Rapid Access Clinics or.RACs for low back pain are designed to support not replace a chiropractor's care. They provide patients, who qualify for the program with a timely consultation on their low back condition and related symptoms to support their self-management. In this episode, we speak with Dr. Henry Candelaria, who has been involved in Ontario's RACs since 2012. Tune in to hear Dr. Candelaria discuss why RACs matter to you, your patients, and our health ecosystem. He outlines the rewards, challenges, and what to expect from the RAC for low back pain (RAC-LBP)'s clinical roles for chiropractors. He also explains how you can advocate for your patients who may benefit from the RAC-LBP and use a new tool to help facilitate their referral.
Rapid Access Clinics or.RACs for low back pain are designed to support not replace a chiropractor's care. They provide patients, who qualify for the program with a timely consultation on their low back condition and related symptoms to support their self-management. In this episode, we speak with Dr. Henry Candelaria, who has been involved in Ontario's RACs since 2012. Tune in to hear Dr. Candelaria discuss why RACs matter to you, your patients, and our health ecosystem. He outlines the rewards, challenges, and what to expect from the RAC for low back pain (RAC-LBP)'s clinical roles for chiropractors. He also explains how you can advocate for your patients who may benefit from the RAC-LBP and use a new tool to help facilitate their referral.
Topics Covered:
Key Links to References/Resources Discussed:
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."
Episode 10: Why Rapid Access Clinics Matter to You Transcript
Introduction:
(music)
Welcome to On Spinal Chat, where we explore what O-C-A is doing or supporting, to help enhance your patient care, grow your practice, or advance the chiropractic profession.
(music)
While most patients don't require advanced imaging or specialized interventions for recurrent episodic low back pain and leg-related symptoms, Ontario's Rapid Access Clinics, or RACs, for low back pain, can support your patients, who you think require a detailed consultation to determine if they would benefit from care escalation.
The RAC for low back pain focuses on providing patients who qualify for the program with standardized assessments, best evidence education, and management recommendations or, a referral to specialized consultation or advanced testing if needed.
And chiropractors account for more than half of all clinical positions in the RACs for low back pain and also fill a number of positions in other RACs.
I'm Leslie. And today, I'm speaking with Dr. Henry Candelaria, who's a chiropractor, practice lead at Trillium Health Partners, Mississauga Halton RAC for low back pain, and also practices in Oakville, Ontario.
Dr. Candelaria has been involved in Ontario's RAC since 2012 when he participated in its predecessor, the Inter-professional Spine Assessment and Education Clinic's pilot, or ISAEC.
In this episode, Dr. Candelaria discusses why RACs matter to you, your patients, and our health ecosystem. He outlines the rewards, challenges, and what to expect from the RAC's clinical roles for chiropractors.
And he also explains how you can advocate for your patients who may benefit from the RAC for low back pain and use a new tool to help facilitate their referral. Listen to learn how RACs are evolving, how they can help you and your practice, as well as your patients.
(music)
Main Interview:
Leslie:
Thank you, Dr. Candelaria for taking the time to meet with me today.
Dr. Henry Candelaria:
Thank you so much for inviting me. Anytime I get to engage with the O-C-A is always a positive one.
Leslie:
First off, what's the purpose of the Rapid Access Clinics, or RACs, in general?
Dr. Henry Candelaria:
The RACs is the Rapid Access Clinics, in terms of the concept, is really trying to put the patient in front of the right person at the right time, to provide the right care.
And traditionally, musculoskeletal care in the health care system has been difficult, to say the least. With extensive wait times to see people, just to provide a patient with a diagnosis, and some guidance in terms of care. So the impetus for the Rapid Access Clinics really came out of that need, this idea of improving access to care for patients and avoiding having people wait for a long period of time on wait lists, just to be seen by somebody.
The hip and knee program started quite some time ago, in the 2000s at Sunnybrook and Toronto Western. And that's where the first model of this kind came to be, where there were advanced practice physiotherapists in the roles, working with orthopedic surgeons, to determine whether or not people who came in with hip and knee symptoms, really required something more invasive or involved, or if they simply required a little bit of guidance and some help with their hip and knee pain.
My role with the Rapid Access Clinics really started in 2012. When ISAEC, at the time, the Inter-professional Spine Assessment and Education Clinics, began at Western.
It was essentially, a small group of chiropractors and physiotherapists throughout the province, coming together to test out a vision, and Dr. Raj Rampersaud at Toronto Western, where he saw significant improvements that can be made in the way people are managed, who had back pain in the province. It was born out of a pilot study that was conducted in Thunder Bay, in Hamilton, and at Toronto Western Hospital, where I was affiliated.
And again, the purpose of it is to try to provide people with quick access, hence the name Quick Access Clinic, in an inter-disciplinary setting, and to provide them with a go-to place where they can get a definitive diagnosis and some definitive advice about what to do and what not to do, with respect to what they're experiencing in terms of musculoskeletal pain.
Leslie:
What is your current role in the RACs for low back pain?
Dr. Henry Candelaria:
I'm a practice lead. I oversee the program within the Mississauga Halton region. I have nine events practice providers that I work with.
On patient cases, I've played the A-P-P role, and I used to facilitate and run the support of the operations team, a chronicity prevention program during the pilot program, where it was primarily done virtually, and we were covering the problems, which was kind of neat.
Leslie:
And you've been involved with them most of your career?
Dr. Henry Candelaria:
Yeah. In 2012, I was going through a bit of a transition in my career. I was trying to find something where I felt my skill set would fit in better. And I always thought that I was good at manual therapy and that kind of thing, but there was always something missing.
And this program filled that void. I am hoping to continue to participate in it as much as I can going forward. So far, there doesn't really seem to be anything that will impede that.
Leslie:
Okay. What type of RACs are there? Was the low back pain the first one, or what was the very first you developed?
Dr. Henry Candelaria:
The model itself has been around for some time, but the R-A-Cs themselves, as they're currently defined, really began in 2018. When the provincial government decided to homogenate all these things under one umbrella, called the Rapid Access Clinics.
And there's a few different models that are currently operational. One of the two most robust programs that are out there is a low back RAC, very centralized operational team. I speak from a biased perspective, obviously, because I'm involved with the team and they're excellent.
There's also the hip and knee RAC, which does excellent work across the province. There is also a shoulder RAC, I believe it focuses on shoulder and elbow. And they're also located in multiple regions and locations across the province.
I believe, in some of the academic centers, foot and ankle has also been implemented.
And again, with full upper extremity RAC has also been something that's been proposed and discussed, in terms of involving hand and wrists. And then, of course, the neck would be the natural extension for the low back RAC, and to broaden it further beyond the low back pain to include neck and upper back.
But right now, the current RAC programs are primarily hip and knee, and low back.
They're growing, and there's more and more of them. I think the argument is very strong to have health professionals that have these skillsets within their scope, utilize their scope to the maximum of their ability and their training. The challenging piece is, as with everything, funding, and the timing of that funding.
There's been quite a bit of interest in terms of the model of care, and how to implement it in other regions in the country. There's even been international exposure that's been presented on a conference. And so, the word is out there. And I think it's just more timing and time, that will bring some of the other models of care into play.
Leslie:
You've mentioned your involvement with Toronto Western. What role do hospitals now play with RACs?
Dr. Henry Candelaria:
They're still the main hubs. The way the program is designed, it's actually quite unique, in that you're trying to decentralize expertise. Most of the expertise that comes from that care and this is arguable, but if it comes to a point where you're needing something more invasive or advanced, generally speaking, people will attend a hospital, because of the level of service and care that's provided at that location.
The impetus for the model, knowing that specifically with back pain, especially that the majority of people don't need that level of care is this idea of decentralizing care and having care offered in the community, to make it more easily accessible by patients closer to home, based on postal code. The way that the model works currently, and this is again mirrored after the pilot, is that, there's a central person, called a practice lead, at the hospital location where the hospital being the regional hub that's sponsoring the program and managing the funding, et cetera, within a specific region. And previous to the amalgamation they were referred to as LHINs [Local Health Integration Networks].
So each LHIN had bits, all rapid access clinics for low back pain. That's the decentralization model. You have a practice lead, who's a chiropractor or physiotherapist at the central hub, which is usually a hospital. And then you have chiropractors, a physiotherapist out in the community, where referrals come directly to them from primary care providers. Patients attend a community clinic, where these practitioners work in already, for a consultation, and then if needed, they're escalated to the central hub.
And as many of the listeners I'm sure know, that a very small percentage of people, about 15 per cent, need to go to that level of care. But the goal is to try to keep the patient in the community, save them having to utilize a more expensive and invasive level of care in the health care system. So, there's one model in Muskoka, where it's actually run out of a Family Heath Team. I think it's actually a really good way to leverage this program, where you can have the fullness of the program still offered at the highly specialized level, but in the community and easily accessible.
Leslie:
Do you foresee more of that type of model emerging?
Dr. Henry Candelaria:
Yeah, I think so. I think the current model is stable, but there's always room for improvement and innovative ways of improving access to care. I haven't heard anything definitively, but I would anticipate that it's probably more cost-effective to have them in community-type settings like that. It would create a little bit more nimbleness, in terms of implementation, and modification of what the program offers.
Leslie:
Sure. Now with the hospital then being the hub. Right? And then all the satellite clinics connected to it. How many clinics are there on average, for the RAC for low back pain?
Dr. Henry Candelaria:
It depends on the region and the population distribution. For example, the Northeast sub-region, or the Northwest sub-region, huge regions that encompass Northern Ontario, essentially divides Ontario in half.
The population's a bit more spread out, and so we may not have the need for as many clinics, than in our sub-region where I oversee the program, Mississauga Halton, we started with 14 different clinics, because the population density is so much.
Leslie:
Now, how do RACs for low back pain differ from other RACs?
Dr. Henry Candelaria:
So the hip and knee Rapid Access Clinic, I'll take that as an example, because they're the ones that I work closely with. Literally, we share the same office. And they're amazing. They offer people quick access to carry them and otherwise have them waiting for literally months and sometimes longer. It works well because it's very specific to a specific segment of the population of patients who have hip and knee pain. So patients who have moderate to severe osteoarthritis, and they're struggling with their rehabilitation, and need a little bit of guidance, in terms of what other elements they may be missing with respect to conservative care. And discussion about okay, well, do you need a total hip replacement or a total knee replacement? Instead of having them wait on surgeons, on a waitlist for an extended period of time for these physiotherapists, primarily, although there are chiropractors that work within the program as well, are able to guide the patient in that regard.
With low back pain, it's a little broader in terms of its capture and reach. There are specific inclusion and exclusion criteria, that are designed to make sure that we're targeting the patients that would most benefit and to keep the numbers appropriate about, we can continue to meet the metrics, et cetera. It's in that area of the body, and with associated leg symptoms, or suspected associated leg symptoms.
And the role for the clinicians is a little bit broader than what the clinician's responsibility is. There's overlap in the sense that, you provide the patients with a little bit of education on the condition, and what things to do, what to avoid, conservative measures. It takes it to the next step, where you're trying to provide the patient with a definitive diagnosis. It's a role where you're leveraging the skillset beyond your hands-on manual skills. In fact, there isn't any hands-on manual therapy that's provided to the patient. It's more consultative, diagnostic workup, the basics. That really provides the patients with a definitive diagnosis, some exercise instruction, and conservative self-management guidance.
Leslie:
It's worth listeners noting, that the RAC for low back pain is designed to provide your patients with timely consultation on their low back condition and related symptoms, to support their self-management, including any manual therapy and rehabilitation they may already be participating in. This RAC consultation can support you, or another manual therapist, or rehab provider, in managing the patient, and reinforces evidence-based recommendations.
So it's designed to support, not replace a chiropractor's care. This consultation also helps to determine if the patient requires further escalation of care, and supports interprofessional collaboration, as we'll discuss later in this episode. And what's the process for a patient to be referred to the RAC for low back pain?
Dr. Henry Candelaria:
Essentially, a person presents with low back pain. The first step is their primary care provider. And then, if they're registered with the program, then they refer directly in.
Leslie:
You mention registering in the program, what's the process for them to get registered?
Dr. Henry Candelaria:
Yeah, so it's a bit of a sticking point that we could be encountering. It's a five to seven-minute process online, where they have to register. As you go through, revisiting how back pain is managed initially, the basics of an exam, the basics of a history, red flags, that kind of thing. Answer a couple of multiple-choice questions. And then, they're provided with registration and a referral form, that's specific to that primary care provider. Then they gain referral privileges, and they're allowed to refer to the program.
Leslie:
Approximately, how many primary care providers in Ontario are currently qualified to refer to the RAC for low back pain?
Dr. Henry Candelaria:
I think we have about two-thirds to three-quarters registered within the program, which is pretty good. From everything that I've seen and read, it's really successful, because of the centralized operations team that is dedicated to ongoing engagement of the primary care team, and primary care group within the province. And just to keep it front of mind, this idea that M-S-K care needs to be improved, a pandemic has exposed that, and sort of worsened things, unfortunately, in terms of wait times. It's really the operations team, and the leads eventually, that have been able to create those successes.
Leslie:
To keep building on this success, how can chiropractors help facilitate their patients' referrals to the RAC for low back pain, and also encourage primary care providers to register, at least those who are not currently registered?
Dr. Henry Candelaria:
I was having discussions with friends of mine and the colleagues in the community that we're seeing patients, or I saw a patient of theirs in the community, and I reached out to them, and we connected via phone, et cetera. And they were asking, "I have this other patient who may also benefit from the program. How would I get them to be seen within the program?"
And that's where the idea of trying to engage these musculoskeletal experts in the community, being chiropractors and physiotherapists, who are already seeing these patients, and probably have a good idea as to what is happening with the patient, because of the frequency of contact, their expertise.
So, we were discussing as the pandemic rolls on, and how to reengage the primary care group. And one of the ways was to empower the patient, and the practitioners who are seeing them, to facilitate those types of discussions at the primary care level.
So, we put together a pseudo referral form, their target information sheet right now, where the hope is that we'll be able to educate chiropractors and physiotherapists in the province who are seeing these patients. And if they feel like the need is there for referral into the program, then they're provided with the opportunity to educate the patient and provide the patient and some information, that they can take their primary care provider, to facilitate the discussion around either registering for the program and referring, or simply referring to register.
And the question is always, "Why can't I directly refer to the program? I'm an M-S-K expert. I might want to know why I can't refer in." This program is specific to supporting primary care. Specialists can't refer into the program. They have to refer the patient back to their primary care provider to be referred back into the program.
And this form is available to be used for this exact purpose. If the practitioner feels that the patient is a candidate for this program, based on what they know about it, then they're provided that information, and the patient then being empowered and educated, goes through a primary care provider, and open for that referral.
Leslie:
Okay. Thank you. And for our listeners, if you check the show notes, you'll be able to see the links to the Rapid Access Clinic webpage, as well as webpages on the O-C-A website, where you can find this form, to help you better support your patients who are potential candidates for the RAC for low back pain.
So, I want to loop back, when we're talking about patients. How have the R-A-Cs for low back pain affected patient outcomes?
Dr. Henry Candelaria:
So, to give context, within the province, the average wait time, prior to these R-A-Cs being developed for a specialist consultation for mechanical low back pain, ranged from eight to 16 months. So, by comparison, we’re mandated to keep our rate, in terms of first contact, within four weeks. And first contact is an advanced practice provider contact in the community, a community chiropractor or physiotherapist who's affiliated with the program.
And then if the patient needs a more advanced or specialized intervention, then they're referred on to a person like myself, the practice lead in the hospital, or a more specialized type setting, and that wait is six weeks. So in total, it's still a little bit of a wait, but in the realm of musculoskeletal care, that's pretty good. And I can say that with confidence, because I still have a small private practice that I see patients in, and I've been straddling this public-private health care role for the past 10 years.
Leslie:
Now, what have you heard anecdotally from patients, about how the R-A-C for low back pain has actually affected them?
Dr. Henry Candelaria:
We have the benefit of time. We're funded in a way that allows us to spend the time necessary to provide patients with appropriate education and guidance, and they're always very grateful. And it's a super rewarding role for me. And the patients are what keeps me going within the program. And we have patient satisfaction survey results, that would reflect that, 95 to 99% satisfaction rates.
But the other thing is that it's quite integrated. If there is a need for something more specialized, then we have subspecialties that are either hospital-affiliated or not, medical subspecialties that we can make those quicker referrals to, rheumatology, physiatry, interventional injection therapy, pain programs, and that kind of thing. So it's quite encompassing, in terms of what the patient's experience is.
Leslie:
Great. Now I want to zero in on chiropractors' skillset specifically. How do our chiropractors' skillsets align with the RAC for low back pain patients’ needs?
Dr. Henry Candelaria:
The beauty of it is that these people aren't seeking out care from manual practitioners in the community, and the people that they're seeing within this program have that expertise, to begin with, just by default. Because they're usually active practicing clinicians in the community themselves. And so, they know the lingo, so to speak.
And in addition, their training gives them extensive background and preparation for the management, and the diagnosis, and workup on these patients. The beauty of our training is that we're diagnosticians. The hands-on manual work comes with practice and time. Both at whatever school you attended, and also, with time out in the community. We come out of school quite prepared, from a textbook perspective, in terms of how to diagnose a problem, and give a person some idea, in terms of what the diagnosis is. It's never been the focus of the clinical team of people who are out there in the community, providing care to patients, it's what the biomechanical analysis is. What is the source of this problem? What imbalance, et cetera, is causing this issue? But at the crux of it, you need a diagnosis. And if you have that, the other stuff will fall into place. And I think, we're really well-trained and well-positioned, to play that diagnostician role within the low back pain RAC, as well as other programs that are similar too.
Leslie:
Okay. So when they're available, what RAC for low back pain roles are available to our members, and how can they become involved?
Dr. Henry Candelaria:
Two roles within the program are this A-P-P role, or advanced practice provider role. Where you're a community provider seeing patients, usually in your own practice, or if you have access to space within a region that the regional hub was hiring within. Then that's an avenue to get engaged and participating, seeing patients within the program.
There's also this practice lead role, which is a full-time position, and you're embedded within the regional hub, seeing patients on a full-time basis, as well as operating and overseeing the implementation, and the continued growth of the program itself. So there's a bit more of an administrative role, as well as obviously, the clinical roles in it. The pandemic has kind of put a pause on things, but because of the pandemic, there's also been a few shifting roles within the programs. As the program continues to grow, there's going to be a continued need for events practice providers in the community, seeing patients across the province.
It's region specific, so usually, whatever region is hiring will target, via the Ontario Chiropractic Association and the Ontario Physiotherapy Association, posts for that region. You'll get a listing, a regional hub or a hospital, or a specific region in the province, hiring for the low back pain Rapid Access Clinic. Similar kind of thing with hip and knee and shoulder. Although, because it's a little bit more region-specific, there isn't that same centralized engagement mechanism, as there is with the low back pain. So sometimes you won't get as many postings for those positions, but LinkedIn is a very good way to find those.
Leslie:
Okay. If there's a posting for an A-P-P role, and one for a practice lead, how do our members decide which one they're better suited for?
Dr. Henry Candelaria:
My modus operandi, even when I was at C-M-C-C, was always integration to the health care system, innovative different roles, different positions, roles that would highlight our diagnostic ability, et cetera. And so, I think you got to go back to that. If that's sort of your mindset, and these interprofessional types of roles are of interest to you, then explore them.
In addition, you have to really be able to answer the question of whether or not you have the bandwidth for it. Because it is going to take you away sometimes, from the clinical role that you currently have in your private practice. But depending on the subregion, you have some flexibility and independence, in terms of when you'd book these patients. You just have these specific timelines that you'd have to meet. And so, if you have a lull on your day, if it's convenient for the patient, you can fill that time by seeing some really interesting and more complex patients. So if you enjoy clinical practice, and that element, your role as a chiropractor, the A-P-P roles would be things that I'd be looking out for.
If you're looking at taking a different step, and engaging with health care senior leadership, depending on what institution you're in, if you're looking at policy development, strategy, that level, then the P-L role offers the beauty of both worlds. About half of it is that, and about half of it is clinical care. And if you have a good sense about you, in terms of managing and overseeing and operationalizing programs, even within your private practice, the practice lead role would be something that I think you'd probably do well at.
Leslie:
Now. What's the feedback been from chiropractors who've been involved with the RAC for low back pain? Both at the A-P-P level, or is that the practice lead level?
Dr. Henry Candelaria:
I think it's been good. There's growing pains as with everything. But generally speaking, I think the opportunity to leverage a practitioner's skillset to the fullness of their ability, has been received in a very positive light, I think. There's no opportunities, that I'm aware of, that allows a chiropractor to leverage their full skillset like this, where you have an ability to manage and diagnose. You do that in private practice, but it's different.
There's been good engagement and integration, and very much well received and accepted roles for chiropractors within this program at the primary care level and beyond that. And gives us an opportunity to display our skillset that we have, and our ability to support patients with back pain.
Leslie:
What are some of the challenges, or growing pains, that chiropractors in the program might experience?
Dr. Henry Candelaria:
There's new E-M-R systems that you have to learn. There's more in the way of paperwork, where there's a certain level of documentation that's required. You're also working within the confines of a specific program, that has set limitations within it to facilitate its delivery. There's some leeway, in terms of clinical judgment. And I specifically facilitate and try to emphasize, that these people are clinicians. But there are certain funding limitations, in terms of how often we can see a person, when we can see a person, how many times we can see a person within their course of care within the program.
And again, with the lens and the emphasis that, this is a specialized program, that's trying to get a person that may otherwise be struggling with conservative care. A little bit more support, in terms of, do they need an expedited referral to a different specialist, like a rheumatologist, like a physiatrist, like an interventionist, like a surgeon? And so, it's very specific in its goal. It's not managing the patient in the full context of what you would probably do in private practice. And so, that's a bit of a switch.
Leslie:
Now with chiropractors getting that opportunity to engage at an extended level, what types of insights have they gained?
Dr. Henry Candelaria:
My core group has been the same from the beginning. And the feedback that I've gotten over the years has been that it gives a different level of confidence in their ability to manage these patients, and complex patients at that. Because you would see things again, with a different lens. The hope is that people are doing this in their private practice anyways, but it's just a different emphasis. Like one other piece, they are pulling into a person's pain experience that I have to consider and address.
And also, what other experts can I leverage to support my ability to manage this patient? We find in private practice, that's a challenge because they don't have that direct ability to refer on to somebody who can help you, and help your patient navigate that, to those options. So I think, it gives an increased sense of confidence, reaffirming their ability to manage patients who have back pain and associated conditions.
Leslie:
Sounds like it really fosters that interprofessional collaboration, much more so than if you're in private practice.
Dr. Henry Candelaria:
Yeah. It kind of puts you at the table. In private practice, your patient-centered care, your goal is to support and help that patient navigate the system. But it really puts you at the table and takes you away from that barrier, this private-public thing. I think that's something that's going to be emerging. There's going to be more discussions about public-private partnerships, et cetera. But there's this kind of shade, for lack of a better term, that comes over any time there's something private that's discussed, or a person has to pay for something. And I think that this program allows a practitioner who lives in the private health care world, to step into this public health care world without that shade.
Leslie:
Great. Is there anything else that you think our members should know about the RAC programs in general, or the RAC for low back pain specifically?
Dr. Henry Candelaria:
Keep an eye out for these, because there are people that speak your language, and that you can directly engage with, in terms of supporting the care that you're providing to your patients. And there are chiropractors that are embedded within shoulder Rapid Access Clinics, hip and knee Rapid Access Clinics, low back pain Rapid Access Clinics, that can help support you in the care that you're providing to your patients. That would be the first thing. I think that this ability to interact with colleagues is huge. And just to break down that barrier of, "Okay. Well, I'm speaking to a different professional, and I have to choose my vocabulary differently, in terms of the lingo, et cetera." Where this is an opportunity where you can speak directly to somebody who knows the lingo, and who can help support you in the care of your patients.
So, keep an eye out for opportunities where you can facilitate that kind of engagement for your patients, or empower your patient to seek out those kinds of referrals, that might support their care and your ability to care for them.
And the other thing, as we talked about, just look out for opportunities, if you're interested in it, to engage with either at the P-L level or at the A-P-P level with the low back pain program, but also with these over Rapid Access Clinics, that I anticipate are probably going to be expanding, and hope, because the value add is there. It's cost-effective. You're seeing the volume of patients. You're providing people in good care. You're deflecting away from an already overburdened central health care system.
(music)
Outro:
Leslie:
Thank you Dr. Candelaria, for giving us the inside story on Ontario's RACs, and how our members can get involved. Thanks also, for sharing your thoughts on how you see RACs evolving, and creating more opportunities for members to help Ontario patients receive appropriate care in a timely manner.
Dr. Henry Candelaria:
Thank you, as well, Leslie. Honestly, I sat on the Ontario Chiropractic Association board of directors a while back, and it was an incredible experience to see what happens in the background. So I know the amount of effort and work and time that you guys put into this, it's invaluable work.
Leslie:
We'll be back in September, with another episode of pragmatic insights and tips to help you and your practice. I hope you'll join us.