Article of the month: Collaboration between your MD and DC


The profession of chiropractic has made impressive strides in establishing collaborative relationships with other disciplines in clinical practice, research and education. Most recently, a pilot study in Ontario, involving family physicians and chiropractors, added to this momentum. The study demonstrated that there is a very real interest, on the part family physicians as well as patients, in adopting a collaborative approach with chiropractors to streamline and enhance treatment strategies for low back pain.

According to the Ontario Chiropractic Association (OCA), “Low back pain is a major health issue in Ontario. It affects 84 per cent of the working population at some point in their life and is second only to the common cold as a cause of lost work time.” We can assume Quebec has similar statistics.


The OCA has reported that the survey shows the vast majority (93 per cent) of family physicians frequently treat patients with low back pain and more than half (55 per cent) find it challenging to treat these patients on their own. Three-quarters (75 per cent) say they think their patients suffering from low back pain could benefit from treatment options offered by other health-care professionals.

Three quarters (74 per cent) of residents surveyed indicated they felt that if professionals such as chiropractors were used more in teams with family physicians, this would be a better use of health-care dollars.


“For this study, the chiropractors were able to see the patients before a referral for advanced imaging and medical specialists, and often, the patient could be managed effectively with conservative care. The importance of physical activity was central in many cases. Having the time to spend with the patient to walk through the guidelines was paramount and resulted in strong patient satisfaction and provider value. Following the assessment, the chiropractor would connect with the family physician to share his findings and discuss the patient care plan.”

The patients’ evaluations forms demonstrated a 95 per cent satisfaction rate with the collaborative consultation model.

“Chronic recurrent LBP patients who do not respond to usual physician care are a particular challenge for both physicians and the health-care system and are cited as the most common reason for referrals to orthopedic surgeons and neurosurgeons. The vast majority of patients referred for specialist medical consultation receive advanced imaging – MRI – prior to the consultation. However, less than 10 per cent of patients referred by primary care physicians to spine surgeons are surgical candidates. This means that most of these MRIs were not required.
Chiropractors have a valuable role to play in effective primary care triaging of LBP patients and can reduce morbidity related to prolonged waiting times and optimize use of limited resources.”

We are turning many acute situations into chronic problems as a result of long delays for the proper care. This type of collaboration makes the best use of resources within the community.

If you have a family physician, ask your chiropractor to give you a referral letter. This letter will open communication between MD and DC, giving your physician the necessary information about your chiropractic care.
If you do not have a family physician, your chiropractor becomes a intrinsic element in your healthcare model. Having a doctorate degree and being a primary care provider, your chiropractor can help you navigate the health care system and create an open line of communication with the other health care providers on your team.
Talk to your chiropractor about how to optimize interprofessional collaboration!