The clinical experience for many chiropractic college students is restricted to treating musculoskeletal complaints of friends, family, students, and ... even a few patients. Some chiropractors have suggested that this limited clinical exposure is the reason why approximately 84 percent of chiropractic practice is strictly musculoskeletal.1
The clinical status quo for some chiropractic colleges is beginning to change. Canadian Memorial Chiropractic College (CMCC) in Toronto, Canada has taken strong steps to broaden the clinical experience of its students. Spurred by the evolving nature of health care in its community, CMCC is taking advantage of opportunities never before available by having their clinical interns serve their communities in four new chiropractic clinics.
Muki Baum Clinics
While the unique needs of handicapped patients are often overlooked, the adults and children of the Muki Baum clinics, some of whom have "multiple impairments" (i.e., physically and emotionally/psychologically handicapped), receive chiropractic care on a regular basis. According to the chiropractic interns there, the adjustments do more than just relieve neck or back complaints: they seem to have a significant calming effect that helps these more challenging patients enjoy a better quality of life.
Many of the patients are nonverbal, which makes diagnosing more of a challenge. "It teaches you to read the patient more," explains chiropractic intern Marci Goldstein. Marci applied specifically for rotation through the Baum clinic: "I wanted the experience. I wanted something outside the (regular) clinic. It's easy to have a patient come in and say, 'I have a low back pain.'"
Nehama T. Baum, PhD, C.Psych., is the founder and executive director of the Muki Baum Association, which has an adult and a children's program. The children's programs are part of the public school system, with half of the children attending regular classes. This is the first time that chiropractic care has been offered at a Canadian public school.
Cheryl Farrugia, the program manager for Baum's adult program, believes that "one of the main benefits (of chiropractic care) is our people connecting with their body."
Dr. Baum is very pleased to have the CMCC clinicians at her facilities: "I feel that the attitude of the Canadian Memorial Chiropractic College is so much beyond teaching the usual. I know that our people love going to the chiropractor."
Wellesley Central Hospital
When the community speaks, community hospitals usually listen. When Wellesley Central's HIV/AIDS Community Advisory Panel (CAP) wanted a chiropractic clinic in the hospital, the people at Wellesley heard them.
"This all started two and a half years ago," explained Tony DiPede, who chairs Wellesley's HIV/AIDS Community Advisory Panel. "I had severe back problems, and a friend of mine told me, 'You have to see my chiropractor.' This clinic is the result of cooperation between a hospital that is committed to meeting the needs of its community and a college that is interested in serving an underserviced population. Together, they have responded to the needs of the community in a very positive and favorable way."
"This is the first time in Canada that DCs have been treating in a teaching hospital," said Laurie King, BSc, DC, chief of staff at Wellesley's Chiropractic Clinic.
Laurie adds: "Everyone is very receptive to having the chiropractic interns here. This will give the interns a chance to work inter-professionally with different cases."
Anishnawbe Health Clinic
The opening ceremony of the Anishnawbe Health Clinic was not your ordinary ribbon cutting festivities. The Anishnawbe (translated as "first peoples") are the native Indians of what today is the Toronto area. The availability of chiropractic services of CMCC interns to the indigenous Canadian population was celebrated by the traditional Anishnawbe feast of meegwetch (giving thanks). The ceremony includes songs that honor their ancestors.
Gifts were presented as part of the celebration, with each person or family bringing food for the feast. During the meal, people shared their understandings of health, particularly as it relates to the native culture.
University of Waterloo Chiropractic Clinic
The University of Waterloo (UW) in Toronto and the CMCC have opened Canada's first chiropractic research clinic on a university campus. The event was another important step in CMCC's effort to broaden their clinic base.
"This is an exciting relationship that will allow us to enhance our strong teaching and research programs in spinal biomechanics and neural control of human motion in the department of kinesiology," asserted Dr. Bob Norman, dean of the faculty of the applied health sciences. "Together with CMCC, we hope to improve the understanding of mechanisms of chiropractic manipulation, and to assist people in the community in reducing disability resulting from pain," he added.
UW President Dr. James Downey enunciated a broader perspective: "A century after Palmer, there is a considerable body of scientific knowledge, a large cadre of skilled practitioners, 23 professional training institutions around the world, and millions of helped patients to give substance to the claim of chiropractic as a healing profession.
"Waterloo too knows what it's like to be outside the mainstream, to be unorthodox and unconventional. What's more, we have come to believe that, for the sake of creativity and responsiveness, we must somehow remain so."
"CMCC is delighted to work with the University of Waterloo in developing this unique project," enthused Dr. Howard Vernon, director of research at CMCC. "A joint research clinic will not only enhance chiropractic research, but will also broaden the scope of scientific investigation within the university environment."
As the health care environment continues to evolve, chiropractors will continue to discover new and challenging roles as health care providers. The demand for chiropractic is expanding into areas never before imagined. CMCC President Jean Moss, DC, MBA, looks to that future: "Our profession is growing in leaps and bounds. As we enter the 21st century, there is an exciting future before us. During the next century chiropractic will secure its position as an equal member of a patient centered team which focuses on the provision of the most cost effective and efficacious health care. It is essential that we educate our students to meet these challenges.
"All too often the emphasis of the education of health professionals, including chiropractors is on tertiary conditions. By the time our students graduate they are confused and unsure of the full extent of the benefits of chiropractic care. The emphasis of their education must be on those conditions commonly encountered by a primary contact health practitioner. They should be exposed to a wide range of clinical conditions. This can be achieved by developing partnerships and cooperative programs with other health care and educational institutions.
"CMCC has begun to develop these partnerships, and they will have a significant impact on the future of chiropractic in Canada. With the opening of these clinics, CMCC has expanded the boundaries of our profession. We are now positioned to be recognized as an integral member of the health care team, effectively contributing to the management of conditions in which it was traditionally believed that we had no role to play. Equally important, we have ensured an excellent and broad education for our interns, who are the future of chiropractors of Canada." Reference
1. Cramer GD, McGregor M, Triano JJ, Emde JW. Generalizability of patient profiles from a feasibility study. JCCA 1992;36:84-90.
