OBESITY – A BIG ZERO Consider the obesity epidemic that is pro-jected to “overwhelm” every major medical system in the world,2 “...as big a threat as global warming”, according to Paul Zimmet of the International Congress on Obesity. In response to this epidemic, the Canadian Medical Association recently launched na-tional guidelines for the treatment of obesity. In these guidelines, again the role of thera-peutic lifestyle management is clearly identi-fied as the first line therapy for the treatment and prevention of this epidemic. Did chi-ropractors stand up and acknowledge their role as obesity prevention doctors? A PROFESSIONAL HEART ATTACK Consider cholesterol and heart disease.... consider stress related disorders and dys-function...consider smoking and certain respiratory diseases – all modifiable, all pre-ventable! At what point does the profession of chiropractic intervene and stand account-able in this –the single largest health crisis in human history? If we aren’t collectively addressing diet, exercise, and smoking ces-sation, measuring blood pressure, or im-pacting cholesterol etc., what exactly is this wellness that chiropractors and chiropractic institutions are selling? The leading cause of death in Canada remains heart disease, yet most DCs are still not even taking regular blood pressure measurements on patients. We are, by our own collective non-response activity, isolating ourselves from both the population and other health care providers, wondering why utilization rates continue to drop3 continue to narrow! and scopes of practice Contrast that to all other Canadian health disciplines, both medical (nurse practitioners, pharmacists and physiotherapists) and complementary (naturopathic doctors and midwives) which have seen dramatic expansions in scope of practice and utilization! The failure of chiropractors to directly address lifestyle, and its implication on life-style disease, in private practice is no longer acceptable.4 Many chiropractors and chi-ropractic practice management consultants still feel that wellness, for the chiropractic profession, only means regular or lifetime adjustments and this is being projected to the general public. (In fact, recently, a woman who was referred to our clinic – which has the word ‘wellness’ on the sign – said that she had been reluctant to come see me because other “wellness” chiroprac-tors she had visited had tried to saddle her 20 • CANADIAN CHIROPRACTOR | JULY/AUGUST 2010 with thousands of dollars worth of lifetime adjustments. She was quite surprised to hear that wellness, in my clinic had a completely different, and much more comprehensive meaning!) The idea of lifetime adjustments, especially where there is a lack of lifestyle disease management, is as antiquated in the face of this crisis as medicines’ infectious dis-ease paradigm or over-reliance on drug-only therapy. The working model and scope of chiropractic clinical practice has to evolve to meet the needs of the population it services. The rise and fall of any institution has his-torically been predicated based on its ability to address societal needs, not on its unwav-ering adherence to tradition or past history. Continuing to provide spinal adjustments only as the primary methodology of health propagation in this lifestyle disease epidemic is clinically weak and patently ridiculous, analogous to lifetime prescriptions of statin drugs or proton pump inhibitors for the same inadequacies of lifestyle. The time for change is now! A PRESCRIPTION FOR CHANGE Facilitating the therapeutic lifestyle arm in global healthcare is critical to both posi-tively impacting the health crisis and for better integration of chiropractic into exist-ing health care delivery channels. Step one in this process is a commitment to measur-ing patient lifestyle and correlating said life-style to both chief complaints, such as high stress, and headaches and future health risks such as high stress and cardiovascular dis-ease. Screening tools for these factors are now available to chiropractors for clinical practice, corporate wellness and other larger public health ventures. The second step in the process is the utilization of evidence-based biometric and laboratory markers in measuring estab-lished disease risk and relative health. In terms of lifestyle diseases, some of the es-tablished biomarkers include: blood pres-sure, body composition analysis, waist-to-hip ratio, blood glucose, cholesterol and others. Each of these measures directly correlates to disease risk and health status in universally understood ways! More-over, chiropractors must also begin re-porting health status of these established risk markers much like they do for spinal health – along a relative scale or continuum. HISTORIC EVENT FOR CHIROPRACTIC In June 2010, Healthscore, a chiropractor run lifestyle measurement and biometric testing service, secured laboratory privi-leges for its licensed Canadian offices – a historic first for chiropractic in Canada. Although not the last word in increasing the profession’s scope of practice to in-clude laboratory analysis privileges, this opportunity and the support offered by the medical team at DriverCheck Inc. – Canada’s largest and most comprehen-sive drug and alcohol testing company – was a testament to Healthscore’s com-mitment to both building interdisciplin-ary bridges and to repositioning DCs on the front line of disease prevention in their communities and in corporations. I assert that chiropractors can play an integral role in the health care crisis fac-ing all Canadians. Requisite to success in this endeavour includes: the right tools, continued training, support of our provincial and national leaders and most importantly a keen understanding of the epidemic which has changed global health care delivery and chiropractic’s role within it. Laboratory analysis, considered a criti-cal tool in the assessment of health has been an unfortunate casualty in previ-ous scope of care reductions for chiro-practic. But chiropractors who become clinically certified Healthscore partners will have access to laboratory privileges/ requisitions through the Healthscore-DriverCheck Network of Medical Review Officers. This historic achievement now allows Canadian DCs to facilitate wellness on par with other medical professionals. EDUCATING YOUR PATIENTS Patient education is the last but perhaps most critical component in the facilita-tion of therapeutic lifestyle. Chiroprac-tic offices must commit to providing lifestyle education or lifestyle medicine as standards of practice. Building health beyond battling disease requires a firm commitment to patient education be-yond the spinal health model. Every day, chiropractors interact with patients that will either be diagnosed or suffer from a chronic disease that could have been prevented or is reversible. The time for chiropractors to begin saving these lives – is now! A commitment to this model of wellness will provide our society, and our profession, with tangible hope for a brighter future. • For article with references, please visit www.canadianchiropractor.ca. www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor July/August 2010: Page 20
