Chiropractic in Canada

The Canadian Chiropractic Association (CCA) is a blend of two voluntary and eight mandatory provincial associations representing approximately 84 percent of all licensed chiropractors in this country. Canada's 26 million plus population is spread across a vast expanse of some 3.8 million square miles, second only in size to the USSR. This gives Canada a practitioner-to-population ratio of approximately 1:7500. Less than two years ago, the ratio was 1:8100. So you see, chiropractic in Canada is viable and growing.

Canada's only chiropractic college, the Canadian Memorial Chiropractic College (CMCC), has a student enrollment of 588 and graduates about 145 DCs per year. CMCC is fully accredited and, along with many of the accredited colleges in the United States, annually supplies newly-minted chiropractic practitioners to replace those who retire, die or otherwise leave practice, which accounts for the CCA's impressive growth rate of almost 7 percent in 1990.

Perhaps the most important political happening to take place in Canada in 1990, as far as this profession is concerned, was the passage in early December of the "Chiropractors Act" by our most easterly province, Newfoundland. Approximately three quarters of a century has passed since the first law regulating chiropractors in this country came into force and nearly a decade of painstaking preparation and negotiations preceded this particular achievement. Finally, except for a large and primarily barren region in Canada's far north (Northwest Territories), all jurisdictions from the Mexican/U.S. border to the North Pole can now claim chiropractic legitimacy.

Unfortunately, unique idiosyncrasies, peculiar to Newfoundland (such as the fact that there are no free-standing x-ray clinics in that province, which means that even medical radiologists work out of hospitals) gave our profession considerable anxiety for the eventual outcome of negotiations with that province's government. However, our fears proved to be groundless as Newfoundland now has probably the most acceptable act of any province in Canada; certainly the newest.

Besides this momentous accomplishment, I feel I should also mention a very recent event with potentially far-reaching ramifications for the profession in this country and possibly the rest of the world as well. It is this: Canada's largest province, Ontario, with more than a third of the country's population, introduced new and perhaps "revolutionary" legislation earlier this month. If this legislation passes, it will give Ontario (after 66 years) its own chiropractic act. It will be contained in legislation made up of an omnibus bill, the "Regulated Health Professions Act" which will provide equal status for chiropractic with 24 other soon to be proclaimed health disciplines, including Medicine.

I say "revolutionary," because for the first time anywhere in the world, Ontario will be embarking on a totally different concept of licensure as has been understood heretofore. No longer will health professions, per se, in Ontario be licensed; but rather, the practitioners themselves, whose procedures or treatments constitute a potential risk to the well-being of the public (patient), will be licensed to perform those acts. There are 13 of these categories called "controlled medical acts" and chiropractors will be licensed to perform just two of them tentatively defined as follows:

1. "communicating the diagnosis of a disease, disorder or dysfunction as the cause of a patient's symptoms under circumstances in which it is likely that the patient relies on the practitioner's diagnosis;" and

    

2. "moving the joints of the spine beyond an individual's usual physiological range of motion using a high velocity, low-amplitude thrust."

I am sure you will agree that this is a completely new approach to the issue of licensure. One, no doubt, Ontario hopes will ultimately set the standard for the world. Over the past five years, considerable time and money have gone into a thorough review of every health group which made representation to the Ontario government (more than 200). This proposed legislation is the provincial government's response.

Following a second reading it will be sent to committee where anyone may make representation. Thus, some parts could be removed or altered.

However, considering the fact that this legislation was first introduced by the previous liberal government, just prior to an election and that all parties agreed to its reintroduction by the new NDP government, it is not likely any major changes will be proposed or tolerated.

John G. Cochrane, B.Sc, DC
Kitchener, Ontario
Canada