ON Spinal Chat: Recent Episodes

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With a growing number of Canadians interested in self-care as we transition from the pandemic, Dr. Dwight Chapin, the OCA’s Chiropractor of the Year in 2018 wrote: "Take Good Care: 7 Wellness Rituals for Health, Strength and Hope." To bring evidence-based research to life, he engaged 21 influential Canadians, such as Jann Arden and Michael "Pinball" Clemons, to share their unique approaches to self-care. In this episode, Dr. Chapin discusses how they shaped this book, as well as how patients and chiropractors are using it to foster the self-care rituals to support improvements to their health and well-being.

Topics Covered:

• Take Good Care overview
• Selecting the book's 21 influential Canadians or mentors
• Role of science and evidence-based care
• Who benefits from Take Good Care?
• What drives Dr. Chapin to strive for optimal health and wellness
• How Take Good Care is helping Ontarians and other Canadians
• Insights from pro athletes and Globe and Mail staff
• How chiropractors can lead their patients' health and wellness journeys
• Most relevant rituals for OCA members/chiropractors
• How you can use this book to help patients and team members
• Where are Canadians falling short in self-care?
• What's next for Dr. Chapin?
• Key takeaways

Key Links to References/Resources Discussed:

• Take Good Care: 7 Wellness Rituals for Health, Strength & Hope by Dr. Dwight Chapin(Good Reads site)
• Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones, by James Clear
• 7 Wellness Rituals website

About Dr. Dwight Chapin:

Dr. Dwight Chapin is an award-winning chiropractor, owner of a large multidisciplinary wellness clinic, Team Chiropractor for the Canadian Football League’s Toronto Argonauts, onsite clinician and Health Advisor for The Globe and Mail, and author.

He has co-authored workplace wellness e-learning modules for the Canadian Centre for Occupational Health & Safety-CCOHS, was awarded the 2018 Chiropractor of the Year by the Ontario Chiropractic Association and is a two-time Grey Cup champion as a member of the Toronto Argonauts’ medical staff.

In his first book titled, Take Good Care: 7 Wellness Rituals for Health, Strength & Hope, he brings the science of prevention to life with a behind-the-scenes look at the self-care formulas of 21 influential Canadians.

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In part two of this series on pain management, Dr. Demetry Assimakopoulos returns to provide a more in-depth view of the work chiropractors do at the Comprehensive Pain Program at the University Health Network (UHN) and the Pain and Wellness Centre in Vaughan. Both these clinics were founded and led by Dr. Angela Mailis, a physiatrist, pain physician, clinical professor, and leading authority on the diagnosis and management of chronic pain. In Part 1, Dr. Mailis discussed her interdisciplinary approach for addressing pain, her experience and her work with chiropractors.

In this episode, Dr. Demetry will share a case study about a patient who was given the full-blown treatment at these clinics. To help you and other chiropractors hone an expertise in chronic pain management, he will also provide tips and useful resources, including must-read articles you can start with today.

Topics Covered:

• Key points about Dr. Mailis' approach to interdisciplinary care
• Differences between work chiropractors do at University Health Network (UHN) versus the Pain & Wellness Centre in Vaughan
• Evolution of the interdisciplinary model at UHN
• Dr. Demetry's tenure at UHN
• How chiropractors can prepare for working in an interdisciplinary clinic and what to expect
• How chiropractors can enhance their work with physicians
• Case study of patient with chronic pain
• Impact of mental health on chronic pain and treatment
• Must-read current research on chronic pain management
• How you can develop an expertise in chronic pain management

Key Links to References/Resources Discussed:

• Slater, H., et al. (2022). Listen to me, learn from me: a priority setting partnership for shaping interdisciplinary pain training to strengthen chronic pain care. Pain.
• Caneiro, J.P. (2022). From Fear to Safety, a Roadmap to Recovery from Musculoskeletal Pain. Physical Therapy.
• All Aboard the Pain Train: A Chiropractor's Guide to Chronic Pain, Dr. Shawn Thistle: Trusted Chiropractic Evidence-Based Learning (RSS Education)
• Pain & Wellness Centre in Vaughan
• Comprehensive Integrated Pain Management Program at UHN
• CE Course: The Role of Chiropractic in Opioid Use Reduction

About Dr. Angela Mailis:

Dr. Mailis is a specialist in Physical Medicine and Rehabilitation, has a Master's Degree from the Institute of Medical Science, University of Toronto, has served as Senior Investigator with the Krembil Neuroscience Centre/ University Health Network up to 2015, and became a full professor at the Department of Medicine, University of Toronto in 2005. She is a member of the School of Graduate Studies at the University of Toronto and is currently an Adjunct Clinical Professor, Faculty of Medicine, University of Toronto, Division of Physical Medicine. Since she started practising in 1982, her clinical and research interests focus on the diagnosis and management of chronic pain.

Dr. Mailis founded and directed the Comprehensive Pain Program of the Toronto Western Hospital, University Health Network (1982-2015) and continues to be a full member of the Division of Physical Medicine and Consultant at the University Health Network Comprehensive Integrated Pain Program.

She is a national Evidence-Based Guideline developer, Chair of ACTION Ontario since 2005 (a not-for-profit organization for education and advocacy for patients with neuropathic pain), and a highly respected medicolegal expert in matters of chronic pain across the country.

Dr. Mailis has published more than 130 peer-reviewed scientific papers; credited with “first publications in the world” on a number of pain conditions; recognized as an international expert on specific specialty areas; has trained numerous students and international trainees; and has lectured around the world on matters of chronic pain.

She is also a Popular Science writer (has written BEYOND PAIN published in the USA and Canada) and CARP-Advocacy electronic newsletter contributor monthly (2009-2014), while her new book “Smart, Successful and Abused” will be published in September 2019 by Sutherland House. She has appeared on numerous media outlets (print, radio, TV) over the years promoting understanding and advocacy on chronic pain.

She has participated in several hospital and university committees and serves as an advisor to the Ontario Ministry of Health since 2009 as well as federal committees and health panels.

Dr. Mailis was nominated to the 75 semi-finalists “top immigrants” in Canada for 2011. She is a recipient of the Hellenic Women’s Coming of Age Celebration Award (May 2004); Division of Physiatry, University of Toronto, Achievement Award (June 2005); the 2013 Canadian Pain Society Harold Merskey Award; and the Division of Physiatry Life Award in 2014.

As of September 2014, Dr. Mailis created an interdisciplinary best-practices community pain clinic in Vaughan (Pain & Wellness Centre). The Centre was proclaimed in October 2016 by the Ontario Ministry of Health the “Demonstration Project of Ontario” as the template for further similar community-based clinics, that connect the community to the academic hospitals. The Pain and Wellness Centre not only offers chronic pain consultations but serves as an educational hub for numerous trainees, and also a research centre studying chronic pain in the community.

About Dr. Demetry Assimakopoulos ('Dr. Demetry'):

Dr. Demetry received his specialized honours undergraduate degree from York University in 2008. He concurrently earned a specialty in Fitness Assessment and Exercise Counseling, and the title of Certified Exercise Physiologist (CEP) through the Canadian Society for Exercise Physiology (CSEP).

Dr. Demetry graduated from the Canadian Memorial Chiropractic College (CMCC) in 2012 and immediately began practising in midtown Toronto. In 2014, Dr. Demetry became the Clinical Coordinator for the University Health Network (UHN) Comprehensive Integrated Pain Program at The Toronto Rehabilitation Institute. In the hospital setting, Demetry works with a team of physicians, nurses, occupational therapists, and physiotherapists to adequately diagnose and manage chronic pain.

He earned his diplomate in chronic pain management through the Canadian Academy of Pain Management in 2015. He has since been hosted by several provincial associations across Canada to lecture to health care providers on the conservative and interdisciplinary management of chronic pain. He was happy to finally join the fabulous team at the Pain and Wellness Centre in November 2017.

Dr. Demetry was voted to receive the members' choice 2022 Dr. Michael Brickman Heart and Hands Award from the Ontario Chiropractic Association for embodying a generous and giving spirit (the heart) with remarkable passion and dedication to chiropractic care (the hands).

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Topics Covered:

• Physician-led Pain & Wellness Centre in Vaughan and its interdisciplinary model
• The Centre's innovative culture, patient-centred communications and supports to optimize it
• Dr. Assimankopoulos' approach to pain management
• Unique features of Demetry's work and environment
• How Dr. Mailis learned about chiropractors and what surprised her
• Demetry's transition to the Univerity Health Network (UHN)
• Evolution of chiropractic care at UHN
• Role and value of chiropractors at the Centre
• Dr. Mailis' message to other physicians
• Top three attributes Dr. Mailis seeks in chiropractors

Key Links to References/Resources Discussed:

• Pain & Wellness Centre in Vaughan
• Comprehensive Integrated Pain Management Program at UHN

About Dr. Angela Mailis:

Dr. Mailis is a specialist in Physical Medicine and Rehabilitation, has a Master's Degree from the Institute of Medical Science, University of Toronto, has served as Senior Investigator with the Krembil Neuroscience Centre/ University Health Network up to 2015, and became a full professor at the Department of Medicine, University of Toronto in 2005. She is a member of the School of Graduate Studies at the University of Toronto and is currently an Adjunct Clinical Professor, Faculty of Medicine, University of Toronto, Division of Physical Medicine. Since she started practising in 1982, her clinical and research interests focus on the diagnosis and management of chronic pain.

Dr. Mailis founded and directed the Comprehensive Pain Program of the Toronto Western Hospital, University Health Network (1982-2015) and continues to be a full member of the Division of Physical Medicine and Consultant at the University Health Network Comprehensive Integrated Pain Program.

She is a national Evidence-Based Guideline developer, Chair of ACTION Ontario since 2005 (a not-for-profit organization for education and advocacy for patients with neuropathic pain), and a highly respected medicolegal expert in matters of chronic pain across the country.

Dr. Mailis has published more than 130 peer-reviewed scientific papers; credited with “first publications in the world” on a number of pain conditions; recognized as an international expert on specific specialty areas; has trained numerous students and international trainees; and has lectured around the world on matters of chronic pain.

She is also a Popular Science writer (has written BEYOND PAIN published in the USA and Canada) and CARP-Advocacy electronic newsletter contributor monthly (2009-2014), while her new book “Smart, Successful and Abused” will be published in September 2019 by Sutherland House. She has appeared on numerous media outlets (print, radio, TV) over the years promoting understanding and advocacy on chronic pain.

She has participated in several hospital and university committees and serves as an advisor to the Ontario Ministry of Health since 2009 as well as federal committees and health panels.

Dr. Mailis was nominated to the 75 semi-finalists “top immigrants” in Canada for 2011. She is a recipient of the Hellenic Women’s Coming of Age Celebration Award (May 2004); Division of Physiatry, University of Toronto, Achievement Award (June 2005); the 2013 Canadian Pain Society Harold Merskey Award; and the Division of Physiatry Life Award in 2014.

As of September 2014, Dr. Mailis created an interdisciplinary best-practices community pain clinic in Vaughan (Pain & Wellness Centre). The Centre was proclaimed in October 2016 by the Ontario Ministry of Health the “Demonstration Project of Ontario” as the template for further similar community-based clinics, that connect the community to the academic hospitals. The Pain and Wellness Centre not only offers chronic pain consultations but serves as an educational hub for numerous trainees, and also a research centre studying chronic pain in the community.

About Dr. Demetry Assimakopoulos ('Dr. Demetry'):

Dr. Demetry received his specialized honours undergraduate degree from York University in 2008. He concurrently earned a specialty in Fitness Assessment and Exercise Counseling, and the title of Certified Exercise Physiologist (CEP) through the Canadian Society for Exercise Physiology (CSEP).

Dr. Demetry graduated from the Canadian Memorial Chiropractic College (CMCC) in 2012 and immediately began practising in midtown Toronto. In 2014, Dr. Demetry became the Clinical Coordinator for the University Health Network (UHN) Comprehensive Integrated Pain Program at The Toronto Rehabilitation Institute. In the hospital setting, Demetry works with a team of physicians, nurses, occupational therapists, and physiotherapists to adequately diagnose and manage chronic pain.

He earned his diplomate in chronic pain management through the Canadian Academy of Pain Management in 2015. He has since been hosted by several provincial associations across Canada to lecture to health care providers on the conservative and interdisciplinary management of chronic pain. He was happy to finally join the fabulous team at the Pain and Wellness Centre in November 2017.

Dr. Demetry was voted to receive the members' choice 2022 Dr. Michael Brickman Heart and Hands Award from the Ontario Chiropractic Association for embodying a generous and giving spirit (the heart) with remarkable passion and dedication to chiropractic care (the hands).

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Topics Covered:

• Current advocacy objectives
• Overall strategy
• Current priority: scope enhancement
• Grassroots initiatives
• Member involvement and the Local Leaders Program
• OCA's upcoming activities to advocate for the profession

Key Links to References/Resources Discussed:

• Advocating for Chiropractors and Collaborating with Health Care Professionals (Member page on OCA website)
• Local Leaders Program (Member page on OCA website)
• Counsel Public Affairs

About Ms. Caroline Pinto:

As Managing Principal and a co-founder of Counsel Public Affairs, Caroline Pinto provides strategic political and policy advice across a broad range of issues and sectors, including health care, the sharing economy, housing and land development, forestry, Indigenous issues, regulated industries, and professions, as well as a host of not-for-profit sectors.

Ms. Pinto’s profound understanding of the political and public policy development process stems from her work as a policy advisor to the Attorney General of Ontario and Minister Responsible for Native Affairs under the Mike Harris government, from 1995 to 1998. Building on her experience in government, she had a two-year stint as Vice President and Director in the Private/Public Partnership Group at Deloitte & Touche LLP. Prior to her more than 20-year career in politics and government relations in and around Queen’s Park, Caroline practiced law in Ontario.

Clients count on her to craft and execute complex and integrated government and public relations action plans built to succeed, including effective political and public policy analysis and solutions, stakeholder mapping and engagement, and strategic communications.

Ms. Pinto’s experience as a trusted strategist is supported by years of leading interdisciplinary teams, her work on coordinating health professions’ regulatory reviews, and working collaboratively with government on emerging public policy areas including the sharing economy.

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Topics Covered:

• Defining advocacy and grassroots advocacy
• Role and value of advocacy to OCA
• Impact of other regulated health professions
• OCA's approach to advocacy
• Changes in perceptions of the profession
• Innovative work to enhance perceptions
• Insights supporting the chiropractic profession and other regulated health professions
• OCA's top three advocacy achievements in recent years (interprofessional collaboration, Rapid Access Clinics for low back pain, and spousal exception)
• Spousal exception and why it matters
• Strategy to declassify chiropractic care as complementary and alternative medicine
• Impact of initiatives to date

Key Links to References/Resources Discussed:

• Advocating for chiropractors (member page on OCA website)
• Counsel Public Affairs

About Ms. Caroline Pinto:

As Managing Principal and a co-founder of Counsel Public Affairs, Caroline Pinto provides strategic political and policy advice across a broad range of issues and sectors, including health care, the sharing economy, housing and land development, forestry, Indigenous issues, regulated industries, and professions, as well as a host of not-for-profit sectors.

Ms. Pinto’s profound understanding of the political and public policy development process stems from her work as a policy advisor to the Attorney General of Ontario and Minister Responsible for Native Affairs under the Mike Harris government, from 1995 to 1998. Building on her experience in government, she had a two-year stint as Vice President and Director in the Private/Public Partnership Group at Deloitte & Touche LLP. Prior to her more than 20-year career in politics and government relations in and around Queen’s Park, Caroline practiced law in Ontario.

Clients count on her to craft and execute complex and integrated government and public relations action plans built to succeed, including effective political and public policy analysis and solutions, stakeholder mapping and engagement, and strategic communications.

Caroline’s experience as a trusted strategist is supported by years of leading interdisciplinary teams, her work on coordinating health professions’ regulatory reviews, and working collaboratively with government on emerging public policy areas including the sharing economy.

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Topics Covered:

• Mental Health First Aid and Training
• How Dr. D'Arcy Became Involved
• Practical Application of Mental Health First Aid
• Key Available Resources and Applications
• Safeguarding Your Own and Family Members' Mental Health
• Chronic Pain and Mental Health
• Supporting a Patient's Mental Health Within Scope
• Real-Life Examples and What Helped
• Three Steps to Start
• Future Mental Health Support

Key Links to References/Resources Discussed:

• Mental Health First Aid Course (Mental Health Commission of Canada)
• 211 Ontario (helpline and online database of Ontario's community and social services)
• Connex Ontario (24/7 online and phone access to health care services information)
• Bounce Back Ontario
• Canadian Mental Health Association
• Centre for Suicide Prevention
• Applied Suicide Intervention Skills Training (ASIST)
• Employee and Family Assistance Program (OCA Member Assistance Program )
• Opioid and Pain Reduction Collaborative
• safeTALK
• Anxiety and Phobia Workbook
• July 14 - OCA Bulletin with Mental Health Article
• August 11 - OCA Bulletin with Follow-up Mental Health Article

About Dr. Janet D'Arcy:

Dr. Janet D’Arcy is a seasoned chiropractor who practises in an east-end Toronto Beach(es) clinic, along with a registered massage therapist.

In addition to her private practice, she is an Assistant Professor at the Canadian Memorial Chiropractic College (CMCC). Within this role, Dr. D’Arcy supervises interns providing patient care at CMCC’s clinic at Sherbourne Health. She also serves on the OCA’s Board of Directors.

Dr. D’Arcy received her undergraduate degrees in biology and physical & health education from Queen’sUniversity in 1989 and her Doctor of Chiropractic degree from the CMCC in 1993. She was also certified in acupuncture from Acupuncture Canada (formerly AFCI) in 2007.

In 2014, Dr. D’Arcy was certified by the Mental Health Commission of Canada to teach mental health first aid. Since then, she’s helped fellow clinicians, as well as CMCC staff, faculty and students increase their knowledge of mental health conditions, resources and practical approaches.

Dr. D’Arcy also received her Fellowship in Sports Sciences from the Royal College of Chiropractic Sports Sciences (Canada) in 2016. Along with Dr. Cameron Borody, she was recently awarded a Canadian Chiropractic Research Foundation (CCRF) grant for a study on Attitudes toward chiropractic: a survey of Canadian sport and exercise medicine physicians.

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Topics Covered:

• Purpose of the Rapid Access Clinics (RACs)
• Dr. Candelaria's involvement with the RACs
• Types of RACs
• Design of RACs and role of hospitals
• Difference between RACs for Low Back Pain and others
• Patient referral process
• Primary care provider engagement and registration requirements
• How to facilitate patient referrals to a RAC-LBP
• RAC-LBP patient outcomes
• Chiropractors' skills and RAC-LBP requirements
• Chiropractor roles in the RAC-LBP program
• RAC-LBP chiropractors' feedback
• Growing pains or challenges working in a RAC-LBP
• Chiropractors' experience and insights from RAC-LBP work

Key Links to References/Resources Discussed:

• Why RACs Matter to Chiropractors (includes PCP form for facilitating referrals)
• Rapid Access Clinics for Low Back Pain
• Get Involved in OCA-Sponsored Programs
• Access Appropriate Low Back Pain Care (public/patients' page)

About Dr. Henry Candelaria:

Dr. Candelaria is a Practice Lead at Trillium Health Partners, Mississauga Halton Rapid Access Clinic for Low Back Pain and also a practising chiropractor in Oakville, Ontario.

Dr. Candelaria holds a Bachelor of Physical Health and Education from the University of Toronto. He graduated Magna Cum Laude from the Canadian Memorial Chiropractic College (CMCC) in 2007. During his time there, he was heavily influenced by a number of leaders and trailblazers in the chiropractic profession who placed an emphasis on functional movement analysis and evidence-based manual therapy and rehabilitation. Most importantly, the process of establishing an accurate diagnosis was instilled in him during his time at CMCC and is something he has carried with him since graduation and throughout his career.

Since graduation in 2007, he sought out non-traditional interprofessional chiropractic opportunities in the health care system. He has since worked in various capacities in four different greater Toronto area hospitals, as well as a family health team and a community physiatry practice both in his current hometown of Oakville, Ontario. These experiences have provided opportunities to engage and collaborate with a variety of musculoskeletal-related medical specialties, including neurology, physiatry, orthopaedics, neurosurgery, rheumatology, and sports medicine.

He has also benefited from working with some of the best in the manual therapy and rehabilitation fields, ranging from osteopaths, physiotherapists, massage therapists, athletic therapists, chiropractors, strength and conditioning coaches, personal trainers, functional movement experts, and pilates and yoga practitioners."

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Topics Covered:

• Motivation for becoming a nurse practitioner (NP)
• NP's introduction to chiropractic care
• Value of chiropractic care to NPs
• How NP assesses patients for manual therapy
• NP's process for selecting the type of manual therapy for each patient
• NP's priorities when selecting a chiropractor to refer to
• Barriers and solutions to collaborating with primary care providers
• Pandemic's effect on collaboration between primary care and chiropractors
• Addressing the opioid crisis with collaboration
• Using OCA's Opioid and Pain Reduction Collaborative tools
• How chiropractors can provide extra value to NPs

Key Links to References/Resources Discussed:

• Primary Care Low Back Pain Program
• Centre for Effective Practice (CEP) - Manual Therapy as an Evidence-Based Referral for Musculoskeletal Pain Tool
• OCA Chiropractor's Pain Reduction Toolkit

About Kristy Naulls:

Ms. Naulls is a full-time Nurse Practitioner (NP) at the Belleville Nurse Practitioner-Led Clinic and is also a Certified Respiratory Educator.

She graduated from Queen's University in 2004 and worked at Kingston General Hospital for eight years before moving to Belleville to work as an NP.

Ms. Naulls has a Master’s degree in nursing and enjoys teaching NP students online as a course instructor for Athabasca University.

She is a well-regarded clinical preceptor for NP students from a variety of universities

Ms. Naulls won the Patient Choice Award from the NPAO in 2015 and is a big advocate for patient-centered care and the benefits of working in a collaborative, multidisciplinary model of care.

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Topics Covered:

• Purpose of OCA-commissioned fall 2021 Environics Research survey
• Overview of survey audience demographics and timing
• Ontarians' current attitudes toward their health
• How Ontarians are prioritizing time and money for their physical and mental health
• Issues currently prompting Ontarians to seek chiropractic care
• The gap between chiropractors' scope and consumers' perceptions
• How OCA is working to raise awareness of the breadth of chiropractic care and what members can do
• Ontarians' access to and attitudes about extended health care or employee benefits
• How Ontarians value specific online features in their health care professionals' clinics
• Top opportunities for Ontario chiropractors
• How Ontarians assess their health

Key Links to References/Resources Discussed:

• Circle It Arthritis Campaign (OCA member page)
• Opioid and Pain Reduction Collaborative
• Role of Chiropractic in Opioid Use Reduction

About Nancy Gale:

An award-winning accredited Business Communications (ABC) professional, Nancy is Vice President, Strategic Communications and Stakeholder Management for the Ontario Chiropractic Association (OCA). She has more than 25 years of experience designing and executing measurably successful strategies for public and private sector organizations in Canada.

Nancy joined the OCA after more than a decade of experience in leadership roles for several public sector health care organizations, including Southlake Regional Health Centre, Mississauga Halton Community Care Access Centre and Trillium Health Centre.

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Topics Covered:

• Best practices implemented to protect patients, clinicians and staff during the pandemic
• Extra steps clinic took to enhance safety
• Good practices likely to be retained as we move out of the pandemic and beyond
• Advice for managing staff and colleagues' needs
• How to best support registered massage therapists within and outside your clinic
• Keeping in touch with patients in the pandemic or uncertain times
• Patients who haven't returned for care
• Virtual care or telehealth during the pandemic
• Keeping patients, staff and clinicians safe when mandatory restrictions drop
• New or tweaked business practices that are helping now and beyond the pandemic

Key Links to References/Resources Discussed:

• OCA Return to Practice Working Group
• OCA Return to Practice Playbook
• Return to Practice FAQs
• Registered Massage Therapists' Association of Ontario (RMTAO)
• Understanding Extended Health Care Guide (member-only access)
• Patients' Guide to Extended Health Care (public access)
• Understanding Audits (from insurance providers, member-only access)

About Dr. Erika Kuehnel:

Dr. Erika Kuehnel is a Chiropractor, Registered Massage Therapist and CMCC graduate.

She owns and operates a multidisciplinary practice in Milton, Ontario, at Milton Back Doc, provides assessment services to the Low Back Pain Rapid Access Clinic, teaches in the massage therapy program at Oxford College, and is on the Board of Directors for the Registered Massage Therapists' Association of Ontario (RMTAO) Her prior involvement with the OCA includes working with the OCA advocacy program (now the Local Leaders program) and the Return to Practice Working Group.

Dr. Kuehnel lives in Milton with her husband, her two children and two dogs. She can be found hiking and camping in her spare time.

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Topics Covered:

• Why OCA developed the Evidence-based Framework Advisory Council (EBFAC)
• The EBFAC's key goals
• How will the EBFAC change misperceptions?
• Approach to assessing, diagnosing and treating arthritis
• EBFAC members and its patient-focused process
• Supporting the Research Agenda
• Partnership4BetterHealth and the EBFAC
• Providing optimal care for patients with arthritis
• How Identifying Research Priorities benefits members
• Existing patient preference work
• EBFAC's impact on the chiropractic profession
• Impact of OCA Aspire - OCA's electronic patient record
• EBFAC and patient care
• What's next for the EBFAC after research and assessment?

Key Links to References/Resources Discussed:

• Evidence-based Framework Advisory Council
• About Caroline Brereton
• Partnership4BetterHealth
• OCA Aspire

About Caroline Brereton:

Caroline is CEO of the Ontario Chiropractic Association and oversees the Evidence-based Framework Advisory Council (EBFAC).

Through working for 18 years on acute care’s front-line to now leading the fourth largest chiropractic association in the world by membership, she has lived varied perspectives of our health care system.

Her passion for quality patient care in Ontario began in 1992 with her work as a registered nurse caring for elderly patients with complex needs at Queensway General Hospital, in Toronto’s west end.

As Caroline's career evolved, she moved to Trillium Health Centre (now Trillium Health Partners) in 1998, where she held several senior level positions, from Director, Medical Health Systems, to Vice President, People, Corporate and Clinical Support Services. At Trillium, she applied a new leadership philosophy and accountability framework to initiate customer service models that improved patients’ experience and outcomes. Caroline was also honoured to lead the implementation of the University of Toronto’s Mississauga Medical Academy and the Shared Service West Organization transformation, on behalf of four organizations.

In addition to her nursing and midwifery credentials, Ms. Brereton has an MBA from Queen’s University and is a graduate of the Rotman School of Management Advanced Health Leadership Program.

Since joining the Ontario Chiropractic Association (OCA) as CEO in June 2018, she has focused on building relationships with all partners that impact chiropractors and their patients in Ontario. Caroline is committed to ensuring the OCA is making a difference for its members and supporting others in their accountabilities to the profession.

In her previous tenure as Chief Executive Officer of the Mississauga Halton Community Care Access Centre (CCAC) and Vice Chair of the Ontario Association of Community Care Access Centres (OACCAC) Board of Directors, she collaborated with multiple partners to help drive our system’s transformation to integrated, patient-centred care.

Caroline was inspired by the initiatives CCAC's interconnected teams implemented to improve patients’ experience and outcomes. These initiatives ranged from a primary care advisor model that achieved a 76 per cent engagement rate with primary care providers across the region to our seamless transitions hospital partnership that reduced the number of patients returning to hospital within 30-days after discharge by 52 per cent.

Delivering home and community care every day gave her and the CCAC a front-line advantage. It showed what works and what is vital to our health care system. These experiences opened Caroline's eyes to our system’s potential.

Caroline is excited by the possibility of creating a world-class, fully integrated health system in Ontario and potentially across Canada. Like many health care leaders, Caroline is also constantly thinking about ‘how’ to best achieve this for Ontarians.

She believes all health care partners must share their insights and work together, hand in glove, to shape a system that overcomes long-term challenges and continuously raises the bar for quality of care.

In addition to her OCA role, Caroline is also a Board member of the Regional Geriatric Program of Toronto.

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Topics Covered:

• Why arthritis is a rising priority
• New research on arthritis and pain
• New BMJ guideline for treating degenerative spinal stenosis
• Approach to assessing, diagnosing and treating arthritis
• Treating different demographics
• Collaborating with physicians as part of the circle of care for a patient with arthritis: on next steps, imaging and more
• Tips for building collaborative relationships with physicians
• Providing optimal care for patients with arthritis
• Assessing psychosocial issues and specific skills to hone
• Enhancing compliance and patient outcomes

Key Links to References/Resources Discussed:

• Spine Clinic and the Spinal Stenosis Program
• Status of Arthritis in Canada (from the Arthritis Society)
• BMJ Guideline for Spinal Stenosis
• Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline
• Prevention and treatment of low back pain: evidence, challenges, and promising directions
• Michael Schneider - University of Pittsburgh

OCA Circle It Arthritis Campaign Links:

• Circle It Arthritis Campaign (on OCA member page)
• Team Approach to Arthritis Pain (for MDs and other health care professionals)
• Help to Manage Your Arthritis (for patients)

About Dr. Carlo Ammendolia:

Dr. Ammendolia is the Director of the Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Disease at Mount Sinai Hospital in Toronto.

He received his MSc degree in Clinical Epidemiology and Health Care Research and his Ph.D. in Clinical Evaluative Sciences from the University of Toronto and his Chiropractic degree from the Canadian Memorial Chiropractic College (CMCC) in Toronto.

Dr. Ammendolia is an Assistant Professor in the Institute of Health Policy, Management, and Evaluation, the Department of Surgery, and the Institute of Medical Sciences at the University of Toronto.

In 2012 and 2017, Dr. Ammendolia was the recipient of the Professorship in Spine Award from the Department of Surgery in the Faculty of Medicine. Dr. Ammendolia has been in clinical practice for over 39 years and now combines clinical practice, research, and teaching in the areas of non-operative treatment of mechanical, degenerative, and inflammatory spinal disorders with a special interest in degenerative spinal stenosis.

In 2021. He was given the distinction of “world expert” in spinal stenosis by Expertscape based on his publication in this area in the past 10 years. ​

Our next podcast will drop in late January 2022.

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Topics Covered:

• Why you'll want to avoid incentives
• How chiropractors are using virtual care or telehealth
• Virtual care trends and patient feedback
• Insurers and virtual care
• How the COVID-19 pandemic is impacting EHC
• Keeping up with EHC providers and fluctuating rules
• What new grads should note about EHC
• How new grads can use the EHC guide and its tools
• Working effectively with insurers and their patients

Key Links Discussed:

• Understanding Extended Health Care: The chiropractor’s guide to patient support and administrative compliance (access restricted to OCA members)
• The Patient’s Guide to Extended Health Care Coverage

About Dr. Moez Rajwani:

Dr. Rajwani is Vice President of Clinical Services at North York Rehab Clinic (NYRC), where he manages and works with a multidisciplinary team of medical consultants overseeing complex medical evaluations. He also practises and manages orthopedic rehabilitation centres in the Greater Toronto Area (GTA).

He is also Executive Director of the Future Ready Initiative, which aims to increase the community’s preparedness, as well as its resilience in the face of disruptive changes in the area of the future of work.

An active volunteer, Dr. Rajwani serves as the Co-Chair of the Coalition of Health Professional Associations in Auto Insurance Services in Ontario and is a board member at Michael Garron Hospital. He is also on the Board of Directors for World Spine Care (WSC) Canada.

Dr. Rajwani is a recipient of the Queen’s Golden Jubilee Volunteer Award, the OCA Volunteer Service Award, and an award from the Ministry of Citizenship for 25 years of service to the community.

He graduated as a Doctor of Chiropractic in 1994 and has post-graduate certifications in Occupational Health and Sport Sciences.

About Dr. Amy Brown

Dr. Brown divides her time between Coronation Chiropractic, Massage, & Physiotherapy, her private community-based practice, and a practice onsite at Langs Community Health Centre.

She is also an Advanced Practice Clinician with Ontario’s Low Back Rapid Access Clinic (RAC) program and a treating chiropractor with Health2Work. The Heath2Work program provides chiropractic assessment and treatment for clients of the Ontario Works program who have MSK conditions.

In addition, she works as a consultant to the Ontario Chiropractic Association, contributing to health policy-related work, outreach and advocacy.

Dr. Brown graduated from the Canadian Memorial Chiropractic College (CMCC) in 2001.

Watch for Chiropractic Care for Patients with Arthritis - coming on November 15, 2021

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Topics Covered:

• OCA’s Extended Health Care Advisory goals
• What makes extended health care (EHC) relationships complex
• How OCA’s Extended Health Care Guide can help your practice
• Key trends in EHC: cost containment insurance, preferred provider networks, digital transformation and more
• What today’s insurers are asking about treatments and patients’ conditions
• Types of preferred provider networks and their impact
• Rise of adjudication and evidence-based questions
• Types of audits and how to prepare for one
• Sharing members’ experience through forthcoming OCA Audit Tool
• Increasing audits and who’s affected

Key Links Discussed:

• Understanding Extended Health Care: The chiropractor’s guide to patient support and administrative compliance (access restricted to OCA members)
• The Patient’s Guide to Extended Health Care Coverage

About Dr. Moez Rajwani:

Dr. Rajwani is Vice President of Clinical Services at North York Rehab Clinic (NYRC), where he manages and works with a multidisciplinary team of medical consultants overseeing complex medical evaluations. He also practises and manages orthopedic rehabilitation centres in the Greater Toronto Area (GTA).

He is also Executive Director of the Future Ready Initiative, which aims to increase the community’s preparedness, as well as its resilience in the face of disruptive changes in the area of the future of work.

An active volunteer, Dr. Rajwani serves as the Co-Chair of the Coalition of Health Professional Associations in Auto Insurance Services in Ontario and is a board member at Michael Garron Hospital. He is also on the Board of Directors for World Spine Care (WSC) Canada.

Dr. Rajwani is a recipient of the Queen’s Golden Jubilee Volunteer Award, the OCA Volunteer Service Award and an award from the Ministry of Citizenship for 25 years of service to the community.

He graduated as a Doctor of Chiropractic in 1994 and has post-graduate certifications in Occupational Health and Sport Sciences.

Watch for Part 2: EHC and Virtual Care, Post-Pandemic and More - coming on October 15, 2021

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Topics covered:

• Initiating contact with a patient's prescribing health care professional
• Clues your patient may provide to help you approach their MD or NP
• When to contact a patient's prescribing health care professional
• Report/update content and tone that resonates with a patient's MD or NP
• How coordinating care helped one patient reduce her opioid dependency (case study example)
• A Nurse Practitioner's role in care coordination
• Using the OCA’s Opioid and Pain Reduction Collaborative’s Chiropractors’ Toolkit to provide an informed referral and build rapport
• Ways to use OCA's Manual Therapy as an Evidence-Based Referral for Musculoskeletal Pain Clinical Tool, developed with the Centre for Effective Practice (CEP)
• Why now is the time for chiropractors to help address the opioid crisis

Key links discussed:

• Address the Opioid Crisis (OCA’s initiative)
• CEP- Manual Therapy as an Evidence-Based Referral for Musculoskeletal Pain Clinical Tool
• Chiropractor Toolkit to Address the Opioid Crisis

About Dr. Albert Scales:

Since 1981, chiropractor Dr. Albert Scales has treated many patients recovering from automobile accidents and workplace injuries, including many with opioid dependencies. He also served as a chiropractic consultant for WSIB Ontario’s Hamilton office for 10 years and has worked for 20 years as an Independent Medical Evaluator for automobile accident claims.

Dr. Scales is familiar with OCA’s Opioid and Pain Reduction Collaborative, having participated in a focus group to inform its development.

His multi-disciplinary practice is located at Lakeshore Chiropractic Group in St. Catharines, Ontario. He is also a chiropractic provider at Quest Community Health Centre.

Dr. Scales is the current president of the Niagara Chiropractic Society, a Rotarian, and received OCA’s Political Service Award in 2004 and its Community Services Award in 2001. He graduated from the Canadian Memorial Chiropractic College (CMCC).

We are taking a break in August for you to enjoy your summer but will be back on September 15, with an episode on How Extended Health Care Trends Affect Your Practice.

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Topics covered:

• Unique attributes of patients who’ve been in auto accidents or had workplace injuries
• Identifying a patient who has an opioid dependency
• How and when patients reveal an opioid dependency
• Encouraging these patients to pursue a treatment plan
• Attaining maximum value from OCA’s Opioid and Pain Reduction Collaborative’s chiropractors’ toolkit and using it to initiate dialogue
• Winning back patients who quit
• Maintaining long-term trust

Key links discussed:

• Address the Opioid Crisis (OCA’s initiative)
• Chiropractor Toolkit to Address the Opioid Crisis
• Chiropractor Dialogue Map

About Dr. Albert Scales:

Since 1981, chiropractor Dr. Albert Scales has treated many patients recovering from automobile accidents and workplace injuries, including many with opioid dependencies. He also served as a chiropractic consultant for WSIB Ontario’s Hamilton office for 10 years and has worked for 20 years as an Independent Medical Evaluator for automobile accident claims.

Dr. Scales is familiar with OCA’s Opioid and Pain Reduction Collaborative, having participated in a focus group to inform its development.

His multi-disciplinary practice is located at Lakeshore Chiropractic Group in St. Catharines, Ontario. He is also a chiropractic provider at Quest Community Health Centre.

Dr. Scales is the current president of the Niagara Chiropractic Society, a Rotarian and received OCA’s Political Service Award in 2004 and its Community Services Award in 2001. He graduated from the Canadian Memorial Chiropractic College (CMCC).

Watch forPart 2: Building Rapport with a Prescribing Health Care Professional coming on July 15, 2021.

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If you're a member of the Ontario Chiropractic Association, this upcoming monthly podcast is for you. But many of the topics we'll discuss with varied guests have a wide-reaching impact and will also likely be of interest to other professionals in Ontario's broader health ecosystem.

Listen to this trailer to learn more.

Trailer text:

You’re a chiropractor practising in a rapidly evolving profession in Canada’s largest province (by population).

You joined the Ontario Chiropractic Association for programs, services, and resources. What else?

I bet you want the backstory and how it helps your practice.

That’s why we launched ON Spinal Chat – your OCA podcast.

I’m Leslie and each month I’ll interview your colleagues, other health care professionals, or experts about what OCA is doing or supporting to:

• Help enhance your patient care

• Grow your practice or

• Advance the chiropractic profession

So take us on your commute, lunch break, or run to get the in-depth value of member care in 30 minutes or less – and then, you can start using it today.