RESEARCH Feds fund McMaster study on collaborative health care The federal government is allocating $6.5 million to fund a project led by Mc- Master University to study the use of team-based care as a way to achieve better health outcomes for patients and make the system more cost effective. The announcement was made by Parliamentary Secretary Eve Adams on behalf of Health Minister Rona Ambrose, during a recent visit to the Hamilton, Ont.-based university. The project, Teams Advancing Patient Experience: Strengthening Quality (TAPESTRY), will examine how changing the way a primary health-care team operates and interacts with its patients can improve the quality and efficiency of primary health-care services. By integrating resources such as community volunteers, eHealth technologies and system navigation, the project will support patient- centred care and stronger connections to community services. “Innovation is critical to improving the efficiency of the health-care system but also to helping Canadians maintain good health. This project is looking at innovative ways that health professionals can work together to provide care to Canadians,” said Adams. The TAPESTRY project is expected to provide valuable information regarding ways to increase access to primary health-care services. The initiative aims to generate evidence and develop tools to assist provincial and territorial governments in addressing ongoing primary healthcare challenges. “We’re finding ways to combine the personal touch of community volunteerism and the latest technologies to improve primary health care. The TAPESTRY project will connect citizens with their health-care team to encourage early identification of potential health problems. This is important for Canadians and for the efficiency of our health-care system,” said Dr. David Price professor and chair, Department of Family Medicine, McMaster University. The Canadian government invests more than $1 billion annually on healthcare research. It has also increased health transfers to the provinces and territories to unprecedented levels, according to the federal health ministry, adding that this funding will continue to grow to $40 billion by the end of the decade. “The TAPESTRY project is an ideal platform for advancing patient health through collaboration. Combined with access to evidence- based information, such as through the McMaster Optimal Aging Portal, Canadian citizens, clinicians, public health professionals and policymakers will be able to make informed decisions and support older adults to remain healthy and engaged as long as possible,” said Dr. Susan Denburg director of the Labarge Optimal Aging Initiative and associate vice-president, faculty of health sciences at McMaster. For more stories on research and collaborative care, visit www.canadianchiropractor.ca PRACTICE MANAGEMENT Chiro vets offer newbies proven tips for practice success Aspiring chiropractors got a dose of reality from experienced practitioners at the recent Practice Opportunities event hosted by the Canadian Memorial Chiropractic College (CMCC). At a panel session, sponsored by the Ontario Chiropractic Association, a group of veteran chiropractors offered some first-hand insight to chiropractic students about the realities of practice and the keys to achieving success. “If you don’t know where to start, get experience from as many practitioners as you can. Seek out mentors,” said one of the panelists Dr. Arif Alarakhia, founder of Physical Therapy One, a group of 12 clinics in Ontario providing multidisciplinary health care. Alarakhia, who graduated from National University of Health Sciences in 1999, knew early on he wanted ultimately to own his own practice and work alongside other health-care practitioners. Although he started out as an associate at a chiropractic clinic, he learned what he can while he was there and, when it was financially feasible for him, he left the clinic to start his own practice. Alarakhia added that new chiropractors today may have an easier time getting into multidisciplinary practice as it has become more of the norm in recent years, whereas it was a new concept when he started out more than a decade ago. Another panelist, Dr. Anthony Lombardi, who owns the Hamilton Back Clinic, based in Hamilton, Ont., echoed Alarakhia on the importance of having good mentors. “Find someone or some people who fit your belief systems. No one does it alone,” Lombardi said. He also offered his own advice: “If you provide outstanding clinical results within the first three patient visits, people will refer you.” Lombardi explained this strategy has worked for his own practice and helped him build up his patient base. “Ask yourself, ‘Am I giving the patients what they want or am I giving them what I want them to have?’” Making the process easy and convenient for the patient is also key, from booking appointments to actual treatments, Lombardi added. The panelists agree the best way to achieve success in practice is to take a patient-centred approach. “Focus on the patient and what it is they are looking for,” said Dr. Katherine Tibor, who was also part of the panel. Tibor graduated from CMCC in 2006 and is now the owner and clinic director of a multidisciplinary wellness practice in the Don Mills community in Toronto. She said figuring out what the patient’s goals are and being aware of their limitations are important in providing patient-centred care. “Referring out is also part of that patient-centred care,” she added. Tibor also pointed out the importance of being part of a community and constantly finding opportunities for learning. “There is a lot out there to learn,” she said, adding that being part of a peer group offers some good opportunities to get some professional advice. “There are some things that you just cannot get out of a textbook. You need that advice.” Another advice from another chiropractor: “If you want to be an effective practitioner and leader, listen and accept with humility feedback that other people have for you.” These words of wisdom came from Dr. Josh Binstock, a 2009 CMCC graduate. Aside from being a chiropractor, Binstock is also an Olympic athlete. He played for the Canadian beach volleyball team in the London 2012 Olympics. His challenge has been finding a balance between his chiropractic and athletic careers. But that has not stopped him from pursuing to build his practice. He urges would-be chiropractors to be resilient. “You’re going to have negative things happen; you can’t be emotionally attached. Look at things with objective perspective.” Chiropractors also need to look at opportunities for growth outside their clinical practice, said Alarakhia, such as giving back to their community. “Be conscious about social responsibility as well,” he said. “Give back. The rewards and impact you will have is unbelievable.” - Mari-Len De Guzman TRIBUTE In memory of Dr. Sherman The chiropractic profession pays tribute to a beloved colleague, accomplished scholar, mentor and educator with the passing of Dr. Ray A. Sherman. Sherman died on Feb. 7, 2014, in Buffalo, NY after battling vascular dementia. He was 75. Sherman was born in 1938 and graduated from Canadian Memorial Chiropractic College (CMCC) in Toronto in 1960. In 1961 he married Woody Martin and the couple settled in Buffalo where Ray began practice with his uncle and fellow chiropractor, Dr. Joe Ott. During this time, Sherman served in the New York National Guard for three years. In 1965, Sherman and his wife moved to Sydney, Australia where their two daughters were born: Melissa in 1966 and Mardi in 1969. In 1976, after ten years of practice in Australia, Sherman was appointed director of clinics at CMCC, gaining the admiration and respect of his colleagues and students. In 1979, the family returned to Australia where they resided and Sherman practiced until 2008. From 1988 to 1999, he fulfilled several of his passions – for traveling as well as teaching and practicing chiropractic – by spending six months each year in his chiropractic office in Australia, and six months as a supervising clinician at CMCC in Canada. “Ray was a remarkable man who led by encouragement, enthusiasm, and example. Likewise he demonstrated the value of a happy-go-lucky demeanor and personality – his knack for putting patients, students and colleagues at ease was nothing short of prodigious – and always insisted that high standards were essential in education, health care delivery and professionalism,” said Dr. James P. Laws, who graduated from CMCC and has taught in the college. Dr. Don Henderson, who worked closely with Sherman at CMCC recalls Ray having “a very kind and caring way of dealing with folks and that his relentless good humor was instantly contagious. People were made better just by knowing him. He was one of a kind, a keeper.” Sherman is a former editor of the Journal of the Australian Chiropractors’ Association. He has published extensively in that journal and in the Journal of the American Chiropractic Association and the Journal of the Canadian Chiropractic Association. In 2000, Sherman was awarded an Honorary Fellow of the American Chiropractic College of Radiology for his “contribution to chiropractic radiographic excellence, quality assurance, and radiation reduction measures.” - By Dr. John A.M. Taylor CLINICAL Researchers probe polio-like illness afflicting kids A polio-like illness has afflicted a small number of children in California since 2012, causing severe weakness or rapid paralysis in one or more limbs. The Los Angeles Times reports that state public health officials have been investigating the illness since a doctor requested polio testing for a child with severe paralysis in 2012. Since then, similar cases have sporadically been reported throughout the state. Dr. Carol Glaser, leader of a California Department of Public Health team investigating the illnesses, called the doctor’s request “concerning” because polio has been eradicated in the U.S. and the child had not travelled overseas. The symptoms sometimes occur after a mild respiratory illness. Glaser said a virus that is usually associated with respiratory illness but which has also been linked to polio-like illnesses was detected in two of the patients. Dr. Keith Van Haren, a pediatric neurologist at Stanford University’s Lucile Packard Children’s Hospital who has worked with Glaser’s team, will present the cases of five of the children at the American Academy of Neurology’s upcoming annual meeting. He said all five patients had paralysis in one or more arms or legs that reached its full severity within two days. None had recovered limb function after six months. “We know definitively that it isn’t polio,” he added, noting all had been vaccinated against that disease. Glaser wouldn’t provide the number of illnesses. Van Haren said he was aware of around 20. She urged doctors to report new cases of acute paralysis so that investigators can try to figure out a possible cause. – The Associated Press HEALTH CARE Alberta town wants more docs The mayor of a town northwest of Edmonton has asked the Alberta government for more support in providing needed health practitioners in his community of 11,000. Health Minister Fred Horne, however, says Slave Lake, Alta., has “more than enough” resources to provide health care to residents. Horne said there are currently four physicians working in the community, and there are two more doctors from outside the town who visit Slave Lake to see patients. Alberta Health Services said there are also seven nurse practitioners working in the community. But Slave Lake Mayor Tyler Warman said it’s simply not enough. “We’re a young community. The median age is 31. Lots of families, lots of young children. And these babies aren’t born in our community, very few of them are,” Warman said. Horne maintained there is no critical shortage in the town, but said the province is currently working to recruit two more doctors, a general practice anesthetist, and a general practice obstetrician to help perform C-sections. - The Canadian Press APPOINTMENT Parker Professional has new executive director Dallas-based Parker University has appointed Dr. Mark Mandell as its executive director of Parker Professional. Mandell, a third generation chiropractor and experienced business developer, will oversee Parker Professional, which encompasses Parker Seminars, Parker SHARE Products and Parker Knowledge, including continuing education courses and other professional education opportunities. “We’re excited to welcome Mark to Parker” said Dr. Brian McAulay, president of Parker University. “As a chiropractor and someone who also has significant experience in business development, professional education, seminars and sales, he’s going to play an important role as we continue to support chiropractors and other health and wellness professionals.” Prior to joining Parker, Mandell served as the president and CEO of The Vital Health Depot where he managed all areas of operation, directed manufacturing of health-care equipment and developed clinical manuals, apps and digital training videos for rehabilitation and clinical products. He also previously served as president of Spark, providing sales and marketing consulting for companies seeking significant business growth. Mandell also served as president and founder of Brainstorm Group where he provided marketing services and FDA consulting for healthcare companies. He was in practice for more than seven years at Mandell Chiropractic, his family’s third generation chiropractic clinic. Mandell holds a doctorate of chiropractic from National College of Chiropractic, where he also earned a certificate in acupuncture. He earned an MBA in management from New York University’s Leonard Stern School of Business and a Bachelor of Science from Cornell University, and has written numerous publications and books, including Spark Your Sales and Becoming Your Own Cheerleader. PAIN MANAGEMENT U.S. National Pain Foundation eyes global database for pain management The U.S. National Pain Foundation (NPF), based in Golden, Colorado, plans to create global digital communities for people suffering from pain in an effort to increase understanding of pain, its treatment and management. The NPF also announced it is being reformed as an independent, not-for-profit organization to transform the way pain is fundamentally understood, assessed and treated for every human being. “We are resurrecting The National Pain Foundation because of the continued and unmet need for significantly more patient input into how pain is diagnosed and treated,” said Dr. Daniel Bennett, MD, of Denver, Colorado, who founded NPF in 1998. The foundation will give voice to 1.5 billion people in pain by creating digital communities where they can share their experiences and needs through surveys, forums and data collection means – what the foundation calls the “digital footprint of pain.” “We will effectively create the world’s most comprehensive observational database of people in pain, their behaviours, their treatments and their needs. This will allow pain patients to actually participate in advancing how pain is understood and treated, versus being the misunderstood sufferers they have been for so long,” Dr. Bennett added. According to statistics, pain affects 1.5 billion people globally and is the number one reason people see a doctor - PR Newswire STATISTICS Injury study shows discrepancies A new study shows unintentional injury rates are higher in remote and low-income neighbourhoods with a high percentage of First Nations residents. The study, from Statistics Canada, shows the differences were particularly acute for women aged 20 to 44. Those living in low-income neighbourhoods with high First Nations population were three and a half times more likely to be hospitalized with an unintentional injury than women in low-income neighbourhoods with fewer First Nations residents. Statistics Canada analyst Evelyne Bougie says this group seems to be particularly vulnerable to unintentional injuries, but the study wasn't designed to shed light on why. Unintentional injuries hospitalizations are things like falls, motor vehicle accidents and other types of injury-inducing events that are typically deemed to be preventable. The rates of people hospitalized for unintentional injuries were between two to three times higher in low-income areas with high First Nations populations when compared to low-income neighbourhoods with fewer First Nations people. Unintentional injury rates were about two times higher in remote areas with high First Nations populations when compared to remote areas with lower numbers of First Nations residents. It is known in general, people who live in remote and low-income areas are hospitalized more frequently for unintentional injuries than people in more central and affluent neighbourhoods. But some other factor or factors must be contributing to the higher injury rates in remote and low-income neighbourhoods with high First Nations populations, says Bougie, who is the study's first author. – Helen Branswell, The Canadian Press INTEGRATION Integrated health care needed for optimal athlete performance: F4CP The Foundation for Chiropractic Progress (F4CP), a Carmichael, Calif.-based not-for-profit organization dedicated to raising awareness about the value of chiropractic care, has raised the importance and effectiveness of an integrated approach to health care to enhance athletes’ performance. Congratulating the Seattle Seahawks on their victory at this year’s Super Bowl, the F4CP said the good health and impressive athletic performance displayed by the athletes can, in part, be attributed to the dedicated and diverse team of on-staff healthcare professionals, including team chiropractor, Dr. Jim Kurtz. “This season, our team entered the Super Bowl with every available player on our roster healthy and ready to play,” said Kurtz, a major supporter of the F4CP. “The end result was remarkable, and demonstrated the commitment and hard work put forth by all, including the athletes, healthcare staff and management. We can only hope that each year we strengthen our approach and achieve continued success.” Health-care personnel who serve professional athletes and teams generally encompass medical doctors, doctors of chiropractic, physical therapists, certified athletic trainers and support staff. Utilized by all 32 NFL teams, doctors of chiropractic are qualified to diagnose, treat and manage a broad spectrum of health conditions. For athletes, chiropractic care helps to reduce the risk of injuries, and improve health and performance through enhancements in range of motion, flexibility, muscle strength and other key factors. “The health-care professionals and practices utilized by the Seahawks are certainly worth noting,” said Kurtz. “This collective, modern approach contributed to a tremendous season, which marked the end of an era and beginning of unprecedented potential for the Seattle Seahawks. I am beyond thankful to have been included in this landmark victory, and encourage others to join us in our success and celebration.” The Foundation for Chiropractic Progress aims to inform and educate the general public about the many benefits associated with chiropractic care. TECHNOLOGY Online ‘university’ for laser therapy launches, features multimedia resources LaserTherapyU.org LLC (LTU), based in Atlanta, Ga., has launched the LaserTherapyU.org, a content-rich online resource featuring the latest research, webinars, abstracts, videos and protocols related to laser therapy for pain relief, performance optimization and hundreds of other conditions. “We have dedicated extensive time conducting research regarding low-level laser therapy, and have created a single repository where health-care providers, students and consumers can learn about the latest information and advances,” said Anita Saltmarche, executive director of LTU. “The site is searchable, updated continuously, and open to anyone interested in the health-care science of the future. We would also like to thank Multi Radiance Medical, a major sponsor and a global leader in the field of laser therapy, for helping to make the site a reality.” Subscriptions for LTU are available for a nominal fee that covers the ongoing development of new protocols, webinars and other high-quality information, LTU said. Medical professionals can purchase a three-month or 12-month subscription, which includes unlimited access. There is an “a la carte” option for consumers, educators and students who want to purchase individual treatment protocols and webinars. Upon registration, medical professionals must upload a medical licence for verification and authorization. All others can register without authorization. Content can be accessed and downloaded without limit during the subscription period, and all major credit cards – Visa, Mastercard, Discover and American Express – are accepted. “We’ve taken extra steps to ensure that information is geared toward the right level of laser knowledge and familiarity so the general public won’t have to wade through overly technical information,” Saltmarche added. “We’re excited about the technology, and the yet-to-be discovered advances that laser therapy will bring to the world of health care in the near term and over the months and years ahead.”