We’ve all heard of sports medicine clinics and can understand the need for them. The Al & Malka Green Artists’ Health Centre at Toronto Western Hospital is like a sports medicine clinic for artists.

Creative and performing artists belong to a unique occupational group and as such, they have unique health care needs. Their health concerns are often specific to their profession and to their circumstances. Their work often requires repetitive movements, tight deadlines, less than ideal work environments, grueling rehearsal schedules and performing or creating despite any health issues.

That is why we are here. Our goal is to keep artists creating art.

In the mid-1990s a group of artists began discussing the idea of creating a health care facility that would address the needs of the professional arts community. There was widespread frustration with both the cost and lack of specialized health care for artists. The Artists’ Health Centre Foundation (now the Artists’ Health Alliance) was founded and in 2002 the Al & Malka Green Artists’ Health Centre (AHC) found its home as part of the University Health Network’s Family & Community Medicine Department at Toronto Western Hospital.

We are a unique facility. We are the only clinic in Canada, perhaps North America, that addresses the needs of the entire artistic community – writers, musicians, visual artists, dancers, actors, filmmakers, technicians, arts students and teachers – in a hospital setting. We are an integrative clinic, where allopathic and complementary and alternative health care practitioners collaborate to provide patients with the best possible health outcomes.  It is rare to find an integrative clinic such as ours, especially within a major hospital network. Our patients access an integrative, patient-focused holistic approach within an evidence-based framework. Referrals to doctors and specialists within the hospital system are also provided.

Clinic staff includes:

• 1 full-time Receptionist
• 1 full-time Nurse Practitioner
• 1 full-time Coordinator
• 2 Physiotherapists
• 2 Massage Therapists
• 1 Shiatsu Therapist
• 1 Naturopathic Doctor
• 1 Chiropractor/Craniosacral Therapist/Acupuncturist
• 1 Psychotherapist

As with any complex system, challenges exist. The AHC has the added challenge that comes with varying schedules. Often practitioners will work on different schedules, meaning the team can have difficulty connecting and communicating.

Our Integrative Approach

To foster an atmosphere of integration and collaboration, we have established a number of initiatives:

• Regular staff meetings – the whole team convenes to discuss operations, strategic direction, etc.
• Case presentations – discussion on successes/challenges of particular cases and treatment approaches
• Electronic Patient Records – allows practitioners to easily track patients’ treatment history and progress
• Communication mechanisms – allows for discussion and consultation on cases involving multiple practitioners
• Integrative Assessments – several practitioners will collaborate to determine the best treatment plan for patients
• Integrative Care Plans – a combination of treatments may provide improved outcomes for patients

Integrative assessments are a recent addition to the services offered at the AHC. Rather than seeing one practitioner for an initial assessment and having other practitioners integrated into their care plan at some point, the initial assessment involves three practitioners: a Physiotherapist, a Chiropractor and either a Shiatsu Therapist or Massage Therapist. The team then consults on treatment options and approaches and develops an integrated care plan that would best suit the patient. The recommendations are then discussed with the patient before finalizing the care plan. An integrative assessment is particularly beneficial for patients with complex health histories, multiple overlapping conditions or chronic conditions that have been unresponsive to previous treatments.

The integrative approach recognizes that individuals need care that is tailored to suit individual needs – physical, mental and emotional. Not every person will respond in the same way to a given treatment and a combination of modalities may achieve the best results. It offers many benefits to the patient and practitioner, and to the health care system in general.

Benefits to the patient and health care system include:

• Reduced burden on the health care system – a patient is not going for unnecessary treatments/appointments/tests
• Convenience for the patient – all of their health care needs can be addressed in one clinic setting
• Patient gets the best health care possible due to an integrative approach that involves all relevant practices
• Patient understands there are options for care and gains an understanding of various treatments that can be accessed
• Patient has a voice and can exercise choice in their health care and wellness.

Benefits to the practitioner include:

• A greater understanding among practitioners regarding roles and perspectives along with scopes of practice
• Greater respect for other practices
• Strengthened team atmosphere
• Increased practitioner/team satisfaction

Case Study: Jenny

An excellent example of the potential of an integrative treatment approach is the case of Jenny (patient’s name has been changed), who started dancing at the age of 16 and progressed quickly. Not long into her training however, she was in an accident that left her with two lumbar fractures. She did physiotherapy and wore a back brace for several months, during which she was not allowed to dance. Her physiotherapist said she would never be able to pursue higher levels of dance training.

Being a very determined young lady, Jenny observed in classes and, a few months later, gradually began to dance. She continually attained high marks and grades of distinction. Her back was still causing her chronic pain. Despite this, she auditioned and was accepted at York University’s BFA Program. Shortly afterwards she was struck by an SUV while cycling to work. She suffered a concussion, but was feeling back to her normal self within a month. Jenny began at university in the fall, however her rigorous schedule was causing severe low back pain. She sought medical attention for her chronic pain. X-rays, CT scans and MRIs all came back normal. Jenny was still dancing, but with modifications. Within a couple of months her pain was so severe she could barely move. Jenny knew she had to seek medical help elsewhere and she discovered the AHC.

Says Jenny, “After encountering problem after problem with doctors, living with chronic low back pain and SI (sacroiliac)joint dysfunction, having to drop out of my program, being told to give up my dream of dancing, living in a less than ideal environment with no family around me, as well as dealing with high amounts of stress and anxiety from many fronts, my life took a downward turn. I was going through the toughest year of my life. I developed a serious depression and at times was barely able to take care of myself.

“This is when I began to get treatment from the Artists’ Health Centre. I jumped right in and was receiving shiatsu, craniosacral, chiropractic, and acupuncture treatments as well as physiotherapy weekly. I also began seeing a psychologist outside of the AHC. Through this multi-modal approach to my treatment and health care, I began seeing improvements almost right away. Rather than focusing on just one part of me (like the doctors had been) and then giving up on me, the practitioners at the AHC really fought hard for me! They took the time to treat me as a whole person and took care of both my physical and emotional health.

“Seeing various specialists all at once helped my condition improve faster than if I was to see just one person specializing in a single discipline. Each discipline addressed a specific issue, whether it was my SI joint dysfunction, tight muscles, muscle imbalances, tension, or stress and anxiety, while at the same time complemented and overlapped each other. My multi-modal treatments helped not only to correct the issues I came in with but others I was not even aware of. They helped me regain control of my body and allowed it to begin to work with me rather than against me! I began feeling like a normal person again.

“I’d say the biggest benefits of the Artists’ Health Centre’s alternative health care approach and multi-modal treatments are that it works faster, is more effective, and takes the whole of the person into account rather than compartmentalizing care.”

Comprehensive Programming

Our vision is to have a positive impact on the overall health and well being of professional creative and performing artists, and our mandate includes research, education and outreach to the arts community. We host many workshops and special programs including an Arts Therapy Group, Mindfulness-Based Stress Reduction/Mindfulness-Based Cognitive Therapy Groups and a Gyrokinesis^® Group. Our practitioners participate in outreach and education initiatives to schools of the arts and the arts community.

The Artists’ Health Alliance and the AHC continue to work in close partnership to heal, strengthen and empower the artistic community. The Board of Directors, Artists’ Committee and the staff of the Artists’ Health Alliance are committed to community building, presenting ongoing workshops and seminars through their Education and Outreach Program, providing outreach to the artistic community, and raising funds through the Joysanne Sidimus Subsidy Fund to subsidize health care for artists in need.

A career in the arts can mean creating despite financial difficulty. At times like these, an artist’s health and well being can become a greater challenge. Artists in need can apply for the Subsidy Fund to ensure access to the health care they need to continue creating. The subsidy can be used toward any fee-for-service treatments at the AHC during a one-year period. Patients are eligible to apply for the subsidy program twice in their career. It is especially useful for those suffering from complex injuries or overuse syndromes, which can initially involve multiple treatments to attain significant results.

Celebrating Ten Years

The Artists’ Health Centre recently held an Open House to celebrate ten years of providing specialized care to nurture and protect our artists and support them to keep creating art – since its opening, AHC has had more than 18,000 patient visits. Artists, health care professionals and the general public were invited to tour our facility, hear about patients’ experiences, meet the practitioners and watch dance demonstrations in the Movement Assessment Studio.

As Lyndon Johnson once said: “Art is a nation’s most precious heritage. For it is in our works of art that we reveal to ourselves and to others the inner vision which guides us as a nation. And where there is no vision, the people perish.” The Al & Malka Green Artists’ Health Centre is dedicated to advancing standards of excellence in health care for professional artists, something that will be of benefit not only within the local community, but also far beyond.

For more information on AHC’s services or supporting the Artists’ Health Alliance please go to www.artistshealth.com.

Pictured above: Improvisational dancers Diana Rose and Tom Brouillettes in the Movement Assessment Studio during the Open House

Leisa Bellmore is the Shiatsu Therapist at the Artists’ Health Centre at Toronto Western Hospital. She has been practicing since 2001 and has been a presenter for the Natural Health Practitioners of Canada (NHPC), Alzheimer’s Society of Ontario, Alzheimer’s Disease International and the Artists’ Health Alliance. Leisa is the Past President of the NHPC and a long-time volunteer at Ronald McDonald House Toronto. Her professional interests include stress management and self-care interventions for chronic health conditions. Leisa believes that we all must take an active role in our health, and she enjoys helping her clients attain their health goals while increasing health awareness.