatment of MSK conditions • 7 years minimum education and training • Evidence-informed practice • Strong research focus • Regulated by legislation in all provinces The Role of Chiropractors in EHC: Example of Orthotics

Chiropractic Education and Training • • 4 Undergrad Degree 4 years full time at accredited program at College or University *Massage Therapist is not regulated in all Canadian provinces; therefore, the minimum training required can vary from 1 -3 years (average 2 years). The Role of Chiropractors in EHC: Example of Orthotics

Chiropractic Clinical Care and Employer Objectives 5 Clinical focus aligns with key employer objectives: • Work-readiness • Productivity • Reduced absenteeism and disability • Health and wellness The Role of Chiropractors in EHC: Example of Orthotics

Ailment Reasons for Seeing a Chiropractor: Q 15. For what types of treatment or problem did you see/are you seeing a Chiropractor? Select all that apply. Base: All respondents who have seen a Chiropractor before in their lifetime (n=1308) 6 The Role of Chiropractors in EHC: Example of Orthotics

Back Pain in Canada 7 And other MSK conditions a major driver of healthcare spending 11 MILLION CANADIANS SUFFER FROM LBP EACH YEAR 2 ND LEADING REASON FOR VISITS TO MDS MSK CVD Cancer ECONOMIC BURDEN Respiratory disease The Role of Chiropractors in EHC: Example of Orthotics

Back Pain in Canada 8 Experience LBP in their lifetime Impacts productivity The Role of Chiropractors in EHC: Example of Orthotics

Canada’s Experts in MSK Health Safe, drug-free and non-invasive 9 Highly trained back pain specialists 4. 5 MILLION CANADIANS Regulated in all provinces to diagnose and treat MSK conditions The Role of Chiropractors in EHC: Example of Orthotics

Qualifications for Foot Care 10 The Role of Chiropractors in EHC: Example of Orthotics

Approach to Foot Care 11 “Orthotics when necessary, but not necessarily orthotics…” ü ü ü ü Core competency Full kinetic chain Underlying causes Assessing alternatives Diagnosis and plan of treatment Orthotics when necessary Adjunctive care Referral when warranted The Role of Chiropractors in EHC: Example of Orthotics

The Example of Metatarsalgia • • 12 Common overuse injury affecting “ball of the foot” Worsens while running, walking, standing or flexing the foot Treatment focuses on correcting joint dysfunction or poor biomechanics Orthotics may just support foot in dysfunctional state (like casting a bone without setting it), and create dependence The Role of Chiropractors in EHC: Example of Orthotics

Case Study 13 TBD Reference Evidence Handout a lot of times, used by podiatrists for stabilization. Put an orthotic for motion control. What chiros recognize is that while that might be a short term fix, it can decrease the joint perceptors. Better way is if orthotic is necessary, to use as a short term strategy while doing core strengthening. Wobble ball. Foot exercises. Influence to be more active in their own care. Avoiding dependency on device. Foot conditions that are completely biomechanical, and don’t require dependence on orthotic. The Role of Chiropractors in EHC: Example of Orthotics

Why Include Chiropractic? 14

Why Chiropractic? ü ü ü ü 15 Qualified Continuity of care Reducing risk of knee, hip, back problems Access Many want alternatives to orthotics Avoiding dependence Choice of regulated practitioner The Role of Chiropractors in EHC: Example of Orthotics

Access 16 FOOT CARE PRACTITIONERS IN ATLANTIC CANADA 300 250 200 150 100 50 0 Chiroprator Pedorthist Podiatrist The Role of Chiropractors in EHC: Example of Orthotics

Partnership to Improve Value 17 Chiropractic partnership to improve EHC products: The Role of Chiropractors in EHC: Example of Orthotics

Faster Return to Work • 18 Return to work in less than half the time (WSIB, 2004) • Chiropractic patients: • 23% faster than MDs • 94% than PTs (WCB, 2007) The Role of Chiropractors in EHC: Example of Orthotics

Summary • 19 Why is chiropractic an important choice for orthotics? ü Core competency ü Continuity of care and follow up ü Access for our patients ü Important clinical tool ü Appropriateness ü Avoiding unintended consequences for knees, hips, back The Role of Chiropractors in EHC: Example of Orthotics

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