uOttawa.ca Integrative Medicine in Clinical Practice Presented by: Dr Dirk Keenan DC April 18, 2015 uOttawa.ca Faculté de médecine | Faculty of Medicine

uOttawa.ca The four objectives Assess the change in your knowledge and bias toward CAM at the end of the week Recognize where to find online resources for evidence based integrative medicine Identify which CAM therapies you are most likely to consider using in clinical practice Explain how you will deal with patients interested in CAM therapies and how this will affect your ability to help them. uOttawa.ca Faculté de médecine | Faculty of Medicine

uOttawa.ca Dr Dirk Keenan DC - Second generation chiropractor Oldest CAM clinic in the city (est 1952) Converted Home on Carling Avenue 3

uOttawa.ca

Education and Post Graduate Activities BA from Queens and Carleton U (1980) DC (four years) from Canadian Memorial Chiropractic College (Toronto) (1984) Past Canadian Chiropractic Association Board member Co-author of published research done on integration of first ever chiropractic clinic into a Community Health Centre Recently completed training on the conservative management of lumbar spinal stenosis –boot camp from Mt. Sinai Hospital and Dr. Ammendolia DC,Phd

uOttawa.ca Keenan Health Centre Includes chiropractic, massage, naturopathic medicine, nutrition, & physiotherapy Fee for service Covered by Extended Health, Auto, WSIB, DND, & Veterans Affairs Pilot projects from the MOHLTC in Ontario are funding chiropractic

uOttawa.ca MSK Prevalence 11 M Canadians over age 12 are affected annually #2 as a group of conditions as the leading cause of disability worldwide 22% -2.8 million Ontarians made visits to MD’s for MSK complaints 85% of Canadians experience LBP at least once 90% of all LBP patients are ultimately not surgical candidates 6

uOttawa.ca Chiropractic care Primary focus in on the whole musculo-skeletal system, particularly the pelvis, and spine. Adjustments by hand or instrument restore normal function of the joint enhancing mobility Spinal manipulation (SMT) is best performed by those who do it daily. (PT’s, ND’s, & MD’s share this scope) Other interventions include lifestyle education, prescribed exercises, rehabilitation, adjunctive physical therapies, pain management, health promotion

uOttawa.ca Chiropractic Doctors Recognized experts for their knowledge of spinal conditions and effective conservative care Provide skilled assessment and treatment of many conditions such as spinal stenosis, lower back pain, disc bulge, persistent neck pain, shoulder problems, headache. Included in inter-professional spine assessment and education clinics (ISAEC) pilot since 2012 to reduce the wait for surgical consults Included in the Primary Low back pain pilot launched in 2014

uOttawa.ca Chiropractic Doctors Utilize standard consultation, examination, and imaging Provide a clear diagnosis, and prognosis Provide timely safe and effective interventions including Spinal manipulation, which is recommended in guidelines. Recommend lifestyle changes including specific exercises, nutritional changes, and tips on prevention Refer patients to other providers when the patient presents out of scope of practice, or when the patient fails to progress

uOttawa.ca Chiropractic Doctors Can provide conservative care for the leading disability, (LBP) & 27% of the 2.8 million patient seeing an MD for MSK pain, 33% of whom saw a specialist. 7 Trained to work with other disciplines for a collaborative approach for improved patient outcomes.

uOttawa.ca Patient satisfaction/Efficacy 94.2% in a recent MOHLTC funded project where chiropractors worked with physicians in a consulting and assessing role providing care for LBP patients. 1 Research has shown back pain patients who had access to chiropractic care had reduced costs in hospitalizations, surgeries, and imaging. 2,3

uOttawa.ca Chiropractic Doctors Available to fully able to collaborate with a drugless approach to common conditions that may not respond as well to conventional medical care alone by improving musculo-skeletal function and supporting healthy lifestyle choices. Questions? Interested in observing? me at or x 222