Responsible Interdisciplinary Practice Continued from Page 28 MEET THE TEAM When Canadian Chiropractor visited the Oshawa Health Centre, its multidisci-plinary team consisted of seven family phy-sicians, two chiropractors, three council-ors, one dietician, two registered massage therapists, one nurse practitioner, three occupational therapists, a team of medical assistants and a cohort of administrative specialists filling a variety of front-desk and behind-the-scenes positions. Dental and pharmacy services, though contractu-ally distinct, are available within the build-ing as well. Within the team, practitioners are considered independent consultants and not employees of the clinic. Monthly rounds are held where case presentations geared toward optimizing each patient’s wellness are brought before the care team. The idea is to focus less on the disease or condition with which the patient presented to the clinic –this will be handled by their primary care giver – and more on how the team members can use their respective skills and resources to guide that patient toward achieving opti-mal health and quality of life. (That said, the patient is not consid-ered peripheral to the team’s efforts. In fact, both Drs. Pettyan and Jeyaraj feel that patient-centred care must include allow-ing each patient to take an active role in choosing caregivers, and in planning and executing his/her care plan. This will not only increase the patient’s accountability, but will promote a sense of ownership, thus increasing his/her commitment and, ultimately, compliance to the care plan.) Finally, team presentations might also include in-services held by the different subspecialties. The goal of these is to edu-cate the rest of the team on the skill sets and utility that each discipline brings to the clinic. ACCESSIBILITY AND AFFORDABILITY These two terms are, more or less, the “a” words in health care. Laudable in their intent, their implementation presents special challenges. Within the Oshawa Health Centre model, however, these words lose some of their edge – Drs. Pet-tyan and Jeyaraj believe this is because of the underlying fundamental vision behind 32 • CANADiAN CHiROPRACTOR | FEBRUARY 2011 the clinic’s development, which includes access to and fluidity between a team of professionals without the onus being on billing issues. The rule is that no patient is ever turned away based on the fact that they may have trouble with providing payment for the services rendered to them. “We find ways to assist patients who have trouble paying for their health care,” says Dr. Pettyan. “We can work out pay-ment options for those with difficulties.” “Regardless, we always try to ask for a fee, no matter how nominal,” he adds. “It gives the patient a sense that a fair trade is being conducted – this lends them the dignity of being able to pay for what they take from you and also gives them a sense of ownership for, and commitment toward, their care. Finally, without putting the focus on how much money you make, it lends a value to the service that you provide.” As for accessibility, the level of respect and collaboration among the clinic’s team ensures that patients who come for care re-ceive holistic and wellness-oriented atten-tion that is driven by their best interests and not the silos or affiliations that can some-times motivate health-care organizations. “If a patient comes with musculosk-eletal complaints,” says Dr. Pettyan, “but also seems to have other issues, I will not hesitate to educate that patient on his/her need for further care, and will proceed to make that happen as seamlessly as I can. The other practitioners in the clinic will do the same for their patients, so that no one who comes to us is denied the overall care they need to reach a higher level of wellness.” partner with corporations to promote fun-damental health and safety strategies that ensure employees stay healthy and are able to work. This, clearly, is a win-win for all involved. CHIROPRACTIC IN AN INTEGRATIVE SETTING Dr. Pettyan, himself a DC for more than 30 years, sees chiropractic as having a vital role in integrative care. “We have a great service to provide,” he says, “to keep people functional and to help make them healthier.” He feels that chiropractors can best serve this role by remaining open and willing to learn about other practitioners’ services and to articulate the utility of chi-ropractic in practical and clear terms. He also cautions DCs not to shy away from improving their business acumen and ap-proaching the development of a team – or involvement with one – as a business ven-ture as well as a vocation. In fact, Pettyan feels that the more familiarized a practitio-ner is with the business aspects of provid-ing care, the more sustainable and effective the treatment environment that he/she es-tablishes will be. SUCCESS THROUGH ACTION “Going about improving health care means more than talking/writing about it,” says Dr. Pettyan. “Doing it is a must!” You have to deal with a patient, deal with their finances, work within business models, and so forth, to arrive at a model that im-proves health and is not just about disease management. You have to focus on what you’re trying to do – which is improving health care – and not focus on seeing the numbers. “We can build an affordable, sustain-able patient-centred, caring health system that works in a way that is accessible for all patients across the country,” concludes Pettyan. “This [indicating his clinic] is the kind of model, a team model, that can ac-tually get better results by working togeth-er, responsibly, in a truly interdisciplinary fashion for success. “I want people to live better and I want to do that the right way.” • REFERENCE 1. Osborn, S., Jones, H., with Hoffman, B. and Deitch, J. Discover Wellness – How staying healthy can make your life rich (Canadian Edition). Center Path Publish-ing, St. Paul, Minn. 2010, pg. 10. www.canadianchiropractor.ca COMMUNITY RESPONSIBILITY Pettyan feels strongly that integrative prac-tice involves integrating with the communi-ty as well. The clinic offers programs geared to teaching patients about chronic lifestyle conditions and/or prevention of these. Its newest venture, a metabolic program, pro-vides diabetes education on a one-on-one basis to patients and their families. Each patient is educated through an individual-ized program that includes a plan custom-ized for his/her needs and lifestyle. This has been highly successful, as individualized regimens translate into increased owner-ship and thus better compliance. The clinic’s practitioners are also in-volved in corporate wellness ventures that have met with considerable success. They
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