FEATURE PRACTICE MANAGEMENT Interprofessional education Opportunity for change I by dr . dirk keenan DR. DIRK KEENAN, DC, is a second-generation chiropractor practicing in Ottawa’s oldest clinic for the past 34 years. Dr. Keenan pursues an active interest in multi-disciplinary clinics, inter-professional education, and chiropractic practices abroad. Interested parties in international locums, multi-disciplinary practices, or inter-professional education can contact him at [email protected]. 26 Chiropractic and Naturopathic Doctor May 2020 cndoctor.ca Photo:© elmirex2009 / Adobe Stock nterprofessional education is one of the most important pathways that professions like chiropractic should now be pursuing. Growing up in a chiropractic family in the 1960’s and 70’s, I was always a bit surprised by the amount of nega-tivity I heard, expressed by members of the public, and by the apparently ill-in-formed medical folk, as to the value of chiropractic. During this period, chiro-practic had to overcome many obsta-cles and hurdles to cross the threshold of relative obscurity to eventually emerge and become a part of the pub-lic health system (OHIP in Ontario). Fortunately, despite our detractors, we had excellent leaders within the profes-sion, along with strong supporters in key roles in government, who helped us secure a growing place in Ontario’s health care landscape. We have continued to improve our level of acceptance by the public, and in many medical circles, but there is still a lingering lack of familiarity and comfort that prevents the family phy-sicians from confidently and regularly considering chiropractic as a first choice for medical referral. Even more obvious is the complete lack of referral of post-surgical patients from surgeons or other specialists. Why is this the case? What are the barriers inhibiting medical referrals? It is my belief that medical doctors cannot confidently refer to other prac-titioners when they do not have signif-icant exposure during their formative years in medicine as to the fundamen-tal basis and background of that pro-fession. The practice of medicine may be considered by some of its practition-ers to be an art, but even more so, it is a “science” with specific requisite treatment algorithms. Medical stu-dents then adopt, rigorously follow, and respect these approaches as part of their training. In essence, if a particular rational and reasonable approach to patient care is not part of the medical education and as a result, part of the treatment algorithm, then it (chiro-practic) will not become part of that physician’s list of treatment options. As an example, consider the physi-cian’s prescription of certain medica-tions. Young physicians learn about many medications but they eventually can only confidently memorize the indications, contraindications, dosages, interactions and applications of several dozen at most. Once they know and trust the type of prescriptive drugs that they need, they tend to stick to them and not “try” other drugs unless they are educated, or recommended to do so, by their colleagues or pharmaceu-tical agents. Many doctors of medicine are not comfortable prescribing drugs that are brand new, relatively unknown, or may have unpredictable complica-tions and or side effects. The same might be said when it comes to refer-ring to other health care disciplines. I see their point, and I support it. I certainly don’t want a physician who experiments and likes to try new unfa-miliar drugs on patients. That is a bit like something that was dropped dec-ades ago – exploratory surgery! As a result, chiropractors along with naturopathic doctors, TCM practition-ers, and others are going to have to overcome the same issue – that of
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