Innovative program at St. Mike’s integrates chiropractic care

The St. Michael’s Hospital (SMH) and the Canadian Memorial Chiropractic College (CMCC) are collaborating on an innovative demonstration project that received over $600,000 in funding from the Ministry of Health and Long Term Care in March of 2004 through the Primary Health Care Transition Fund. The project, led by Dr. Deborah Kopansky-Giles, is the first of its kind in Canada. The project entitled – Integrating Chiropractic Health Care in a Primary Care Hospital-Based Setting – will be applying a new model of integrated care, with chiropractors on staff in the University of Toronto-teaching hospital for a period of two years. Dr. Kopansky-Giles and Dr. Igor Steiman, clinical faculty from CMCC, have been seconded for a two-year period to provide chiropractic care within the Department of Family and Community Medicine (DFCM), Inner City Health Program. The DFCM has over 40 family physicians within the hospital that will serve as the main source for patient referrals. Patients may also access care through the Positive Care Clinic (HIV/AIDS program). Staff of the hospital are able to access care through the Employee Health Unit.

The chiropractic program began delivering care in July of 2004. The program is growing quickly with over 40 new patient referrals within the first seven to eight weeks. To date there has been excellent collaboration with the physiotherapists in the Department who have been very supportive of the initiative and have participated in determining scope of practice, referral processes, and other practical practice issues. Evaluation of the model of care, including clinical outcomes, triage/referral processes, satisfaction with the services and others, are all major components of the project evaluation. Project collaborators include Dr. Howard Vernon (CMCC), Jim O’Neill (SMH), Dr. Philip Berger (SMH), Dr. Heather Boon (University of Toronto) and Maureen Kelly (SMH). Two additional studies will be flowing out of this innovative project as well over the next year.

In addition to the clinical care component of the project, an education module is being developed as part of the project. The education module will include development of a curriculum regarding evidence based chiropractic health care to be disseminated to health professionals and health science students within the hospital in a variety of ways. Dissemination of education will occur through Hospital rounds sessions, lunch and learn activities, submission of articles for internal newsletters, direct communication (individual and through committee/team meetings) and teaching students through lecture format as well as observation. The evaluation of the educational component will occur through pre and post intervention survey and interviews assessing change in knowledge level, attitudes and helpfulness of the knowledge exchanged.

For further information about the project, please contact Dr. Deborah Kopansky-Giles, Chiropractic Program, St. Michael’s Hospital, 416-867-7457 or email her at

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