Primary Contact Spring 2018 by Canadian Memorial Chiropractic College

SPRING 2018

Winning in practice Treating chronic pain Supporting elite athletes Strengthening the community

A publication from the Canadian Memorial Chiropractic College for alumni, members and friends

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Stay Connected with CE Announcing fall and winter 2018 programs soon. Visit ce.cmcc.ca for the latest distance and in class programs.

Canadian Memorial Chiropractic College

Continuing Education

From the Chair Spring is the time of the Board’s semi-annual meeting when we gather to hear and see the new and exciting advancements made by the administration, the faculty and the students either singularly or collectively. You will see some of those success stories captured in the following pages. This year our education session included discussion of a risk scenario, sexual violence awareness training and training in governance. Our retreat in June features planning for the future, taking into account the current CMCC strategic plan. The Board Executive meets at the time of Homecoming – this year on June 1 and 2 – and we are very pleased to be able to interact with alumni at this annual event. It is wonderful to see the reunion between classmates who haven’t seen each other for years and among a cross section of the chiropractic profession. New technologies being used as part of teaching and learning are showcased during the Homecoming weekend. Our simulation laboratory where you can test your technique is always a highlight, and the Anatomage® table, added to the anatomy program this year, will have you enthralled with that subject in ways you may never have been as a student. With some new and restructured events taking place this year, it should be a fun event and I hope to see many of you there. June also brings the highlight of the year – Convocation. The Board joins the faculty as part of the platform party to watch the newest graduates cross the stage on their way to joining us in the chiropractic profession. It is always with enormous pride that I participate in Convocation, knowing that we have made an impact on the education of our future leaders. An important part of the spring Board meeting weekend is the annual Backs in Motion Walk/Run raising funds for chiropractic education, research and patient care. The Board has a friendly challenge each year to see which member can raise the most for CMCC in support of our participation in the event. Even if April is over when you read this Primary Contact you are welcome to top up the Board’s total by going to cmcc.ca/donate and enter ‘Board Run total’ in the ‘Tribute Gift’ section. Join us in supporting all that CMCC does.

Spring 2018

Volume 56 / Issue 2 02 From the President 04 CMCC News 06 Treating chronic pain 11 Backs in Motion 2018 12 Supporting Canada at Pyeongchang

18 Good news for chiropractors and practitioners of manual therapy

19 Clinic partnership appreciation awards

20 When the world comes to Plaster Rock, New Brunswick

22 Outreach Abroad in the Dominican

24 Donations

I leave you with a quote by William James, a well-known philosopher –

"The great use of life is to spend it for something that will outlast it."

27 In Memoriam

Through your support and commitment, CMCC and the chiropractic profession continue to grow stronger. With respect and appreciation,

Rahim Karim, DC MBA FCCPOR(C) CHE To contact any member of the Board, please email board@cmcc.ca.

Cover: Dr. Amy MacKinnon at the Olympic closing ceremonies

From the President Spring not only brings forth the blossoms we’ve all been waiting for after a long winter, but it also reinvigorates efforts at CMCC to maintain our leadership in chiropractic education and research.

David Wickes, DC, MA

We are in an enviable position amongst chiropractic institutions in North America with our capped enrolment and extremely high level of interest by prospective students. Unlike the majority of chiropractic programs, we’ve already closed our new student application process and completed interviewing candidates for the Class of 2022. We can only seat just under 200 students from the pool that exceeds 750 hopeful applicants. We are excited not only about this admirable ratio, but

also about the number of volunteers who came forward this year to help with the interviews. Our leadership in emerging technology was also recently showcased at the annual Association of Chiropractic College’s Research Agenda Conference, held this year in Dallas, Texas. Many of the attendees were impressed by the second generation of Force Sensing Table Technology (FSTT®) that we exhibited. What I found particularly rewarding was a joint educational workshop that featured use of the FSTT® in technique instruction at several institutions. A growing number of institutions around the world have acquired our tables to use in their technique laboratories and

Go green You can reduce your carbon footprint and read Primary Contact in a digital format (PDF) instead of receiving a paper copy. Email us at communications@cmcc.ca and we’ll make the switch for you.

"The first step towards getting somewhere is to decide that you are not going to stay where you are." J. Pierpont Morgan

we continue to provide training and to improve the tables and the associated Human Analogue Mannequins (HAM®). In our own simulation laboratory, we have upgraded the video cameras and other technology to allow higher quality slow motion imagery to provide students with feedback on their adjusting skills. Spring also brings forward a renewal of my provincial travel opportunities to visit with alumni and professional leadership across Canada. By the end of April, I’ll have been privileged to have attended the Manitoba Chiropractors Association annual meeting in Winnipeg as well as the Canadian Chiropractic Association’s national convention in Calgary. I

usually have an opportunity to host an alumni event at this type of gathering, so hopefully you will find this another reason to attend these important meetings and conferences. I’ll also be hosting a reception at the European Chiropractors’ Union meeting in Budapest this May. If you aren’t able to attend one of these meetings, then try to come to the CMCC Homecoming June 1 and 2. You don’t have to be a member of one of the anniversary classes to attend, so take advantage of this opportunity to see the great changes on campus and attend an excellent continuing education program. Our semi-annual meeting of the CMCC Board of Governors is another

event in the spring. As you know, CMCC Members in each province elect a representative to our Board. The Board of Governors is comprised of provincial representatives, public members and members-at-large, and these dedicated volunteers work hard to set the vision for our institution and closely monitor the outcomes of our strategic plan. Please take the time to thank your provincial representatives for taking time out of their busy lives to strive for the betterment of our great institution. I look forward to seeing you and interacting with you throughout the year.

CMCC News CMCC welcomes Dr. Martha Funabashi to the Division of Research in July, 2018

Dr. Funabashi completed her PhD at the University of Alberta under the supervision of Dr. Greg Kawchuk. Martha also has a Master's Degree in Neuroscience from the University of Sao Paulo – Brazil. Prior to joining CMCC, she worked as a research associate at the Collaborative Orthopaedic Research Group at the University of Alberta in conjunction with Alberta Health Services in Canada. She is also a CARL (Chiropractic Academy for Research Leadership) fellow and the lead study coordinator of SafetyNET - an international and multidisciplinary research team to support patient safety among spinal manipulative therapy (SMT) providers. Funabashi's research interests and passion are on the biomechanics of spinal manipulative therapy and its safety aspects. Funabashi recently won the New Investigator Award at the World Federation of Chiropractic Conference 2017. She has also published important papers

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in these areas and works in collaboration with emerging and well-known researchers around the world. A summary of Funabashi’s scientific contributions can be found on ResearchGate.

ACC-RAC

CMCC contributed 14 presentations and six workshops at ACC-RAC this year and showcased its FSTT® unit, capable of measuring the force of an adjustment in three different directions along the XYZ axes. Year IV students Lydia Colacino and Richelle Martins, Dr. Simon Wang, Dr. Brian Gleberzon and Dr. Carol Ann Weis presented their research.

Dr. Brian Budgell interviewed by Parker University President Dr. Bill Morgan Dr. Brian Budgell (Class of ’86), Director of CMCC’s Life Sciences

Laboratory was interviewed by Dr. Bill Morgan, President of Parker University in Dallas, Texas, in January, as part of the visiting scholar program at the university. Budgell has published several papers in the area of biomedical and health linguistics as well as a text on biomedical writing that has been translated into Chinese. Here he spoke about the lexicon of chiropractic. Watch the interview at: https://youtu.be/O8LUfFUPY5I While in Texas, Budgell and Dr. Geoff Bove (Class of '88)

participated in a discussion about the importance of the neurosciences in chiropractic and the degree to which modern science supports core chiropractic principles. Both doctors recall CMCC instructor Dr. Mike Wiles as important in fostering their interest in the basic sciences.

Dr. Tony Tibbles interviewed for the Canadian Chiropractic Guidelines Initiative

that best practices are translated into the curriculum. Tibbles spoke about CMCC clinics and initiatives as well as the Dominican Outreach initiative program and the National Advisory Committee on Opioids. The podcast is episode 11 and can be found here: www.chiropractic.ca/ guidelines-best-practice/ccgipodcasts/

“We conducted a scoping review – a very broad review of existing literature, looking at the profession internationally as reported in diverse study designs," say Mior. "After the first review of the abstracts, we excluded over 11,000 studies. We then reviewed 936 articles, gradually narrowing our focus to 328 discreet studies that met our inclusion criteria.”

Chiropractic utilization demographics

The studies, which span from 1980 – 2015, reflect the utilization rates (on the rise in Canada) the types of problems from which people are seeking relief, and a trend towards multimodal care. Brought together in this scoping review, we can also identify the profile of the most common type of patient, and the age range in which patients are most apt to seek chiropractic treatment; facts that can guide both chiropractors and associations in helping to grow the profession.

Dr. Tony Tibbles (Class of ‘90), Dean, Clinic, participated in a podcast for the Canadian Chiropractic Guidelines Initiative(CCGI) and was interviewed by CCGI knowledge brokers, Dr. Kent Stuber and Dr. Gaelan Connell. The CCGI was created to inform chiropractors of the most up to date guidelines based on current best evidence. “What the CCGI does,” says Tibbles, “is to take the latest research and give wheels to it, helping to translate the knowledge gained through research into practice through the website and podcast.” For his work on the initiative, Tibbles ensures

CMCC researchers have co-authored an important benchmark study to assess worldwide chiropractic utilization rates, patient profiles and the type of care provided. Drs. Silvano Mior (Class of ’80), Jessica Wong (Class of '10), Nir Ben Simon (Class of ‘17), a student at the time of the study, and Mrs. Deborah A. Sutton worked with Drs. Peter Belliveau (Class of ’11), André Bussières (Class of ‘91) and Simon French to review an astounding 12,000 initial abstracts in the largest study of its kind.

“It’s very useful for our professional associations’ work in understanding the growth of the profession, and how it compares internationally,” says Mior. “We found the rise in utilization rates on the rise in both the US and in Canada, but were surprised to note it is down in Australia, where it is perceived as very strong.” “Another piece of good news for Canadian chiropractors is that the lifetime utilization rate for chiropractic is 22% internationally, but between 30 and 40% in Canada.” To view the study in its entirety, visit: https://chiromt.biomedcentral.com/ articles/10.1186/s12998-017-0165-8 Note: This study was voted Best article of 2017 in the Journal of Chiropractic and Manual Therapies by the publication’s Editorial Board.

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Treating chronic pain Drs. Sean Sutton, Alex Mailis, Naomi Kupferstein and Demetry Assimakopoulos work at the Pain and Wellness Centre in Vaughan, Ontario. Originally the vision of Dr. Angela Mailis, the clinic operates under a unique model and focuses on chronic pain patients. Chiropractors play a central role in patient intake and treatment implementation. Here they share their experience treating chronic pain and working in this unique clinical set up.

Drs. Sean Sutton, Naomi Kupferstein and Alex Mailis

A vision for chronic pain treatment After graduating from CMCC, Dr. Sean Sutton (Class of ‘13), began his professional career in a performance based practice working with athletes. He had already spent time shadowing the work of Dr. Angela Mailis, a well-known pain specialist in Physical Medicine and Rehabilitation at Toronto Western Hospital who founded the Comprehensive Pain Program of the Toronto Western Hospital, University Health Network and worked in the program for 33 years. Dr. Mailis, a long term advisor to the Ministry of Health and Long-Term Care (MOHLTC) in Ontario, wanted to

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create a community based clinic based on the pillars of the Ontario Comprehensive Pain Strategy. The strategy’s foundation lies on the interdisciplinary management of chronic pain patients from a whole person perspective, addressing comorbidities, coping strategies and patient education. She found an ideal location in 2014 and approached Sutton to come to the centre as the first chiropractor, working with what would be a growing variety and number of therapists. Mailis’ care model is based on best practices and embraces traditional medical

Dr. Demetry Assimakopoulos

and complementary approaches. The philosophy of the model is to provide the patients with choices and build coping skills to improve their quality of life and capacity to function, even in the case where one hundred percent relief would not be possible. Part of her vision for the practice included a funding model that would allow access to comprehensive services in pain patients who meet certain criteria and would not otherwise have access – those who may fall through the cracks due to limited benefits or chronic issues.

She approached the Ministry of Health and Long-Term Care with a proposal to create a community based “academic pain hub” that will be connected both with the Toronto Academic Pain Medicine Institute (TAPMI), a network of five university affiliated hospitals in Toronto, and with the community at large north of 401, consisting of the regions of York, Dufferin, Durham, Simcoe and Peel (an area covering 12,000 sq. km and 3.7 million people). Her efforts were rewarded when she was successful in creating the first of such hybrid models outside of a hospital setting, earning the Pain and Wellness Centre the designation of the Demonstration Project of MOHLTC. The mandate of the Pain and Wellness Centre is to create the template after which similar community-based clinics can be created in Ontario. Part of the role of the clinic is to a) provide education to “academic learners” (undergraduate students, residents, fellows and other academic trainees), as well as to “life-long learners” (i.e., practicing clinicians), and b) generate outcomes research by tracking patient characteristics and responses to treatment.

Exercise therapy is an important part of treatment at the Pain and Wellness Centre

coaching and naturopathic medicine. CBT and mindfulness are geared towards chronic pain, stress and anxiety, and help people manage thoughts and emotions, and improve their judgement.

Chiropractors play multiple roles When patients are referred to this specialty clinic, their intake process involves consultation with the pain specialist and the chiropractor, who often becomes the point person for the patient’s evolving care. “The clinic uses a hybrid approach,” says Sutton. “The chiropractors act initially as a physician’s assistant to the pain specialist during the intake, offering expert insight from an MSK perspective.”

What is it like working with chronic pain patients? “It’s definitely humbling,” says Sutton. “I came through a performance-based setting and was working with hockey and endurance athletes while shadowing Dr. Angela Mailis, so I was exposed to another approach to treatment. Working with chronic pain forces you outside your comfort level. It’s humbling, because you want to fix everything and sometimes you can’t do that with chiropractic alone. You need to do what is best for the patient to help them be independent and go forward with life.”

If a patient qualifies, the program provides a plan of care that can include manual and exercise therapy, mindfulness based chronic pain management, cognitive behavioural therapy (CBT), massage, nutritional

"The typical clinical thought process may not do the trick and you see many things that don’t respond the way you expect them to as well as comorbidities such as depression and anxiety.”

"The chiropractors here spend more time with patients than might be typical. We must listen to everything. It’s one thing to deal with injury and it’s another to manage all the other challenges and take a holistic approach. Often not just straightforward back pain is the problem - underlying psychosocial issues and complicated pain responses can come to the forefront. There can even be maladaptive neuroplasticity (a term we use to indicate changes in the Central Nervous System that are not useful, hence the term “maladaptive”), for example, causing an inappropriate response to a sense of threat, much like a car alarm going off because the car is lightly brushed. Sometimes a light brush or a tap can cause just such a response in an individual. And issues like sleep deprivation augment pain. Pain is a perception of a threat and doesn’t live in a particular place.” How is this model different? “It can be hard when things don’t always go the way you were taught they should,” says Dr. Alex Mailis

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(Class of ‘15). “You must depend on other team members. It’s really important to reach out to the other providers who work with the same patient. After mindfulness practice, for example, we may find the tissues are much easier to work with as the patient has begun to relax. There is a huge psychological aspect to chronic pain.” “Another difference between this and a typical practice is that you must be present and listen well for long sessions," says Sutton. "That could mean between 45 to 60 minutes of active listening while treating the patient at the same time. The time is needed to ensure progress is being made and goals are being met in terms of improving function. Sometimes it isn’t about eliminating the pain because it is chronic. In those cases, our goal becomes more holistic so that we can help the individual become more independent and functional. A typical clinical experience elsewhere doesn’t include the goal setting.” “We often find that patients know little about their diagnosis and what they can expect as an outcome of treatment – what is realistic for them,” he continues. “Patient education is a huge part of what we do to help people become more knowledgeable about what they can expect so they can feel more in control.” “For example,” continues Sutton, “with a car accident, a patient may stop doing everything and become deconditioned which then creates a spiral effect. It’s not something that is often understood or documented in many cases. We have to look at building capacity.” “We show them what they can do,” says Dr. Naomi Kupferstein (Class of ‘12). “We spend a good amount of time showing patients what they can

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do currently by pushing them to their limits to improve their function, with almost half of the session time spent in the gym. We have to physically challenge them, enable them, let them know they can move and help to coach them to do so. It can make tighter relationships with patients.”

challenging for all chiropractors is understanding where your job begins and ends, where you can intervene and facilitate change and where another practitioner needs to take over. At times it requires recognizing that you may not be able to treat the patient at all.”

“It is also important that people are ready to make the changes,” says Mailis. “Patients must meet us half way.”

“In general, it takes patience and a more advanced diagnostic skill set since the findings can be so variable. One also needs to understand how the nervous system works functionally in the context of chronic pain. I’ve had my fair share of successes and failures, and that has been the best teacher for me.”

"The practitioners here focus on improving function and quality of life. Achieving these goals in most cases will result in pain reduction as well and life can go on even when the pain is not fully relieved," continues Mailis. "We can’t always achieve a perfect outcome and a number of treatments have to come together to help the patients cope. “We’re not here to play god. We need to lower our expectations and make an impact on their lives,” adds Kupferstein.

Dr. Demetry Assimakopoulos began his professional career as a clinical coordinator at the University Health Network (UHN) Toronto Rehabilitation Institute (formerly located at Toronto Western Hospital) Comprehensive Integrated Pain Program under the leadership of Dr. Angela Mailis. He was the first chiropractor to join the program as practice leader, and today is the most recent clinical addition to the Pain and Wellness Centre, continuing to work at the hospital program on a part-time basis. What draws him to working with chronic pain? “Chronic pain demands patience from both the patient and the practitioner, says Assimakopoulos (Class of ‘12). “What seems most

A different approach “Empowering chronic pain patients to control the pain when possible is most important. Second is taking an active approach — and it’s not a distant second. Most of our patient encounters are spent in the gym performing some form of active care. We actually spend very little time providing passive therapies.” “It takes a lot of skill development and understanding of what a patient needs. The approach from one patient to another might be very different based on what the patient feels he or she can achieve. There are some patients who refuse to be actively involved in their care, for fear of more pain. The practitioner must tailor their approach to care to the individual patient, and gradually reintroduce movements to unwind a sensitive nervous system.” “Beginning work at the clinic has been a real adjustment for me personally. At Toronto Western Hospital – now Toronto Rehab, I have been on the diagnostic side. Now I am assessing and treating chronic pain on a full-time basis. Treating chronic pain takes longer to facilitate change. A clinician must temper their own expectations while

looking for specific outcomes. At PWC, we may spend a lot of time on counselling and active care, to encourage improvement. Treatment outcomes can be less dependent on what we can do and more about what the patient can do to sustain their own wellbeing. That is a paradigm shift for practitioners and patients alike.” The rewards “That being said, helping a patient achieve success can be extremely rewarding,” continues Assimakopoulos. “There is nothing better than having a patient reduce their reliance on medication because they are able to self-manage their symptoms. I recently had a patient with an undiagnosed painful arthritic condition of the left foot alongside pain on the entire left side of her body. She could barely move without pain. We had tried manual therapy and acupuncture with no results. We worked together very slowly in a goal-oriented fashion in the gym, and she progressively developed her ability to move with less pain. After several weeks, her diffuse body pain significantly improved – all that was left was her left foot pain from her pre-exiting rheumatological condition. She had been in pain a very long time and was now able to get a substantial piece of her life back. It was a great feeling.” “We operate in an interdisciplinary fashion at the Pain and Wellness Centre. The key is to continuously communicate with each other and deliver a consistent message to the patient. It’s amazing to work with such a great squad of people working towards the same goal.”

The trouble treating chronic pain: Dr. Demetry Assimakopoulos discusses maladaptive neuroplasticity

Perhaps one of the pieces in the challenge to define and treat chronic pain is maladaptive neuroplasticity. Entire courses are taught on this and it isn’t completely understood, so we can’t define it here, but with his experience working at the hospital setting Assimakopoulos has had the resources and experiences to examine this phenomenon. He explains it like this: Pain is experienced at the site of an injury. However, the neurophysiological reasons for that pain experience are far more complicated. Peripheral receptors (specifically termed nociceptors, or colloquially danger receptors) encode noxious stimuli and transmit information above a certain threshold of stimulation to

the central nervous system. When the CNS receives this information, it decides whether one needs protection. If the context and intensity are such that the brain decides you require protection, an output of pain is produced by the CNS to change one’s behaviour. If the context is different, or the intensity of noxious stimulation too low, an output of pain is not produced. This is because the central nervous system decides that the stimulation is not threatening enough to require attention and protection. The core theme is that pain is an experience mediated by a series of complex neurophysiological phenomena. Pain is not an input from our environment; nociception

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is. It is the interpretation of nociceptive inputs that translate to the experience of pain. Here is an example: many of us have played sports or worked in a garden. Once the activity is over, we may later discover a bruise or scratch that we were previously unaware of. In this example, a noxious stimulation, the scratch or bruise, was detected by our nervous system at the time of injury. However, the central nervous system decided that the incoming stimulus required neither attention nor behavioural change. These scratches or bruises are often noticed serendipitously after the fact, without experiencing pain. In such cases, the nervous system filters out unimportant information even if they are noxious because they do not warrant a response. A host of reactions occur throughout the central nervous system to mediate these responses. If the context is different (i.e., current or past injury to the scratched or

bruised area) and combined with stimulation that is sufficient enough to activate peripheral nociceptors, an output of pain from the CNS will occur. Pain is an experience that we have evolved to protect us from actual or perceived harm. Our perception, biases, past experiences, thoughts, beliefs, expectations and the context of the injury, change the way pain is experienced. Oneâ&#x20AC;&#x2122;s threshold for a painful experience changes in the context of chronic pain. Previously nonnoxious inputs are interpreted as threatening, and as such, an output of pain is produced more easily or continuously. Several neurophysiological adaptations occur at multiple levels of the nervous system to facilitate this. Initially, these adaptations may be necessary to protect the body from further harm. However, after a certain amount of time, these adaptations become maladaptive. Interdisciplinary chronic pain management aims to re-wire this

maladaptive neuroplasticity. Psychosocial comorbidities such as depression, anxiety and failure to adjust to a life stressor create additional barriers to patient recovery. These psychosocial comorbidities are often the most important clinical targets in chronic pain management, as they have a more robust association with disability and pain intensity than physical variables such as the extent of trauma or imaging. These psychosocial comorbidities require co-management with other healthcare providers. Patient recovery is often due to a combination of efforts from an interdisciplinary team. The idea that pain is not an input, but is a response to actual or potential tissue damage, really changed my idea about what pain is and how it should be treated. Chronic pain is something that every chiropractor must treat or manage. We can provide superior treatment if we understand the mechanisms with which painful conditions exist.

Dr. Carol Cancelliere appointed Project Lead, CCGI Congratulations to Dr. Carol Cancelliere (Class of â&#x20AC;&#x2122;04), appointed to the position of Canadian Chiropractic Guideline Initiative (CCGI) Project Lead May 1, 2018. A clinical epidemiologist, Cancelliere comes to the position from the UOIT-CMCC Centre for Disability Prevention and Rehabilitation, responsible for the Common Traffic Injury Guideline for the Ministry

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of Finance and Financial Services Commission of Ontario. She completed a Masters of Public Health degree at Lakehead University in 2011 and earned a PhD in Clinical Epidemiology and Health Care Research from the University of Toronto in 2017, supervised by J. David Cassidy, PhD, DrMedSc, where she investigated the incidence and prognosis of post-

traumatic headache in adults. She has also been a member of the Board of Directors of the OCA from 2009-18 and served as chair of the research committee, chair of the finance and audit committee, treasurer, and vicechair of the board. Dr. Cancelliere will carry out her work at the CCGI as CCRF Research Chair of Knowledge Translation in the Faculty of Health Sciences at UOIT.

Backs in Motion 2018

A week after an ice storm hit Toronto, and just four days after snowflakes were still falling in the city, the 35th annual Backs in Motion run/walk took place on a gorgeous spring day on Sunday, April 22, 2018. This year, mother nature was on CMCCâ&#x20AC;&#x2122;s side. For the first time ever the event was held entirely on the Don Trail and Duncan Creek Trails, both located in the parkland area that surrounds the campus. In spite of the cold weather before race day, attendance remained strong, as 325 runners and walkers came out for the event, along with 16 very good dogs. The fastest man in the 10 km race was Thomas Coughler (Year I) with a blistering time of 31:28, followed by Lucas Wilson at 37:20 and Kyle Morand (Year III) at 39:11.

The top three fastest women at 10 km were Carrie Snaychuk (Year II) finishing at 42:01, Kodi Morgan at 43:00 even, and Sefrah Daviduck (Year I) not far behind at 43:33.

Were it not for their, assistance the event would not have been possible.

In the 5 km race, the top three men were Stuart Macpherson (Year II) at 16:22, followed close behind by both Jake Coasineau at 16:33, and Ethan Pentland at 16:56.

Bronze: The Orthotic Group, Impact Cleaning Services, Ultimate Glucosamine and RBC

The top three fastest women in the distance were Hannah Woodhouse at 17:07, Zoe Webster at 20:08 and Catrien Kramer at 20:26. A special thanks to the City of Toronto Parks, Forestry and Recreation Division who helped clear branches and debris that littered the path following the storms over the preceding week.

Thank you to our sponsors

Run Kit Sponsors: Core Products International Inc., Ultimate Glucosamine Official Supplier: Trainers Choice, Running Free Media Sponsor: Canadian Chiropractor Student Challenge Prize Sponsor: Riddle Room

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Supporting Canada at Pyeongchang Performance optimization and athlete care is a passion for many chiropractors. Here Drs. Michelle Laframboise, Clark Konczak and Amy MacKinnon share their experiences as part of an elite athletes' support team.

Freestyle Olympic gold medalist (2014) Dara Howell

Michelle Laframboise Treating 2014 Olympic Gold medalist Dara Howell – Slopestyle Skiier With a background in alpine skiing, Dr. Michelle Laframboise (Class of '10) has been in a good position to treat freestyle Olympic gold medalist skier Dara Howell for the past seven years. Laframboise is a sports chiropractor and co-owner of Orillia Sports Medicine. She shares the practice with husband Dr. Lucas Laframboise and friend Dr. Jason Porr, who also went through the sports fellowship program with her at CMCC. Dara has been treated for her injuries and training with her strength and conditioning coach throughout the 2017/2018 season at Orillia Sports Medicine.

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“Dara has worked hard this past year to get back up to the top. I have been supporting her throughout her season with performance enhancement techniques – soft tissue management (ART® and IASTM), dry needling, electrostimulation, spinal manipulation and active rehabilitation.” Back in December 2017 Laframboise had the pleasure to travel with Howell to Breckenridge Colorado for the Dew Tour, a world cup event and qualifying event for the 2018 Olympic Games in Pyeongchang, Korea. “The Dew Tour is a professional freestyle skiing event that includes slopestyle skiing, slopestyle snowboarding and superpipe for

both snowboarding and skiing,” says Laframboise. Unable to travel to Pyeongchang this year, Laframboise was pleased to leave Howell in the excellent care of Dr. Clark Konczak, a sports chiropractor with the health services team for Freestyle Canada. Also, part of the Dew Tour medical team, the two sports chiropractors were able to get acquainted and Laframboise was able to share her treatment protocol approaches for Howell with Konczak. “Collaborative care for athletes is what really helps increase their performance,” says Laframboise “Although I wasn’t part of the core national freestyle team, I was made to feel extremely welcome

and able to work very collaboratively with Dr. Konczak and Dr. Francis Fontaine (Sports Medicine Physician for the National Freestyle Ski Team) throughout the season,” says Laframboise. “Dara’s national coaches, Toben Sutherland and JF Cusson, have opened lines of communication with me during the season on and off the hill making for easy patient management and rapid access to health care services,” continued Laframboise. A turn on the slopes At Pyeongchang, somewhat unusually, both qualifying and finals for the slopestyle ski event were on the same day. “After a hard fall off a rail on her first run, Howell gave a strong second run, but lost a ski doing her last trick, leaving her unable to finish the contest,” says Laframboise, “but she was relieved of the pressure of her past gold, and able to enjoy the games afterwards.” Howell finished the season on a high, with a gold medal at the last world cup event of the season, the Quebec Big Air competition. What comes next? With the 2017/2018 season behind her, Howell will now sit down with Laframboise and the rest of her support team to draw up her short and long term goals for the next four years with the ultimate plan of competing in the 2022 Winter Games in Beijing, China. “She has lots of work to do in a short off season but she is up for the task and excited to see what 2019 will bring.” says Laframboise. Elite athletes have a support team behind them. “We will draw up goals

"...though we were only 30 km away from the North Korean border, there was no indication of anything unusual. The blatantly obvious concerns were not even a discussion. The Olympics is really a kind of bubble where sports trumps politics.” Dr. Clark Konczak

for the summer,” says Laframboise, “which will include working with certified strength and conditioning coaches and athletic therapists here in Orillia as well as meeting with the national trainer for Freestyle Canada, who resides in Vancouver. Dara’s really looking forward to working with the provincial coaches again and her team here, which includes me as her sports chiropractor, a sports psychologist, personal trainer/strength coach, athletic therapist, her parents and close friends.” Clark Konczak Dr. Konczak (UWS '97) is a chiropractor with the Health Services Team for Freestyle Canada which created a system of regional representation for its athletes, ensuring they have the medical care and manual therapy required during competitions

Top: Dr. Michelle Laframboise and Olympian Dara Howell Bottom: Dr. Clark Konczak, Dr. Michelle Laframboise and Tobin Sutherland, Slopestyle National Team Head Coach

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stood out to Konczak and that was the different ways different sports were treated. “You can become very specialized when you treat the same kind of athlete over a period of time. Since the Olympic treating area is an open room, you may have a bobsled athlete on one side and a slopestyle skier on another. What becomes apparent very quickly is that these sports have different effects on the body and require different skillsets. For example, a bobsled treatment can be much more aggressive than what a slopestyle skier might require because of the different demands of the sports. Specialized chiropractors can also become impressively quick at treating athletes in their sports.”

Dr. Amy MacKinnon treating Melissa Lotholz, brakeman for the women's Canadian World Cup and Olympic Team

across Canada and abroad. As the western representative, Konczak does a large portion of the international travel, balancing it with his family practice in Victoria, BC, by relying on “a great treating partner, Dr. Phillipa Carrie," who looks after his local patients while he is away. “I’ve been travelling for about 11 years. I chose a sport I was deeply interested in, for the pure enjoyment of watching it, and over the years it has translated into me working with teams that wanted to work with me." At Pyeongchang, his primary role was that of chiropractor for Freestyle Canada and secondarily for snowboarding. A veteran of elite competitions, Konczak found the Pyeongchang Olympics well organized and said that the Canadian Team felt at home. “The proximity to venues was good, at most we were 45 minutes away. The

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athletes seemed well prepared. There wasn’t a lot of stage fright and they were able to enjoy the experience." “The biggest challenge was the cold and a tough wind. It was one of the windiest scenarios the team had experienced and Alpine Canada struggled because of it.” One of the many highlights of Pyeongchang was seeing the athletes he has been working with succeed. In some sports, such as with moguls and aerials, certain athletes are dominant. With judged sports, such as slopestyle, if the judges don’t like your style, even if it’s a skier’s best day, they may not win, so it’s a real question as to who will come out on top. For these reasons, it was a thrill to see Alex Beaulieu-Marchand take the bronze.“ Treating at Pyeongchang It terms of treatment, one thing

After the Olympics – what’s next “Some of the junior athletes,” says Konczak, “will leave the Olympics and jump right back in to competition or preparing for competition. Others will return home to rest and recover and visit their chiropractors to treat potential injuries. It used to be that athletes were less apt to return home for any type of treatment and would wait until their next competition for treatment there, but that is a shift I’ve seen. They are beginning to understand that sporadic treatment is not enough. Another shift has been that a greater number of athletes are using chiropractors as their primary care provider. That’s a change over the last few years.” One interesting side note, he says, is that though they were close to the North Korean border by a mere 30 kilometres, there was no indication of anything unusual. “The blatantly obvious concerns were not even a discussion. The Olympics is really a kind of bubble where sports trumps politics.”

Amy MacKinnon Dr. Amy MacKinnon (Class of '14) considered it an honour to work with the Olympic team members and was excited to watch all of the teams compete. However, she says, the work behind the scenes was even more exciting – “the sweat, blood, tears, treatment, nutritional counselling, coaching and training that is invested in each athlete.” “I really enjoyed meeting the therapists from other sport disciplines along with the amazing medical staff provided by the Canadian Olympic Committee. It felt like a giant, Canadian family working together to aid in the ultimate Olympic goal of performance.” MacKinnon became involved with Bobsleigh Canada Skeleton (BCS) in January 2017. “The clinic I worked at during that time was owned by Dr. Greg Uchacz (Palmer '92) who had worked with sliding sports for years and graciously put my name forth for the opportunity. After the 2016/17 season was over, BCS asked me to provide track side therapy during the off season in Calgary, AB at the Canadian Sport Institute. I then worked with them for the 2017/18 World Cup season spending 12 weeks on the road in Canada, Germany, Switzerland, Austria and finally in South Korea for the Olympic Winter Games.” The team behind the team MacKinnon views the Olympics as a great representation of how she envisions the best care for everyone, with a range of therapists working together towards a common purpose. “It is so incredibly important to work with multiple professionals in all disciplines to determine the appropriate support which we

provide these athletes to facilitate performance. A chiropractic adjustment, intramuscular stimulation, active release …these therapy tools are all important, but what’s more imperative is finding what combination of therapy tools works best for each athlete.” The integrated Sport Therapy Team for BCS included MacKinnon as chiropractor, a physiotherapist and a massage therapist. Together they worked with coaching and high performance staff to ensure they too were up to date on athlete health. They were also in contact with their sports medicine doctor in Calgary, who could provide assistance when required. Additionally, the Canadian Olympic Committee provided them with an incredible sports medicine doctor who was present for all of their training and saw the athletes for medical issues. The physics of bobsleigh and skeleton Bobsleigh and skeleton athletes transfer tremendous speed and force into the sled in the first few seconds of a run before loading. If any mechanical dysfunctions are present, repetition of this action leads to acute and chronic overuse issues. But that only accounts for the time spent before these powerful athletes get into a bobsled or on a skeleton sled - about five seconds. “Depending on the track,” says MacKinnon, “they still have to endure an additional 45 to 55 seconds of high gravitational forces entering their bodies riding down the track. These sleds can reach speeds up to 154 km/h and are accompanied by the excessive gravitational forces that prove incredibly taxing on the human body. I had the privilege of riding in a four-man bobsled with Chris Spring (pilot) back in September

Olympic bobsleigh champion (2018) Justin Kripps with Dr. Amy MacKinnon

2017 at the Canada Olympic Park to experience these incredible forces first hand. I have a tremendous about of respect for these athletes and their sport.” “Bobsleigh Canada Skeleton did very well at the Olympics,” continues MacKinnon. “It is important to note that Canada fielded the maximum number of athletes and sleds for both bobsleigh and skeleton! Three men’s skeleton athletes, three women’s skeleton athletes, three women’s bobsleds, three twoman bobsleds and three four-man bobsleds.” Congratulations to the team. Canada won gold in the men’s two-man bobsleigh category with Justin Kripps and Alex Kopacz and bronze in the women’s bobsleigh category with Kaillie Humphries and Phylicia George and had many more outstanding runs in what many considered an unforgettable season.

SPRING 2018

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Good news for chiropractors and practitioners of manual therapy Care pathways for traffic injury management in Ontario

For the first time, chiropractors and insurers can turn to evidence-based pathways to treat patients suffering common injuries sustained in motor vehicle accidents (MVA), reducing the confusion and conflicting practices that can increase the frustration for patient, practitioner and insurer. “The purpose of these pathways is to provide effective treatments and improve patient outcomes,” say Dr. Pierre Côté, the Director of the UOIT-CMCC Centre for Disability Prevention and Rehabilitation (CDPR), which houses the research team responsible for the intense literature review that led to the recommendations for best practice outcomes for patients following minor traffic injuries. “One can immediately see the relevance for chiropractors who now have evidence-based best practice guidelines to assist their patients in achieving successful outcomes.”

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On April 14, CMCC, along with the University of Ontario Institute of Technology (UOIT) and CDPR, presented part one of Care Pathways for Traffic Injury Management in Ontario, a live presentation by Côté and fellow researchers to a full house of chiropractors, insurers and other health care professionals in what was considered a “lively afternoon.” “The research demonstrated that chiropractic treatment was clearly beneficial in treating motor vehicle injuries,” says Dr. Tony Tibbles, CMCC’s Dean, Clinics. “It also made recommendations for the frequency of treatment to maximize outcomes. We are learning that potentially, fewer treatments can lead to the optimal outcome, but that there may be a role for the patient to engage in greater self-management, which is something we as chiropractors can teach them.” Several CMCC clinicians attended the presentation

in order to ensure best practice is integrated into the curriculum as it is rolled out to the profession at large. Among the presenters was Keshina Moodley, a former claims adjuster who is currently studying for her Master’s in Health Sciences at UOIT and is supervised by Côté. Moodley’s insight into the struggle felt by many claims adjusters in determining coverage, was also an enlightening presentation, and helps to build a pathway between two traditionally diverse frames of reference. Part Two was presented in a series of webinars. Both Part One and Part Two will be available in one bundled package, entitled Care Pathways for Traffic Injury Management in Ontario for purchase and online viewing by June 1, 2018. To learn more about the presenters and to purchase the package, please visit https://ce.cmcc.ca.

Clinic partnership appreciation awards

Dr. Tony Tibbles, Ms. Margaret Black and Dr. Phil Decina

The CMCC Clinic honoured partnerships and employees who make a significant contribution to their communities through patient care, research, innovation, student mentoring and advancing the profession, during a reception held at CMCC April 5. Eight awards were presented to outstanding individuals and groups, within the following categories: Award: Community Partners in Action – Making a Difference in the community, education and health Honoree: Margaret Black, representative of Toronto’s Tri-Congregational Church Award: Clinical Research Honoree: Dr. Joyce Lee, Clinical Research Coordinator for CMCC Clinics Award: Excellence in Patient Care Honoree: Dr. Matthew Barrigar,

Drs. Tony Tibbles and Joyce Lee

Clinician, CMCC's chiropractic clinic at Anishnawbe Health Toronto Award: Professional Advancement Recognizing those who are improving the public perception and appreciation of the chiropractic profession Honoree: Dr. Carlo Ammendolia, Director of the Chiropractic Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases at St. Michael's Hospital, CMCC Adjunct Faculty Award: Joint Advocacy – providing treatment to underserviced communities Honoree: Mike Twamley, Director, Philanthropy & Communications Toronto People With AIDS Foundation (PWA) Award: Vision Appreciation – Recognizing those who are forward thinking in their inclusion

Ms. Hazelle Palmer and Dr. Phil Decina

of chiropractic services and integration into collaborative care environments Honoree: Hazelle Palmer, CEO Sherbourne Health Centre Award: Leadership: Demonstrating leadership in advancing knowledge within the chiropractic profession Honoree: Dr. André Bussières, holds the Canadian Chiropractic Research Foundation (CCRF) Professorship in Rehabilitation Epidemiology (McGill University). Award: Career Development: Promoting career advancement opportunities in the chiropractic profession Honoree: Dr. Peter Kim, Director, CMCC Development and Clinic Advancement Award: Innovation and Technology: Supporting chiropractic education through the use of technology Honoree: CMCC Division of IT

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When the world comes to Plaster Rock, New Brunswick

Toronto chiropractor Dr. Sue DeWolfe (Class of ’91) calls it "The best thing she’s ever done.” She's talking about a four day outreach during where sleep is minimal, but fun, community and friendship are maximized. The World Pond Hockey Championships grew from a dream – over beer – when Plaster Rock NB local Danny Braun sat down with Tom Chamberlain and the Village Council to commiserate the loss of the town’s old arena (built in the ‘60s) and to discuss ways they could generate the revenue to rebuild it. Pond Hockey was the idea – and it caught. At the time, with no

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other pond hockey tournaments in existence, they called it the World Pond Hockey Championships and set it up as a four on four tournament, with the practical considerations that a team could fit inside a car “or squeeze into one hotel room if they had to,” says Braun. Since its first year in 2002, the championship has grown to include international teams. “I’ve seen teams from England, Bermuda, Puerto Rico, even Egypt. Almost all of them have a connection to New Brunswick and yearn to reconnect,” says DeWolfe, whose father grew up in the village and who still has family in the area who also volunteer. DeWolfe has

been volunteering to treat the players since 2007. “Plaster Rock has a great hospital but there was no one onsite to address the players’ sports injuries. I especially wanted to help the players who had travelled great distances at their own expense to participate. Plaster Rock, situated in the Tobique River Valley, is not an easy place to get to. The nearest airports are in Fredericton or Maine, followed by a two hour drive, in February’s normally challenging weather. I set up a small clinic and when the players realized I was available to help them, I started to get busy.” Braun says the town’s population doubles and may even triple during the Championships. Hotels fill

Left to right: Drs. Andrew Cardenas, Susan DeWolfe, Allyshia Daley and Matt Cochran

quickly and some guests stay with residents. The Championships have grown from the initial 40 teams to 120 teams. “It exploded in 2005 during the NHL lockout, says Braun, “when reporters from the Globe and Mail, the Boston Globe, New York Times, Time Magazine and Sports Illustrated showed up to get their hockey fix.” The popularity of the Championships has allowed Plaster Rock to build their new community arena and has led to several copycat tournaments, one of which is in the Czech Republic, which sent four teams to the World Pond Hockey Championships this past February. One of these teams won the Championship and will be invited back in 2019 to defend the title. Winners also receive small wooden replicas of the “Goodwill Cup” and championship rings for each player. As much as DeWolfe loves the event, she is also happy to showcase chiropractic as an

The winners of this year's championships returning to the Czech Republic

“It exploded in 2005 during the NHL lockout when reporters from the Globe and Mail, the Boston Globe, New York Times, Time Magazine and Sports Illustrated showed up to get their hockey fix.” Danny Braun effective treatment for sports injuries. As the event has continued to grow, DeWolfe has sought additional volunteers to help treat the players. She began by contacting Dr. Brian Seaman (Class of ’82) who put her in touch with Dr. Matt Cochran (Class of ’09), who began to volunteer. Later, she contacted Mohammed El-Bayou, former Executive Director of the New Brunswick Chiropractic Association who helped her connect with Dr. Kelly Spencer (Class of ’88) and Dr. Mike Cochran (Class of ’10) who joined his brother Matt, in volunteering. Soon after, the secret was out. By 2018, there were six volunteer chiropractors, including the present Executive Director of the NB Chiropractors Association, Dr. Frances LeBlanc (Class of '10).

Drs. Andrew Cardenas (Class of ’17), Alaysha Daley (Class of ’17) and John Neal (Class of ’16) all came out in 2018, with Doris Rees Lipscombe, to assist them in keeping track of consent forms. “It’s such a great group,” says DeWolfe, who considers the event her winter vacation. “Everyone who volunteers is blown away by the experience.” “It’s one of the most special events I’ve ever been to,” says DeWolfe – “you work so hard – and so many friendships are made. It’s like a homecoming.” Anyone interested in volunteering with Dr. Dewolfe may contact her via email at Susan@ CoreFocusHealth.com

SPRING 2018

Outreach Abroad in the Dominican

Back row: Dr. Ramon Lopez, Taylor Bonner, Marc Bijman, William Giancoulas with team translators Middle row: Dr. Les Wiltshire, Meghan Adams, Carissa Dupuis, Myla Nguyen, Kaitlyn Szabo, Alena Russo, Christine Klatt, Nardine Bekhit, Dr. Pat Tavares, Richelle Martins and Kirstyn Ross Front row: team translators

On April 3, 12 CMCC interns left for one of the most challenging and rewarding events of their education to date – an outreach to care for patients who live in the rural Dominican Republic with clinicians Drs. Patricia Tavares and Les Wiltshire. CMCC coordinates the trip with Dr. Ramon Lopez, founder of the charity Fundacion Sol Naciente, Santo Domingo, who manages the group’s itinerary, accommodations, meals and security. The outreach group sees individuals from among the most impoverished areas in the Dominican Republic, many of whom have not had previous experience with health care providers as many cannot afford the private health care system or quality tests/imaging. “This year, we stayed further away from the border from Haiti,” says Tavares. Every year the group tries

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to see people who have not had a previous opportunity for treatment. This year, their base was in San Francisco de Macorix, and from there the group travelled as far north as Puerta Plata and as far south as Santo Domingo, which has often been their base in the past. “I estimate that I saw between 70 to 80 patients during the trip,” says William Giancoulas. “My intake process became very efficient. The clinicians,” he says, “were really gifted and each taught us different ways of looking at various patient presentations. It was so interesting.” The lack of health care resources means they often encounter individuals in need of care and intervention. During this trip, Giancoulas was performing a patient intake with Tavares when

they spotted a man who appeared unconscious as he waited for assessment. “Out of the corner of my eye, I saw what may have been a mild seizure,” says Giancoulas. Tavares, alerted by his presentation, approached the man. “He was in a wheelchair, but I was alerted by his posture – his arms were out and his eyes were not tracking movement.” After finding him without a pulse, Tavares asked intern Marc Bijman to second her assessment, after which they moved him quickly to a treatment table where Giancoulas began to perform CPR while she grabbed a ziploc bag to use as a mouthguard and began mouth-tomouth resuscitation. “I had just refreshed my First Aid training, says Giancoulas. “I did about six compressions when his arm moved

up to mine and we recognized that he had regained consciousness. Shortly afterwards paramedics showed up to continue care and transport the man to a hospital.” Although they were unable to follow up on the gentleman’s status, they understood that they had made a crucial intervention that would enable him to receive follow up care. Although alarming, this kind of encounter with someone in need of urgent care is not isolated. The health care system in the Dominican Republic is excellent for those with health care coverage, but for many of the poor, it is inaccessible. Tavares recounted finding a woman with systolic blood pressure over 200 and diastolic over 100 and noted that it was not uncommon for individuals to have extremely high blood pressure due in part perhaps to the diet and

sedentary lifestyle associated with living in a hot country. “It was sobering to understand their day to day struggles in comparison to what we see in Canada,” says Giancoulas. Meeting challenges and providing such aid through diagnosis, intervention and the simple ability to provide an adjustment to bring relief to a patient who may not otherwise have an opportunity for care, is the incentive behind CMCC’s program with the Dominican. The sheer volume of patients and the variety of issues gives CMCC interns extremely valuable experience and confidence. Christine Klatt says she really hit her stride when she could speak enough Spanish to communicate

in basic terms with her patients and says like the other interns, she became very comfortable adjusting during her time away. Many of her patients were cleaners, she says, so she was able to gain experience treating low back pain, knee and even elbow joints. When she returned to her internship at CMCC’s clinic at Anishnawbe, her clinical supervisor Dr. Matthew Barrigar easily noted the benefit the outreach had brought to her level of confidence and ease in treating. “I felt like I had four clinical internships rather than just two,” says Klatt, who is referring to the fact that she was able to learn from Drs. Tavares and Wiltshire in addition to her two regular internships at CMCC. “I would definitely do something like this again.”

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In Memoriam

Dr. George Edwin Mann Class of ’51

Dr. Kenneth Oldaker Class of ’75

Dr. Allen Warren Rahn Class of ’70

Dr. D. Verne Thomson Class of ’54

Dr. Dennis R. Walton Class of ’68

Dr. Jeremy Wertman Class of ’08

CMCC is grateful to its supporters who have thought to include a donation to CMCC in recognition of the passing of their loved one. Memorial cards are available through Donation Services at 416 482 2340 ext. 194.

SPRING 2018

Thank you for helping CMCC and ultimately the chiropractic profession! Hereâ&#x20AC;&#x2122;s how your support is making a difference.

Spring 2018 Volume 56 / Issue 2 Primary Contact is published three times a year by the Division of Marketing and Communications at CMCC. Your opinions, comments, and input are important to us. Do you have suggestions for topics we can cover? Phone: 416 482 2340 ext. 217 Fax: 416 482 3629 communications@cmcc.ca Other frequently requested email addresses: admissions@cmcc.ca alumni@cmcc.ca board@cmcc.ca development@cmcc.ca govclub@cmcc.ca membership@cmcc.ca president@cmcc.ca Executive Editor: Shannon Clark

State of the Art Technology Anatomage Tables Having this revolutionary 3D technology teaching tool available enables our students to have an increased ability to learn and more easily understand anatomy. These tables also enhance the traditional textbook learning but will not replace cadavers.

Research Physiological Effects to Chiropractic Adjustments Among the projects underway are studies that assess the effects of different neck adjustments on the autonomic nervous system, and studies of the effects of non-destructive spinal cord compression in the neck, as

Contributing Editors/Writers: Mara Bartolucci Margaret McCallen Art Director: Dora Kussulas Photography: istockphoto.com Dora Kussulas Chris Vassalos CMCC Media Services Associate Vice President, Institutional Advancement & Communications: Mara Bartolucci Director, Alumni Relations: David Coleman

may occur with spinal dysfunction.

Clinical Outcomes, Health Services and Policy Research Research in this area is directed toward clinical assessment, quality and outcome of patient care, determining prognosis and disability as well as development of clinical guidelines and cost-effective inventions. The result of such studies are paramount in enhancing patient care and informing government agencies, policy makers and insurers with regard to chiropractic care. Funds generated will support research on patient outcomes and quality of care, and support the professionâ&#x20AC;&#x2122;s position as a valued member of the health care team while creating partnerships with higher educational institutions and universities.

If you have not yet contributed and would like to learn more about these innovative opportunities, please contact Dr. Peter Kim, Director, Development and Clinic Advancement at 416 482 2340 ext. 184 or by email at pkim@cmcc.ca.

CMCC does not necessarily endorse or approve advertisements published in Primary Contact. Opinions of individual authors do not necessarily reflect the views of CMCC. Publications Mail Agreement Number: 40062432 Change of address and undeliverable copies should be sent to: CMCC Alumni Relations Office 6100 Leslie Street Toronto, ON M2H 3J1 cmcc.ca Twitter @cmccnews Facebook.com/cmccnews

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SPRING 2018

CMCCâ&#x20AC;&#x2122;s 14th annual golf tournament fundraiser

BackSwing â&#x20AC;&#x2DC;18 Thursday, September 13, 2018 Bayview Golf & Country Club Thornhill, Ontario cmcc.ca/BackSwing Featuring a 2 hour CE Lecture Course

Gold sponsor

To register or for more information, visit the event website or contact Special Events at events@cmcc.ca or 416 482 2340 ext. 200.

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Canadian Memorial Chiropractic College