Success in Patient Care through Integrated Medicine
Date: September 26, 2018
Dr. Alban Merepeza has worked with many elite athletes, including Canadian sprinter Andre De Grasse, a triple-medal winner at the 2016 Olympics. But his community knows him for his work at the Port Hope Health Centre, a privately owned healthcare clinic that he built from the ground up.
The clinic boasts a wide range of services, with 40 employees and practitioners across a variety of different professions. This includes chiropractors, naturopaths, physiotherapists, audiologists, a speech pathologist, a chiropodist, and registered massage therapists. The centre is also praised by patients and clinicians alike for its interprofessional structure, patient focus, and collegial atmosphere.
“Ultimately, chiropractic has been the driving force in establishing the clinic, but […] I’d rather have patients see it as a fully functioning health centre without knowing that there is a chiropractor that owns and built it. I do not want to take away the spotlight from the other professions and professionals that equally contribute to the success of our health centre.” – Dr. Alban Merepeza DC
Clinic Beginnings
Dr. Merepeza’s vision for an interprofessional healthcare centre began while he was in his fourth year at the Canadian Memorial Chiropractic College (CMCC). It was there that he registered a trademark — 11 years before the clinic materialized.
He knew three things back then. First, he wanted to start a multidisciplinary clinic. He wanted it to be in Port Hope, Ontario. And he knew that it was going to have several medical professionals working together. He registered two names — The Port Hope Chiropractic Clinic and the Port Hope Health Centre.
In 2005, he founded the Port Hope Chiropractic Clinic. It offered care from himself as the chiropractor and a registered massage therapist. Over time, the clinic attracted practitioners from different fields and the clinic outgrew its space.
In 2015, his team moved to a new space. They also adopted a new name, the Port Hope Health Centre.
When it came to building the foundation of the new clinic, Dr. Merepeza took on a new role. “I constructed the health centre building with the vision of having all the healthcare professionals here. I was the general contractor, which was a new venture for me. I built it as I wanted it, to fulfill my vision of a clinic where everybody is working together, in a modern facility, as a team of health professionals focusing on an evidence-based, patient-centred approach to care,” Dr. Merepeza says.
His colleagues agree. “I think it is more convenient for the patients … It is always a positive thing to be in a place where everything is under one roof,” says Dr. Jude Obomighie, one of the centre’s four family physicians.
The clinic is beautiful, with large windows and lots of light. Its architecture was designed with incredible consideration to mobility within the space, which took into account the movement of patients and clinicians that would be necessary for a fully-supported interprofessional setting. The clinic’s design also contributes to a sense of well-being for both patients and practitioners.
“We have very stressful jobs, so we need our work environment to be as relaxed and supportive as possible,” says Dr. Michelle Long, a family physician at the health centre.
Interprofessional Approach
Learning about the importance of interprofessional care in school, Dr. Merepeza saw it as the path to the future of primary healthcare.
Dr. Merepeza and his team say the clinic has always been about patient-centred care. “We want patients to come in and feel comfortable, which they do,” he says.
Patient focus goes hand-in-hand with an interprofessional approach to treatment. “We wanted the clinic to feel at home, and for patients to feel like they can get any health services they want in here without having to go anywhere else.”
Dr. Barbara Weiss is one of the naturopathic doctors in the clinic and has worked with Dr. Merepeza for many years. She emphasizes that it’s easier to help patients in this environment. “It’s nice having many [allied professionals] under one roof. We can get people better faster and they don’t have to keep coming back … We are restoring health and [helping patients] maximize their own [return to] health,” she says.
Being able to walk down the hall and initiate a referral—and introduce patients to other healthcare providers and how they might help—allows the team to build trust and rapport. It is quite a unique experience for the patients and it is beneficial for the team. “I like that if I’m having a hard time solving an issue I can [consult another profession] and get a different perspective….It’s the inter-referral within the clinic that has helped patients with their rehab,” says Sandor Jakab, a physiotherapist who worked with Dr. Merepeza for more than 10 years.
The diversity of health fields represented in the clinic is so comprehensive that the only times the practitioners find they need to provide an external referral is if someone needs psychotherapy, counselling, or needs to visit a surgeon or medical specialist.
“I think it is more convenient for the patients….It is always a positive thing to be in a place where everything is under one roof.” – Dr. Jude Obomighie, MD
Guiding Philosophy
Relationship building is incredibly important to Dr. Merepeza and his team, both with each other and with patients. This means eliminating boundaries between professions and allowing patients to see the entire clinic as a unit. This philosophy is part of the reason Dr. Merepeza removed the word chiropractic from the clinic’s title.
“Ultimately, chiropractic—myself—has been the driving force in establishing the clinic, but I don’t want that to be recognized by patients. I’d rather have patients see it as a fully functioning health centre without necessarily focusing on the fact that there is a chiropractor that owns and built it.”
He continues, “I do not want to take away the spotlight from the other professions and professionals that equally contribute to the success of our health centre.”
Dr. Andrew Fagan, another chiropractor in the clinic, agrees. “Evidence-based care, getting people better, and being professional…that’s the biggest thing here. That’s the bottom line.”
The Future of the Clinic
As the number of new patients visiting the clinic grows, Dr. Merepeza knows they can support more patients.
He recognizes the expansion potential and says he has purchased the plot of land next to the centre. The plan is to add more services, such as a pharmacy and a blood laboratory. After that the goal is to bring in more family physicians and a variety of medical specialties. Adding another building, one with 15,000 square feet of space, would make his clinic the biggest healthcare facility in the county outside of the hospital.
When it comes to interprofessional care, he wants to see it become the new norm. “I think that it continues to increase and become more prominent in health care. We [will] see more multidisciplinary clinics, either privately run or even government run.”
When it comes to chiropractic’s place in this healthcare model, Dr. Merepeza emphasizes his hope for the profession’s growing recognition. “More than anything, I would like to see the chiropractic profession take its own deserving spot within the multidisciplinary health team as [a musculoskeletal] specialist with a very diverse and rich set of skills that can help the patient population.”
“It’s nice having many [allied professionals] under one roof. We can get people better faster and they don’t have to keep coming back….We are restoring health, and [helping patients] maximize their own [return to] health.” – Dr. Barbara Weiss, ND