Access to MRI streamlined through assessment at NB-ISAEC June 12, 2023 When Susan Mean started experiencing lower back pain in September 2022, she thought it was simply sciatica (pain that travels along the sciatic nerve from the lower back down through the hips and legs) and figured it would go away. But when the pain continued, she decided to book an appointment with her family doctor. Looking back, she’s glad she did. “The pain wasn’t consistent, only when I moved certain ways,” said Susan. “It also hurt to get up and move in the morning or when I sat down or stood up for long periods of time.” Her doctor referred her to the New Brunswick Inter-professional Spine Assessment and Education Clinic (NB-ISAEC), where she met with Andrew Ross, clinical coordinator and physiotherapist. “When a patient is referred to the program, we book an assessment for them to see a physiotherapist with advanced training in low back pathology within two weeks,” said Andrew. “The goal is to provide quick, specialized care to help speed up the treatment process.” Susan was very happy with the thoroughness of her assessment. “My movements were assessed, and I was asked multiple questions,” said Susan. “I felt very well looked after.” Susan was given a list of exercises specific to her pain to try for six weeks. She stuck to the plan and did her exercises daily. However, when she didn’t feel any changes after three weeks, she booked a follow-up appointment. “That’s when I was referred to get a magnetic resonance imaging (MRI) and was told I may need surgery,” said Susan. When a patient is referred to an NB-ISAEC clinic, and it’s determined they need an MRI, the goal is to book one within 30 days of the assessment. DID YOU KNOW? The average wait time for a lumbar MRI is 176 days, but those referred through the NB-ISAEC program only wait an average of 24 days. Also, the average wait to see a spine surgeon once referred is six to 12 months, but those referred through the NB-ISAEC program only wait an average of 64 days. Dr. Bilal Tarabay, a neurosurgeon and spine specialist at Horizon’s The Moncton Hospital, treated Susan. “In most cases of spine conditions, conservative treatment, such as physiotherapy and pain management, can be sufficient and should be optimized before considering the surgical option,” said Dr, Tarabay. “Unfortunately, in the case of Susan, this wasn’t enough to treat her condition and surgery was needed.” Because of the work Susan put in after her appointments with the NB-ISAEC clinic, she felt better prepared when she met with Dr. Tarabay. “Because Susan has been through the program, she came to her appointment knowing we would be discussing surgery,” said Dr. Tarabay. “She came prepared with questions about the procedure and the risks versus the benefits. This meant she got the most out of the consultation, and I was able to immediately add her to the surgery waitlist.” The NB-ISAEC program was able to help Susan get diagnosed quickly, which will ensure her treatment goes smoothly. “The goal of the program is to get patients with lower back pain treatment from the right person at the right time,” said Andrew. “Most patients don’t require MRIs or surgery, but when they do, we can really speed that process up. I encourage primary care providers to consider referral to NB-ISAEC prior to referring for MRI or specialist consultation.” While Susan waits for her surgery, she is completing an evidence-based home exercise program. She was also given education on what she can and cannot do and strategies to manage her symptoms. “I have nothing but good things to say about my experience with the NB-ISAEC program,” said Susan. “I would recommend it to anyone who is experiencing lower back pain.” To be seen through the program, patients require a referral from their primary care provider. A short registration is required to gain referral privileges. For more information on how to refer to the clinics, contact Andrew Ross, clinical coordinator of the NB-ISAEC program, at 506- 870-2988, or email LBP@HorizonNB.ca. Improving access to care for New Brunswickers is a key priority of Horizon’s plan to ensure all New Brunswickers receive the quality care they need. This plan consists of three other priorities, including improving overall patient experience; the retention and recruitment of physicians, nurses and staff; and improving patient flow at our health care facilities. Further details about Horizon’s four priority areas are available at HorizonNB.ca. This initiative also supports the Government of New Brunswick’s provincial health plan, Stabilizing Health Care: An Urgent Call to Action.