Musculoskeletal (MSK) conditions are the leading cause of disability in Canada and a significant burden to people, health systems, and economies. Predictions indicate a shortfall of approximately 23,000 family physicians by 2050, an important consideration as up to 40% of family physician visits are for MSK conditions.
A proposed strategy to address this is to maximize the scopes/roles of non-physicians with specialized MSK training and to integrate them into funded primary care.
Our study aimed to:
We utilized a mixed-methods approach incorporating questionnaires, focus groups (FG), and key informant interviews (KIIs) to capture participant responses to the intervention (education and/or integration).
The education resulted in improvements in both team and individual providers' knowledge about optimizing team-based care and collaborative competency, as well as attitudes toward chiropractic.
In all 4 integration sites, the chiropractors were successfully embedded, and the services were highly utilized and valued. The results of this study may help inform health policy makers and funders about maximizing the scope and skills of the health workforce to optimize team-based primary care and improve access to economic-barrier-free MSK care as embedded services within funded primary care.
Speaker Bios
Dr. Deborah Kopansky-Giles (Attending In-Person)
Dr. Deborah Kopansky-Giles, BPHE, DC, FCCS, MSc, is a Professor at the Canadian Memorial Chiropractic College and an Assistant Professor at the University of Toronto, Department of Family & Community Medicine. She is actively engaged in collaborative, primary care health service delivery research with a focused area on integrative models of health care, health policy, and health professional education. Deborah is a member of the Global Alliance for Musculoskeletal Health (BJD) International Coordinating Council, sits on the WHO Health Workforce Education Hub and is a member of the WHO Collaborating Centre on Family Medicine and Primary Care at the University of Toronto. She has been actively involved in WHO work on Integrated, People-Centred Care, Healthy Ageing and Global Health Workforce programs for over a decade and currently sits on the WHO World Rehabilitation Alliance Primary Care Workstream advisory committee. Deborah is the principal investigator for the 'All Hands-On Deck' research study and is currently involved in 3 Canadian government funded projects related to integrated care.
Dr. Julia Alleyne (Attending Virtually)
Dr. Julia Alleyne is an academic family physician with a focused practice in sport and exercise medicine. She holds an appointment as Associate Professor, University of Toronto, Department of Family and Community Medicine and is cross appointed to the Dalla Lana School of Public Health.
In 2009, she completed a Master of Science in Community Health with a focus in Health Professions Education and online learning curriculum development. Since that time, she has been active as an educational curriculum consultant including the clinical lead for Ontario’s Low Back Pain Strategy, program designer for the MSK Initiative with Doctors of British Columbia and clinical lead for the OA Education strategy at the College of Family Physicians of Canada. She was the Clinical Lead on the development of the CORE Back Tool, CORE Neck Tool and the OA Tool (Osteoarthritis) and Co-chair of the Health Quality Ontario Osteoarthritis standards and Acute Low Back Pain standards.
In 2013, she was appointed as the first Family Physician chair of Bone and Joint Canada.