Chiropractic Principles: Complementary and Alternative Healthcare; Integrative Medicine

Much of the healthcare community has labelled chiropractic to be a part of the filed of complementary and alternative medicine (CAM) (1). A proportion of chiropractors may not appreciate this label as they feel it is a barrier to become fully integrated into mainstream healthcare (1). However others in the profession support its label by accepting and integrating both alternative and mainstream medical practices (1). Regardless of opinions, it is crucial for practicing chiropractors to understand the importance of interdisciplinary collaborative practice in order to deliver the best possible patient-centered care.

As defined, “Interprofessional Education (IPE) occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (2). Effective interprofessional education works to improve the quality of patient care and encourages professions to learn with, from and about each other while respecting the integrity and contribution of each profession (2). Ultimately, interprofessional education is implemented to promote interprofessional collaborative patient-centred practice. Patient-centred collaborative practice helps to “promote the active participation of each discipline in patient care” (2). It enhances patient and family-centred goals and provides mechanisms for continuous communication among caregivers (2). In the past, many healthcare practitioners worked independently of one another, including chiropractors. As current evidence now strongly suggests, the effectiveness of interdisciplinary collaborative practice is crucial for current chiropractors and those in training to develop stellar interdisciplinary communication skills (2). Chiropractic educational institutions need to identify the core competencies of knowledge, skills/behaviours and attitudes that should be taught and assessed for interprofessional collaborative patient centered practice (2). In North America, chiropractic education is generally not part of the university or college system (i.e. not having direct access to other health professions) and as such IPE infusion may be difficult. Although educational improvements have been made to enhance interprofessional collaboration, I feel as though additional opportunities need to be determined in order to further strengthen interprofessional education as part of their core curriculum as it is such an important aspect of patient care and interprofessional reliance.

The ultimate goal of public healthcare is to “ assure optimal conditions in which people can be healthy” (3). Traditionally, chiropractic care has focused on the individual patient or groups of patients. (3) Unlike the past, the chiropractic profession no longer has major external barriers that prevent participation in public health activities (3). Public health challenges us to focus on the health of global communities rather than independent healthcare providers. As the profession that offers conservative care for neuromusculokeletal and other health-related conditions, chiropractic is positioned to provide contributions to wellness and health promotion (1). However, without a stern effort in all areas of the profession (i.e. collaborative practice), improvements may not be made and opportunities may be lost (3).

As chiropractic care has becomes more accepted and integrated within healthcare, the profession also becomes more responsible for public health care issues. Chiropractors, by the very nature of their health practices and diagnostic skills, are the ideal candidate to promote healthy lifestyles and support major public health initiatives. Our involvement in public health will serve to improve the health status of our patients and the communities in which they live.

References:

1. Haldeman S. Principles and Practice of Chiropractic. 3rd edition. United States of America: The McGraw-Hill Companies, Inc.; 2005.

2. Centre For The Advancement Of Interprofessional Education [Internet]. United Kingdom: caipe; 2002. Available from http://www.caipe.org. uk/about-us/defining-ipe/

3. Meeker W, Haldeman S. Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Ann Intern Med 2002; 136: 216–227