Chiropractic + Naturopathic Doctor • May 2020 • A joint effort

Interdisciplinary co-operation between chiropractors and naturopaths is creating better results for patients

As more patients and practitioners discover the benefits of an integrated multidisciplinary approach, partnerships between chiropractors and naturopaths are becoming particularly common. Interdisciplinary cooperation between these professions is quickly becoming an effective tool for solving patient issues.

Kristin Heins, ND, R.P., and Jennifer Wise, DC, are the co-founders of Thrive Natural Family Health in Toronto. An interdisciplinary health practice, Thrive’s team of 16 practitioners includes chiropractors, naturopaths, psychologists, registered massage therapists, osteopaths, and acupuncturists.

Heins and Wise say that they worked together at a different multidisciplinary clinic for two years before starting their own clinic together. Thrive, they say, grew out of the fact that they often referred patients to each other. Wise says that chiropractors and naturopaths are a good fit because the two disciplines focus on complementary scopes of treatment:

“There’s the mechanical side of what I do, and then there’s the cellular and physiological side of what Kristin does. It’s a good way to treat things concurrently, or to focus on the other scope of treatment when one doesn’t produce results.”

Heins says that the scientific underpinnings of chiropractic and naturopathic medicine are what enable close collaboration. Both disciplines focus on the nervous system, she says, and viewing the same problem from two different angles creates a clearer picture: “When we’re working collaboratively, it’s another lens, another brain, another set of eyes. That means there’s a wider image of the patient to be seen. We’ve each become specialists in areas that allow us to be complementary in our work.”

The duo note that while the logistics of collaboration can be challenging in a busy practice due to time constraints, effective communication involves figuring out what the other practitioner’s methods are and then creating systems that enable collaboration. At Thrive, patients are very much in favour of these systems.

Wise notes that in a city like Toronto, a collaborative practice also has other logistical benefits for patients:

“One of the things we hear over and over again is that it’s nice to come to one place for care, that you don’t have to drive all over the city. In a place like Toronto, that’s really valuable.”

Another tool they use to facilitate better patient care? Smart tech. Thrive Natural Family Health implemented online patient charting at the start of 2020, which enables faster collaboration. Thrive’s next major development will involve opening a satellite clinic to expand upon the services available at their Yonge-Eglinton clinic. This satellite clinic is still early-stages, but this expansion proves the viability of collaborative DC/ND relationships.

Erin Balodis, ND, and D’Arcy Stonehouse, DC, are the co-founders of Brickyard Health in Halifax, a 12-person interdisciplinary practice that provides chiropractic and naturopathic treatment as well as massage therapy, acupuncture, nutrition counselling, mental health services, and prenatal care.

The pair met when Balodis attended a mobility class at a local CrossFit gym and later became colleagues when they were both hired to work at the same clinic.

“At our old clinic, we quickly saw that we had the same values and the same approach to evidence-based patient care,” Stonehouse says. “And we wanted to create a space that supports that. Brickyard is two years old, but we’ve been working together for seven years.”

Balodis says that their shared desire to be business owners is what prompted them to start Brickyard Health. The business would ultimately provide them with the opportunity to provide more effective treatments for patients who have comorbid conditions.

“We find that when we collaborate, our patients tend to get better faster and stay better longer,” Balodis notes. “Once we get the right recipe down, patients get to a point where they don’t need to rely on us as heavily.”

Brickyard’s approach to care enables better treatment of patients with comorbid health problems while also creating synergistic benefits: “Someone with comorbidities might not respond well to treatment, but Erin’s work makes it possible for the body to better receive manual therapy,” Stonehouse says.

Migraines are a common co-treat issue. A patient coming in with migraines will receive chiropractic care in the form of a postural assessment, manual therapy, and home exercises, as well as naturopathic measures like bloodwork, diet and supplement recommendations, or even a sleep hygiene assessment.

“Co-treatment comes down to cases where there’s more than one cause of a symptom,” Stonehouse explains. “Migraines can have a lot of different causes that are difficult to isolate. I’ve treated migraine sufferers who saw only partial improvement with chiropractic treatment.”

Balodis and Stonehouse work to keep each other up to date on the latest research in each other’s respective disciplines, enabling each of them to communicate to patients about the other’s capabilities and scope of treatment. Their clinic also uses all-electronic charting to facilitate the constant flow of communication between team members. The Brickyard Health team engages in case conferences every day (with patient permission), which keeps all team members apprised of a patient’s progress and enables practitioners to avoid plateaus. Stonehouse says that for now, Brickyard is focusing on finding more ways to serve more clients.

Practitioners who are looking to ramp up a collaborative practice quickly can benefit from a variety of processes and technological tools that facilitate collaboration. Electronic health records systems can make sharing patient files fast and easy, while videoconferencing tools like Zoom and team instant-messaging platforms like Stitch can enable faster communication, even between professionals who aren’t in the same city.

Complementary and alternative medicine practitioners are increasingly finding ways to collaborate and co-treat, and when they do, patients see better results. That’s why the Canadian Chiropractic Association released a statement in support of interprofessional collaboration in 2018, noting that interprofessional collaboration increases quality of care and patient satisfaction while reducing the cost of care delivery. There are now clinics that offer integrated chiropractic and naturopathic services in cities across Canada. The symbiotic relationship between chiropractors and naturopaths is one that enables these two professions to gain a clearer picture of a patient’s symptoms and create more effective, longer-lasting treatments. With digital tools and a growing body of knowledge making collaboration easier, these collaborations should be encouraged. Both patients and practices benefit when chiropractors and naturopaths work together, and these collaborations (and others like them) are the future of CAM.

MIKE STRAUS is a freelance writer based in Kelowna, British Columbia. He has written on health and science topics for Canadian Chiropractor/Massage Therapy Canada, Nutritional Outlook, and Grow Opportunity.