Page 27 - BackSpace October 2017

Newsletter of the European Chiropractors’ Union
Feature
In the face of increasing calls to shun surgery, to avoid reaching immediately for drugs and to embrace conservative care, the evidence-informed chiropractic lexicon of bespoke elements, wrapped in powerful context, seems an obvious route to take. Educated, skilful, confident and caring chiropractors, are likely the central mechanism underlying the efficacy of chiropractic care, and on which the profession’s identity and authority rests, not manipulation.
Now, that is a big idea!
1. Babatunde O, et al (2017) Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLoS ONE 12(6)
2. Chou R, et al (2017) Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline.
Annals of Internal Medicine. 166 (7) 493-505
3. MD Bishop et al (2017) The Influence of Clinical Equipoise and
Patient Preferences on Outcomes of Conservative Manual Interventions
for Spinal Pain: An Experimental Study. J Pain Res 10, 965-972. 4. Wampold B (2015). How important are the common factors in
psychotherapy? An update. World Psychiatry; 14:270–277
Dave Newell is registrar at the European Academy of Chiropractic and senior researcher at the Southampton University Department
of Primary Care and Population Studies. He teaches at the AECC. The views he expresses are his own and are not necessarily the views of the European Chiropractors’ Union or the AECC.
Scope of mind
Reflections on joining a multidisciplinary clinic by Gerly Truuvaart
WE HAVE all spent many hours discussing scope of practice with our chiropractic colleagues, but until now I never stopped to think what it really means. Technically, I know very well what it entails, but what does it really mean in the daily life of a chiropractor?
After 10 years of busy practice I find myself challenged to think what is my scope of mind? Does the care I offer reflect the adaptability and expandability of my mind? Or does my thinking process limit the care I can offer my patients?
Our professional frame of mind is largely built upon
the quality of the education and the educators we have experienced. But it must not be frozen in time; I have recently become aware of this, as I joined the private CONFIDO multidisciplinary clinic in Tallinn, Estonia.
The goal of the clinic is to provide top-quality health care services and integration of health care professionals from a range of disciplines. When we all met in January 2017 to begin a process of exchanging visions of integration I was so surprised at how welcome I was and how excited others were to have
me as part of the team. When I found myself talking about pregnancy and chiropractic, the neurologist at the end of the table said: “Well that is the first time I have heard those two words in the same sentence.” And I replied that pregnancy and neurosurgery in the same context was also new for me. We have lot to learn from each other!
It is early days for the clinic, but I have found that all of us working there want the best for patients and have the best intentions, but our treatments and scope are different. As health care professionals, maybe in the past we have failed to communicate effectively. This is the challenge for all medical professions, not just chiropractors. We each tend to see things from only our own perspective and spend lot of energy explaining to others how we think, instead of really listening and expanding our knowledge and understanding.
On another day, the neurosurgeon borrowed my spine model and later commented that a lateral disc such as in the model hardly ever happens in real life, and when it does the patient would not present with clear symptoms. So, I find
myself wondering about why we hold the model in our hands so often to describe a disc bulge to patients. Why do we use misleading models in our profession?
CONFIDO is a great meeting point for professionals who would not pass my office otherwise! Random meetings with the president of the Cancer Association of Estonia, with the director of the Health and Work Ministry, lunch with a clinical psychologist and many great general practitioners, just to mention few!
Integration is a process of growth and self-analysis as well.
One great bonus from running my own practice inside the multidisciplinary centre is that I have access to the national health care system records with all the existing tests and imaging available for the patient. It is exciting for me to have all that at the click of a finger! What if you open a male patient’s information just before he walks in, and you notice that in the past ten years he has had numerous sets of imaging done... in different prisons, and mainly of jaw and skull fractures? What a great lesson to learn to stay in the present, non-judgmentally, and to treat him as neutrally as you do everyone else. What if you find in the health history that the patient has had a cancer that they did not want to put into their intake form, as this is something they prefer not to talk about?
My first two months in CONFIDO have challenged me - in very different ways than I thought they would. The centre makes me question things I have taken for granted and it makes me listen and observe more carefully. As Donald Rumsfeld once said: “You don’t know what you don’t know!”
L-R: Helle Nurmsalu, physiotherapist; Karl Pärjamäe, DC; Gerly Truuväärt, DC; Dr Edward Laane, haematologist; Kadi Lambot, CEO of CONFIDO
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