Chiropractic in Saskatchewan
The cost of health care is covered by the government of Canada. However, chiropractic is not considered a federal responsibility and, therefore, each province is left to decide whether they will include chiropractors in medicare or whether they may only partially cover the cost of this service. As you can imagine, this creates quite a difference from province to province in our country as far as coverage of chiropractic care is concerned. One could say that the amount of coverage provided by the provincial government for chiropractic care is probably an indication of what value the Department of Health places on this service. One might also say the more coverage you have, the more you are expected to participate in mainstream health care programs. Saskatchewan was the first province in Canada to initiate a medicare system for its population. This was done back in the 1960's; thus, we have had 20 years at working within this system.
At the present time, Saskatchewan has full coverage for chiropractors. This means that every person in Saskatchewan has unlimited use of a chiropractor should he require this service. This kind of complete coverage has some obvious advantages and some obvious disadvantages. The advantages are as follows:
a) every person has access to a chiropractor whether they have money or not,
b) interprofessional referral is enhanced when the referring physician knows his patient will not have to face a charge,
c) the chiropractor has no concern or worry about collecting fees,
d) complete statistics are available via computer for research on practice patterns and patients' use of chiropractors.
The disadvantages are as follows:
a) excessive utilization of this service by both the patient and the chiropractor,
b) The Provincial Chiropractic Association has very little control in bargaining for fee increases,
c) and this system occasionally causes chiropractors to place more emphasis on numbers of patients, as opposed to good quality care.
Also, as previously stated, medical specialists such as orthopedic surgeons, neurologists, and rheumatologists are paid the same rate for accepting a chiropractic referral as they are for accepting a medical doctor's referral. This is very helpful for interprofessional cooperation. Currently, private radiology labs accept chiropractic referrals for x-ray procedures. As a result of this coverage, interprofessional cooperation in Saskatchewan is probably second-to-none.
The reason we have been able to maintain full coverage for chiropractors in Saskatchewan is probably the result of research being done at University Hospital in Saskatoon. Most readers will be familiar with the work done by Dr. David Cassidy, a chiropractor, in cooperation with Dr. W.H. Kirkaldy-Willis, an orthopedic surgeon. They have, of course, lectured in many areas of the United States and other parts of the world. Saskatchewan has only a million people, and with two prominent researchers working at the only medical teaching institution in the province, this has an immediate impact on interprofessional cooperation. There is no question that in Saskatchewan, chiropractors believe the future of our profession definitely lies in continued research.
James D. Howlett, D.C.
Regina, Saskatchewan
The annual Alaska Chiropractic Society convention was held at the Clarion Hotel in Anchorage, Alaska, on September 28, 29, and October 1.
Relicensure credit hours were instructed by Dr. Gary Guebert, radiology; and Dr. Fred Carrick, neurology. The CA/CW program was presented by Dr. Edward Rothman. Our keynote speaker at the banquet was Dr. Bill Dallas, president, Western States Chiropractic College.
Also in attendance were Dr. Donald Kern, president, Palmer College of Chiropractic; and Ms. Vickie Palmer. Dr. Kern and Ms. Palmer spoke at the Palmer Alumni Breakfast.
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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A central challenge in creating our identity is that chiropractic is a method of care, not a technique or procedure. This is an important concept for us to promote. Our patients are treated with lifestyle modification, exercise, nutritional supplements, diet and a whole-body approach to accelerate the natural healing process. We are not simply CMT providers.
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