“Chiropractors now have a much more science-based education and as a result we’re seeing a lot more cooperation with physicians.” toward chiropractic have also evolved over the last several years, he notes. In 1978, Leprich recalls, having a conversation with a general practitioner about a patient or health care was something that “just didn’t happen.” Today, patient referrals to chiropractic by medi-cal doctors are happening to some degree. Multi-disciplinary clinics, where chiropractors and other health-care practitioners are co-located and prac-ticing integrated health care, are also increasing in numbers. “Chiropractors now have a much more sci-ence-based education, much more evidence-based, and as a result of that we are seeing a lot more cooperation with physicians,” Leprich says. www.canadianchiropractor.ca Although MD referrals are already taking place today, the veteran chiropractor admits, they don’t happen very often – not as much as many in the profession would like. There are still some family physicians “who have the old attitudes and the old opinions” who would never refer to a chiropractor. It’s the younger generation of doctors who are typically more inclined toward interprofessional collaboration and more aware of what chiropractic can offer in patient care, he says. With progress come great challenges as well. In the chiropractic realm, patient utilization rate has remained generally constant over the years – be-tween 12 and 15 per cent – despite dramatic growths in the number of DCs and the increasing recogni-tion by the health-care community. This is espe-cially true in Ontario, where nearly 60 per cent of all Canadian DCs are practicing. “It’s a negative thing, but it’s a fact,” Leprich notes. “It doesn’t seem to matter what we say or what we do, the utilization rate just has not in-creased.” He acknowledges there are other areas in Canada that have a relatively higher utilization rate (i.e. Alberta, B.C.), and there are also areas where it is lower (i.e. Quebec, Atlantic Canada). Leprich believes it has never been more vital for new chiropractors to not only have the clinical skills but also the business savvy to run a practice – and they need to be proficient in both from the get-go. For one thing, students are graduating with a sig-nificant amount of debt load, he notes. “When I entered practice [more than 30 years ago], I could afford to learn by trial and error. I had some debt but not much. I bought a building; I had a mortgage to pay. There was some pressure on me to get going. But nothing, nothing like what people face today,” Leprich says. Opportunities Despite the challenges and increasing competition, the last couple of decades also saw some new and emerging opportunities for chiropractic to flourish and make its mark. One area that has significantly grown in recent years is in sports medicine. Chiropractic has really taken off in the sporting world, not only as a treatment for sports-related injuries but also for maintenance care and perfor-mance enhancement. Dr. Brian Seaman is one of the few pioneers of chiropractic sports sciences. He was among the first batch of Canadian DCs to have completed a chi-ropractic sports fellowship through the Canadian Royal College of Chiropractic Sports Sciences (RCCSS) – then called the Canadian Chiropractic Sports Academy. “Over the past 32 years [RCCSS] has done a tremendous amount of liaising with various na-tional bodies, such as the Canadian Olympic Committee (COC) and other sport organizations May 2016 Canadian Chiropractor 27
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