WORKPLACE Arthritis sufferers lack physical activity: study Research has shown that people with arthritis who engage in regular physical activity or exercise report fewer limitations in their dayto- day lives. However, many of those who suffer from arthritis feel that the struggle of their daily lives is exhausting enough on its own and therefore do not participate in additional physical activity. Dr. Monique Gignac, a senior scientist and associate scientific director at the Institute for Work & Health (IWH), led a study with eight focus groups involving 24 women and 16 men ranging in age from 29 to 72 years, in order to look at the relationship between arthritis, work and personal life roles. All study participants have been recently employed and had either osteoarthritis or inflammatory arthritis. “They pointed to the fatigue that resulted from juggling the demands of arthritis, employment and personal life as an important barrier to physical activity,” says Gignac, who is also affiliated with the Arthritis Community Research and Evaluation Unit at the Toronto Western Research Institute. “For many, arthritis threatened their ability to hang on to their jobs, so jobs were given priority over exercise when it came time to deciding where to put their energy.” Gignac found that although study participants were aware of the benefits of physical activity and exercise in relation to their arthritis, they didn’t know when or how to go about implementing physical activity or exercise in their lives. This issue was exacerbated by the episodic and unpredictable nature of arthritis pain. “They just didn’t know if physical activity would make things better or worse, or what activities they should do or for how long,” she said. Couple this fear with the anxiety people have about being forced to take time away from work due to their pain – an option the majority of study participants found unacceptable as they cited work as their first priority. “We need to find ways to help working adults with arthritis tailor their physical activity in light of changing pain, energy and fears of exacerbating their symptoms,” said Gignac. For more news on workplace health visit canadianchiropractor.ca BUSINESS FORUM Practice management takes centre stage at second annual Canadian Chiropractor Business and Professional Growth Forum Chiropractic professionals gathered at McMaster Innovation Park in Hamilton, Ont., for a full day of practice management and business education at the second annual Canadian Chiropractor Business and Professional Growth Forum held Saturday, June 14. The forum featured guest speakers covering everything from community involvement, positive risk management and building practice excellence, as well as a panel discussion on using social media for practice building. New this year were the 15-minute Business Briefs, featuring best practices, innovative products and services designed to offer chiropractors the tools they need to grow their practice. PRACTICE “DROWN PROOFING” First to the podium was Dr. David Leprich, who spoke to the audience on the importance of raising their chiropractic profile in their community. Leprich graduated from CMCC in 1977 and has been practicing in St. Catharines, Ont., ever since. He is a member of the board of directors of the Canadian Chiropractic Research Foundation and is a chiropractic consultant to the Niagara Health System and Mentholatum Canada. He spoke to the audience – a mix of new and experienced chiropractors – about how to “drown-proof” their practices, by making slow and steady steps forward. “You want to set your practice up in a way that is going to get the ball rolling,” he said. “But longevity is key.” Currently the theatre chiropractor for the Shaw Festival in Niagara-onthe- Lake, Leprich stressed the benefits of looking for opportunities to get involved with the community through sports teams, theatre groups or service clubs. He also suggested that chiropractors perform safety talks for local businesses, or hold their own health and wellness seminars, as a way to get their names out in the community and get people interested in chiropractic care. “They’re fun to do, it gets us out of the clinic and into the community, and it generates referrals for the practice,” he said. Once these building blocks have been established for a practice within the community, Leprich’s next piece of advice was to nurture long-term relationships, both with patients and staff. He states that once these longterm relationships are in place, a chiropractor can stop worrying about bringing new people in and focus on enjoying the work they do at their practice. “It’s easy to forget why you’re there, but when you do that, it makes it more difficult to do what you need to do,” Leprich said. “The bottom line is that you have to really care about the people that you’re working with.” TELLING IT LIKE IT IS Attendees were also treated to some hard-hitting risk management advice from Toronto-based lawyer, Allan Freedman. Having been an instructor at CMCC since 1976 where he was also a course coordinator until 2008, Freedman knows the ins and outs of the legalities of the chiropractic profession and presented the audience with a no-nonsense approach to managing risk within their practices. “You have to hope for the best, plan for the worst and expect the unexpected,” Freedman warned the audience. “You can’t deal with willful blindness.” He outlined the many types of risk facing the chiropractic profession, from external to operational, and urged attendees to do everything in their power to protect their practices in the event they come up against risk. From filling out forms properly, to backing up office computers, from keeping staff up to date to instituting office policy and ensuring the validity of insurance, Freedman urged every chiropractor to get educated and get involved in the risk assessment and management of their practice. “There’s a value to your practice if you look at the issues, if you look at the risks,” he said. “All this takes is a checklist, it’s not an aggravation – it’s an aggravation if you don’t pay attention to it.” Freedman encouraged all chiropractors to keep up to date with ever-changing legislations and to look at the business aspect of their practice. “The best of intentions means nothing,” he warned, citing instances of chiropractors facing legal troubles. “Every decision you make should be an informed decision.” He advised everyone in the room to go back to their practices and assess them for the worst-case scenario and asked them, if Murphy’s Law were to take place, “will you be ready or would your life be over?” EXCELLENCE MATTERS Next to share his experience and expertise was Dr. Anthony Lombardi, the founder of the multidisciplinary Hamilton Back Clinic and a private consultant to athletes in the NFL, CFL and NHL. Lombardi started his Hamilton practice right out of school and 12 years later, he averages 12 new patients a week, he said. He attributes this success to the fact that he works with two goals in mind: to provide incredible clinical results and an outstanding patient experience. He states that in order to be successful in anything in life, you have to possess the following three elements: passion, motivation and commitment. “Not everyone is going to be successful, because not everyone wants to be successful – because it’s hard work,” Lombardi said. He urged the audience to develop or adapt a system that can work for them in their practice and allow them to provide clients with quality results. “Focus on the things you can control,” he said. “I have a patient every 15 minutes, and the only thing I can control in that time is what I can deliver to that patient. The growth of my practice, the success of my practice, depends on what happened within those 15 minutes.” According to Lombardi, if a chiropractor can give a patient what they want and give them results they’re not used to getting – all within their first two visits – that patient will not only return for treatment, but will also refer their family and friends. Lombardi said once a chiropractor has established a quality product, they need to begin thinking like a business in terms of spending, collecting and saving money. Like Freedman, he urges chiropractors to do their homework before making any decisions, whether it be buying real estate or choosing to incorporate a practice. “Option is power, give yourself every option possible because you’re going to need it,” he said. Lombardi said with systems in place that give patients a phenomenal experience with outstanding results and by thinking of a chiropractic practice as a business entity, chiropractors can boost referrals and overall practice excellence. “If you’re committed to the overall process, you will be successful,” he said. “You’ll never change your outcome if you don’t change your approach.” SOCIAL MEDIA FOR CHIROPRACTORS When it comes to social media use, chiropractors should err on the side of caution or risk legal and regulatory repercussions. To ronto lawyer Al l a n Freedman issued this caution at the panel discussion on social media. “Be careful, be careful, be careful,” Freedman said, pointing out that as regulated health professionals, it is almost impossible to separate the chiropractor from the person, especially when it comes to social media conduct. Social media has become one of the biggest phenomena of this decade and a great tool for professionals and businesses to engage their audience. However, as regulated health-care professionals, chiropractors have a responsibility to conduct themselves in a professional manner, at all times, Freedman said. Joining Freedman in the panel discussion on social media were chiropractors Dr. Ashley Worobec and Lombardi. Rob Lindsay, vice-president of Search Engine People Inc., a digital marketing firm, was also in the panel. Worobec uses her own blog, Twitter and Facebook pages to reach out to her audience and promote her chiropractic practice. Lombardi makes use of Twitter and YouTube to connect with his audience, promote his courses and offer some practical tips for fellow chiropractors. Both Worobec and Lombardi admit their social media efforts seldom directly lead to new patients and referrals, but it has been a good way to raise their profile as chiropractors and experts in their fields. Lindsay notes when engaging in social media, chiropractors need to provide quality, useful content for their audience on topics that they are an authority at. Original content is always a great way to earn the trust of your audience, and to increase one’s search rating in the eyes of Google. If using content from another source, remember to quote the content and attribute the excerpt to the source of the content, he said. – Jessica Beaulieu and Mari-Len De Guzman APPOINTMENT Brian McAulay appointed to F4CP board The Foundation for Chiropractic Progress (F4CP) recently announced a new member to its board of directors. Dr. Brian J. McAulay, president of Parker University, brings over 30 years of experience in higher education and health-care practice to F4CP, a not-forprofit organization that aims to raise awareness about the value of chiropractic care. “We are honored to welcome Dr. McAulay to our board of directors,” Kent S. Greenawalt, chairman of F4CP, said. “He brings a wealth of knowledge about the chiropractic profession that will complement the activities of our organization. He is a valuable addition to our board of dedicated industry leaders, and his involvement will help to expand our campaign and achieve even greater levels of success.” McAulay brings a list of credentials along with him to the F4CP, as he serves on multiple community and professional boards and is also the president of the Association of Chiropractic Colleges. “I am honored by this appointment to the board of directors for the F4CP, which continues to fulfill its successful mission of advancing the public’s understanding of chiropractic and generating positive exposure,” McAulay said, eager to assume his new position. McAulay is the first individual in chiropractic education to be awarded the American Council on Education (ACE) Fellowship. He completed his postgraduate work at the Institute for Educational Management at Harvard University’s Graduate School of Education. He earned his PhD in management from Temple University, a DC from Pennsylvania College, and a Bachelor of Commerce degree from the University of Toronto. NUTRITION Vitamin D helps manage chronic conditions: studies According to a Digital Journal press release, recent studies suggest that vitamin D could be a safe, effective and inexpensive treatment for chronic conditions such as fibromyalgia, multiple sclerosis and Parkinson’s disease. Fibromyalgia is characterized by chronic pain and fatigue as well as heightened sensitivity to pressure. The affliction also causes stiffness, sleeping disorders, an inability to concentrate and anxiety or depression. There is currently no cure for fibromyalgia and prescription medications can be costly and come with undesirable side-effects. Recently, researchers have found that women who suffer from fibromyalgia characteristically have lower levels of vitamin D in their blood stream. Dr. Florian Wepner at Orthopaedic Hospital Speising in Vienna, Austria, led a research team that conducted randomized controlled trial of 30 women who suffered from fibromyalgia and had low vitamin D levels. Half of these women were placed in a treatment group, in which their vitamin D intake was raised to normal levels for a period of 20 weeks. The other half of the women received no change in vitamin D levels. The results, which were monitored throughout the trial process and then again 24 weeks after the trial had concluded, indicated women who received higher levels of vitamin D in their blood stream showed substantial improvements in physical functions, less morning fatigue and a significant reduction in pain levels. Wepner’s study was published in the February 2014 issue of Pain journal. Vitamin D has also been found to benefit those suffering from multiple sclerosis, a central nervous system disease that negatively affects muscle control and strength, balance, vision and cognition. Dr. Alberto Ascherio of Harvard School of Public Health in Boston led an international research team to study the effects of increased vitamin D on the progression of multiple sclerosis within early-stage patients. The study, which has been published in the March 2014 issue of JAMA Neurology, found that of the 465 patients followed, those with adequate levels of vitamin D in their bloodstreams reported 57 per cent fewer new brain lesions, 57 per cent fewer relapses and 25 per cent lower increases in legion masses than their vitamin D-deficient counterparts. Symptoms of Parkinson’s disease, a degenerative central nervous system disorder, were also eased by an increase of vitamin D. Dr. Amie Peterson’s research team at the Veteran’s Administration Medical Center in Portland, Oregon, conducted a study on 286 Parkinson’s patients, 61 of whom also suffered from dementia. Results found that those with higher levels of vitamin D in their blood streams, including those with dementia, tested higher on areas of verbal fluency and verbal memory as well as reported lower levels of depression. The study was published in the September 2013 issue of the Journal of Parkinson’s Disease. The work done by these researchers proves there are safer and more natural alternatives to prescription medications, and that in the case of fibromyalgia, multiple sclerosis and Parkinson’s disease natural treatment methods should be given more consideration. EDUCATION Parker University announces new College of Business and Technology Parker University recently announced the establishment of a new College of Business and Technology. The college, which includes undergraduate and graduate health-care business administration and technology degree programs, is currently enrolling students each month for its online classes. “We’re excited about the addition of the College of Business and Technology as well as the education and opportunities the new college will provide to our students,” said Dr. Brian McAulay, president of Parker University. “In addition, the College of Business and Technology will continue to expose more students to Parker University’s roots, including health, wellness and chiropractic care, which Parker was founded on.” The college will serve as an intersection between business and technology studies, with courses geared toward health care, economic, technical and professional application and development. Currently, the College of Business and Technology encompasses the online Master of Business Administration with a concentration in Health Care Management, the online Bachelor of Science in Health Information Management, the online Bachelor of Science in Computer Information Systems with concentrations in Cybersecurity and Information Technology and the Associate of Applied Science in Health Information Technology. “Both of these degree programs are extremely important and in demand in many industries, including health care,” said McAulay. “With the implementation of electronic health records, the Bachelor’s in Computer Information Systems degree is in high demand in order to secure electronic health records.The MBA with a concentration in Health Care Management is ideal for practitioners and middle managers within health care who lead or aspire to lead health-care businesses.” The MBA degree focuses on the issues facing health-care businesses today, including coursework in classes such as health policy, marketing strategy, business analysis, health-care finance, and strategic implementation and development. Dr. Charlene Conner has been named the founding dean of the new college. Conner previously served as dean of the College of Business and Graduate Business Programs at Dallas Baptist University. Prior to that role, she served as associate dean and led the successful reaffirmation and accreditation efforts for the college’s national accreditation. “Doctors of chiropractic who earn master’s degrees have a competitive advantage in the workforce,” said Conner. “Not only are they more equipped to lead or own their own business, they are well positioned to serve in additional roles, including policy makers, spokespeople and teachers.” In addition to the previously named programs, the College of Business and Technology will offer a Bachelor of Science in Business Administration beginning in the fall of 2014. “The creation of the College of Business and Technology not only further positions Parker as an academic leader in Dallas, but also enhances the interdisciplinary learning that’s so essential for today’s job market,” Conner said. WELLNESS Province urges Albertans to talk about wellness Alberta residents are invited to share ideas and inspire new ways to improve wellness in communities across the province. The province’s new program, Let’s Talk about Wellness, engages residents and aims to broaden Albertans’ collective understanding of health and wellness and shift conversations from the delivery of healthcare to the factors that contribute to wellness. Let’s Talk about Wellness conversations begin this fall, to be led by Dave Rodney, the associate minister of wellness, and Dr. James Talbot, chief medical officer of health. Albertans can visit talkwellness.ca to express their interest in taking part. Participants will have an opportunity to join together and share their wellness priorities this fall through local community events and online conversations. “Alberta has become a leader in disease prevention and wellness, but there is so much more that we can do – that’s why we’re asking Albertans to participate in this important conversation. I encourage all Albertans to think about the possibilities we have to strengthen our collaboration and broaden the amazing opportunities for Albertans to enjoy a greater degree of wellness,” said Rodney. The Let’s Talk about Wellness engagement supports Alberta’s Strategic Approach to Wellness, which aims to improve health outcomes for Albertans by addressing the social, economic and environmental factors that contribute to health and wellness. “Wellness is more than not being sick or hurt – it is something we build together with our families, schools, communities and workplaces, in our parks and playgrounds, the places we live, the air we breathe and the choices we make. Promoting wellness in our communities requires all of us to work together as individuals, families, communities, businesses and governments. The true wealth of our province is our people – promoting the wellness of Albertans is essential to our future,” said Talbot. The Government of Alberta has undertaken a number of initiatives over the past few years to help improve quality of life for Albertans, including: Tobacco Reduction Strategy; Get Outdoors Weekend; International Symposium on Wellness; U-Walk; Healthy U initiatives; 5&1 Experiment; Social Policy Framework; Poverty Reduction Strategy; and Early Childhood Development. HEALTH Health care wait times may be linked to rise in female death rates: Fraser Institute Canada’s growing wait times for health care may have contributed to the deaths of 44,273 Canadian women between 1993 and 2009, a new study released by the Fraser Institute has concluded. The study, The Effect of Wait Times on Mortality in Canada, examines the relationship between mortality rates and lengthy wait times for medically necessary care in Canada. As wait times between referral (from a general practitioner) and treatment increase, so does the rate of female mortality, the study found. “Deaths resulting from delayed medical care are unacceptable. Canadian taxpayers fund one of the developed world’s most expensive universal access health-care systems, yet delays for emergency care, primary care, specialist consultation and elective surgery are among the longest in the world,” said Nadeem Esmail, study author and Fraser Institute senior fellow. The estimated 44,273 deaths between 1993 and 2009 represent 2.5 per cent of all female deaths in Canada during that 16-year period, or 1. 2 per cent of Canada’s total mortality (male and female). More specifically, during that same 16-year period, for every one-week increase in the post-referral wait time for medically necessary elective procedures, three female Canadians died (per 100,000 women). In a separate analysis, the study finds that changes in wait times for cardiovascular treatments were associated with approximately 662 potentially avoidable female deaths between 1994 and 2009. These deaths represent 0.16 per cent of avoidable female deaths during the period No significant relationship between wait times and male mortality rates was found. So what drives this gender disparity? Possible factors include an increased participation among women in the workforce and differences in access to medical services. “While the reasons for the potential gender difference remain unclear, the solution to the problem is obvious. Lengthy wait times for medically necessary treatment, and the deaths associated with them, are Canada’s shame, but we can solve both problems through sensible policy reform,” Esmail said. So what can be done? “Countries with relatively short health-care wait times rely to varying degrees on market incentives and private competition, such as cost-sharing and competing private hospitals, within the universal health-care system. Policymakers who cling to flawed policies, and argue against reform with rhetoric rather than fact, should consider whether Canadians who die while waiting for health care are being sacrificed to ideology,” Esmail said. The Fraser Institute is an independent Canadian public policy research and educational organization with offices in Vancouver, Calgary, Toronto and Montreal, and ties to a global network of think-tanks in 87 countries. Its mission is to measure, study and communicate the impact of competitive markets and government intervention on the welfare of individuals. To protect the Institute’s independence, it does not accept grants from governments or contracts for research. – Marketwired NUTRITION Study finds weight gain is a worldwide issue Almost a third of the world is now fat, and no country has been able to curb obesity rates in the last three decades, according to a new global analysis. Researchers found more than two billion people worldwide are now overweight or obese. The highest rates were in the Middle East and North Africa, where nearly 60 per cent of men and 65 per cent of women are heavy. The U.S. has about 13 per cent of the world’s fat population, a greater percentage than any other country. China and India combined have about 15 per cent. “It’s pretty grim,” said Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington, who led the study. He and colleagues reviewed more than 1,700 studies covering 188 countries from 1980 to 2013. “When we realized that not a single country has had a significant decline in obesity, that tells you how hard a challenge this is.” Murray said there was a strong link between income and obesity. In developing countries, as people get richer, their waistlines also tend to start bulging. In many rich countries like the U. S. and Britain, the trend is reversed, though only slightly. Murray said scientists have noticed accompanying spikes in diabetes as obesity has risen and that rates of cancers linked to weight, like pancreatic cancer, are also rising. The new report was funded by the Bill & Melinda Gates Foundation and published online in the journal, Lancet. In May, the World Health Organization (WHO) established a high-level commission tasked with ending childhood obesity. “Our children are getting fatter,” Dr. Margaret Chan, WHO’s director-general, said in a speech at the agency’s annual meeting in Geneva “Parts of the world are quite literally eating themselves to death.” Earlier this year, WHO said that no more than five per cent of your daily calories should come from sugar. “Modernization has not been good for health,” said Syed Shah, an obesity expert at United Arab Emirates University, who found obesity rates have jumped five times in the last 20 years even in a handful of remote Himalayan villages in Pakistan. Shah’s research was presented during a conference in Bulgaria last May. “Years ago, people had to walk for hours if they wanted to make a phone call,” he said. “Now everyone has a cellphone.” Shah also said the villagers no longer have to rely on their own farms for food. “There are roads for (companies) to bring in their processed foods and the people don’t have to slaughter their own animals for meat and oil,” he said. “No one knew about Coke and Pepsi 20 years ago. Now it’s everywhere.” In Britain, the independent health watchdog issued new advice recommending that heavy people be sent to free weight-loss classes to drop about three per cent of their weight. It reasoned that losing just a few pounds improves health and is more realistic. About two in three adults in the U.K. are overweight, making it the fattest country in Western Europe. “This is not something where you can just wake up one morning and say, ‘I am going to lose 10 pounds,’” said Mike Kelly, the agency’s public health director, in a statement. “It takes resolve and it takes encouragement.” – Maria Cheng, The Associated Press PUBLIC POLICY Ottawa creates panel on health care innovation The federal government has launched an advisory panel on health-care innovation aimed at improving the quality and cost-effectiveness of Canada’s health system. Health Minister Rona Ambrose announced the official launch of the panel in Toronto last June, as members held their first meeting to discuss how various innovations could bring the greatest value to Canada’s health-care system. Former University of Toronto president Dr. David Naylor was appointed chair of the new body, which is made up of prominent Canadians from a variety of backgrounds. Ambrose said innovation within the health system is essential to ensure the future sustainability and quality of care for Canadians. Over the next year, the panel will look at creative approaches being applied to health care in both Canadian jurisdictions and abroad, and recommend how Ottawa can adopt and support them. The panel’s mandate includes meeting with provincial and territorial representatives and seeking the input of Canadians and organizations with an interest in health-care innovation. “We know more money is not the solution,” Ambrose said in a statement. “It is time to get innovative and ensure our health-care system continues to improve.” Naylor said that “given the pace of technological and social change, every health-care system must innovate relentlessly to maintain quality, accessibility and affordability.” Other panel members include Dr. Cyril Frank, CEO of Alberta Innovates – Health Solutions; Medtronic president Neil Fraser; Francine Girard, dean of nursing at the Universite de Montreal; Jack Mintz and Toby Jenkins, both of the School of Public Policy at the University of Calgary; Chris Power, CEO of Capital Health in Halifax; and Heather Reisman, chair and CEO of Indigo bookstores. – The Canadian Press HEALTH B. C. invests $375K to promote healthy communities Forty-nine local governments in British Columbia have received B.C. Healthy Community Capacity Building Fund grants ranging from $2,000 to $20,000 to assist with healthy community planning, projects and policy development. “Though B.C. is one of the healthiest provinces in Canada, we must continue to work together at all levels of government to foster health-minded citizens and communities,” said Health Minister Terry Lake. “It is important for healthy living to start where we live, work, learn and play. These grants help support local governments to work collaboratively within their communities to make lasting change in the health of British Columbians.” This round of grants marks the second year for the Healthy Communities Capacity Building Fund, which was first announced in March 2013. Co-ordinated by the BC Healthy Communities Society’s PlanH progam, 38 local governments received grants of up to $5,000 and 11 local governments received grants of up to $20,000 for a total of $375,000 this year. To date, government has invested $650,000 in the Healthy Community Capacity Building Fund. “We know that by leading healthier lives we can dramatically reduce the occurrence of chronic disease,” said Michelle Stilwell, parliamentary secretary for Healthy Living. “Whether it is quitting smoking, starting a new activity that gets you moving or having healthier eating habits, I believe that the healthier choice needs to be the easier choice and we are committed to helping communities throughout B.C. to take those important steps to support their residents.” This round of grants will help to fund a variety of projects, including: • a learning event led by the Snaw-naw-as First Nation community on food sustainability; • adding capacity to the Comox active travel to school program, which helps children to travel on bike or by foot safely to and from school; • welcoming new B.C. residents through the Smithers newcomers recreation and healthy eating accessibility project; • identifying gaps in youth services and expanding the services offered by the Mission collaborative youth health practices initiative, which provides meaningful, social and healthy activities for low-income and marginalized youth; and, • creating a long-term wellness strategy for the community of Wells. “We are proud of our partnership with government to promote healthier communities and increase local government capacity,” said Jodi Mucha, executive director, BC Healthy Communities Society.