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Integrated care under one roof

She’s a stagehand, pyrotechnic technician, electrician, audio engineer, community services board member, city councillor, mountain bike racer, mountain climber, skier, paddle boarder, registered massage therapist (RMT), 2010 Massage Therapists’ Association of British Columbia RMT of the year

January 2, 2014  By Cathy Ryan


She’s a stagehand, pyrotechnic technician, electrician, audio engineer, community services board member, city councillor, mountain bike racer, mountain climber, skier, paddle boarder, registered massage therapist (RMT), 2010 Massage Therapists’ Association of British Columbia RMT of the year, massage therapy educator, researcher, multidisciplinary clinic owner, and the first ever RMT panellist at the International Fascia Research Congress (FRC). With her list of accomplishments, the many hats she wears and her flair for pyrotechnic, one could say Susan Chapelle is on fire.

Susan-Chapelle.jpg  
RMT and researcher Susan Chapelle believes collaboration among multidisciplinary practitioners brings the best possible outcome for wellness.


 

Chapelle was a presenter at the 2012 FRC in Vancouver, where she shared her innovative massage therapy research entitled “Visceral Mobilization Can Lyse and Prevent Peritoneal Adhesions in a Rat Model.” Her research provides evidence that massage therapy does work in measurable and scientific ways.

Chapelle’s massage therapy career has been dynamic and diverse. She has worked in a variety of professional settings and continually expands her horizons. As an example, she worked backstage in the entertainment industry for 15 years before deciding to take up another profession as a massage therapist. Chapelle has also dipped her foot into local politics and is currently a city councilor in the District of Squamish in British Columbia. In 2012, she opened the doors to Squamish Integrated Health, a multimodal clinic serving a diverse and dynamic community that lies on the Sea-to-Sky Highway, partway between Vancouver and Whistler. The clinic is as awe inspiring as the vista in which it is nestled.

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Chapelle has embarked on a collaborative research venture with Dr. Geoffrey Bove, a chiropractor and associate professor at the University of New England College of Osteopathic Medicine in Biddeford, Maine.

I sat down with Chapelle to get her perspective on interprofessional collaboration, research and professional growth

What inspired you to embark on such an ambitious project with Dr. Bove?
SC: I don’t find building collaboration “ambitious.” The clinic has grown over 14 years to serve a dynamic range of disabilities, but mainly has focused on post-surgical care. The collaboration has been an education for both CAM (complementary and alternative medicine) therapists, as well as allopathic doctors. The collaboration extends to dental, yoga and a variety of other practitioners. We grew both as a community and as a health-care destination because of the collaboration. Collaboration is always the best possible outcome for wellness.

What health-care services are available at the clinic?
SC: Naturopathic doctors, acupuncture, massage therapy, chiropractic doctors, ayurveda, shiatsu, clinical counselling – all under the practice of our biggest medical clinic. 

From your perspective what value or advantages does this approach provide your community?
SC: The integration of all of our practices through iPad charting, the ability to share and collaborate for better outcomes, and the integration and expertise of referrals from educated allopaths who understand how to refer.

How is interprofessional collaboration at the clinic carried out?
SC: Collaboration at the clinic is carried out in a variety of ways. We have meetings to discuss professional development. I teach and we have visiting professionals provide education. Also, we share daily. The charting is a hallmark and a work in progress that includes jpegs, movies and anatomical blow-ups. Our patients can have access online, through their profile, to anything we need to share. Each practitioner charts on software providing all treating practitioners access to what that patient has received for care. This approach supports continuation of betterment as opposed to reinvesting in an entire new process. We are able to see what has worked and what hasn’t and can search keywords in each chart. Everyone is in one space, so it is easy to bring other professions in to collaborate in the same appointment.

What are some of the challenges you have encountered with interprofessional collaboration? And what advice would you give others on how to foster excellent interprofessional relationships?
SC: As a clinic owner, it is important to have a team, not just hire to pay bills. I would rather wait for someone who is going to fit and be a collaborator than hire to fill space. Each practitioner has a remarkable understanding of anatomy and physiology, as well as research literacy. There is an education credit to encourage learning. We are a family, and suffer each other’s difficulties and challenges by helping out. We celebrate the good. There are always challenges, but none of us are above learning from each other. We drop our egos at the door because there is a higher [patient-centred] purpose.

What have been some of the challenges in creating, establishing and sustaining such a complex business? And what one piece of advice would you give others who are interested in creating such a clinic?
SC: I don’t find it complex at all. It has been an evolution. ‘Integrated’ is the new health-care buzzword. True collaboration takes years.

For you personally, what are some of the most rewarding aspects of working in an interprofessional setting?
SC: Happy, healthy, recovering patients getting what they need out of health care. The referral of other professionals to the practice due to outcomes.

And now for your work with Dr. Bove. How did your research collaboration come about?
SC: Geoff came up to me at a breakfast in Amsterdam at the Fascia Research Conference where I was getting help from Dr. Thomas Findlay on a grant application for breast cancer protocol. We started discussion on mechanisms immediately.

What are some of the challenges you have experienced conducting an interprofessional research project?
SC: Geoff and I work extremely well together. The work has been a pleasure. The only challenges are finding funding for CAM research and the distance we have to travel. However, the Internet has made collaboration a pleasure.

What has been the most rewarding part of this collaboration for you?
SC: Finding a like-minded person who attacks things like a terrier with a sock. It is hard to find people to work with who not only share ideals but also work as hard or harder. Science in CAM therapies is not collaborative due to poor funding situations. It makes people competitive and behave badly toward each other. Geoff and I are interested in mechanisms due to a similar outcome of being involved in a profession that has had to make up much due to lack of education or scientific reasoning.

What advice can you provide others who might be interested in participating in an interprofessional research project?
SC: We are in an unusual and tenuous situation. We may not have a lab for long – we may not get funded. It is not an easy road. One suggestion would be to find a project that you can add a group to and then raise the funds to do it. It has taken Geoff and me years to develop and put together projects. Hard work and persistence are the only ways to get anything done. Don’t get discouraged. Apply for funding. Get an education. One step at a time; otherwise it can be overwhelming.

What are you currently working on? What is on your research must-do list?
SC: The effects of massage therapy on neural regeneration, and if we get funded for our next project by the [National Institutes of Health] (currently in sequestration land) then looking further into abdominal adhesion formation and treatment. I have a lifetime worth of things I want to work on. Mary Barbe, PhD, needs to let me rub her rats with repeat motion injuries.


Cathy Ryan, RMT, has maintained a diverse, treatment- oriented massage therapy practice and an extensive postgraduate training roster since 1990. Cathy is a longstanding member of provincial massage therapy associations and has served as a subject matter expert and examiner trainer at the CMTO’s provincial licensing examinations. Currently residing and working in beautiful B.C., Cathy maintains a private practice, teaches and writes massage therapy related material and is the managing editor for TouchU.ca; an online source providing accredited continuing education for touch professionals and students. Cathy can be reached at: cryanrmt@gmail.com or via www.touchu.ca.


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