Member Spotlight: Serving with the Canadian Armed Forces
June 5, 2020
Nancy Littke, PT
This month Physiotherapy Alberta shines our spotlight on Major Adam Hannaford, Physiotherapy Officer (PTO) with the Canadian Armed Forces (CAF). Adam is currently posted at Canadian Forces Bases (CFB) Edmonton and agreed to provide some insight into life as a physiotherapist in the Canadian Armed Forces.
Adam was born and raised in Nova Scotia. When asked to reflect on what or who influenced his decision to become a physiotherapist, Adam talked about how his mother, a registered nurse, encouraged him to pursue a career in health care. Adam’s father was very involved in sports and basketball so athletic endeavors were a big part of Adam’s youth. Adam’s high school coach was also his family physician and introduced him to physiotherapy through referrals to treat the frequent injuries experienced as a competitive athlete. Adam considered other health-care professions but decided on physiotherapy because of the profession’s emphasis on exercise and activity, which seemed to fit well with his outlook on life.
Once the decision to pursue a career in physiotherapy was made, Adam enrolled in the Master of Physiotherapy program at Dalhousie University, graduating in 2000. After graduation, he worked for five years in both private and public practice in Halifax, NS. Adam had considered joining the Officers training program in the Royal Canadian Navy after completing his undergraduate degree but decided that he wanted to acquire his physiotherapy degree first. In 2005, he entered the CAF, completing basic training and learning a second language.
Adam’s journey has taken him across Canada and around the world. He has been posted to CFB Borden (2008), CFB Esquimalt (2013) and CFB Edmonton (2016). Adam was deployed to Afghanistan in 2010 and was the Officer In-Charge of Physiotherapy (outpatient and inpatient services) at the NATO Role 3 Hospital at Kandahar Air Field. He did a “Technical Assistance Visit” to Ukraine in 2015 where he spoke at a Rehab Conference and taught some classes to medical staff. Most recently Adam was deployed to Latvia where he helped to set-up the physiotherapy clinic that supports the CAF and NATO troops there. Adam was a member of the Team Canada Medical Team at the 2017 Invictus Games in Toronto and covered international sporting events in support of ill and injured soldiers as part of the Soldier On program. Over the years he has had the opportunity to pursue a variety of continuing professional education courses and has been involved in clinical research.
Adam’s current role is as one of four Physiotherapy Regional Practice Leaders (RPL) (Atlantic, Ontario, Quebec, and the West). As an RPL he advises and supports CAF clinics throughout the West and liaises with the National Practice Leader, Lieutenant Colonel Peter Rowe. Physiotherapy is a small occupation in the CAF with less than forty uniformed physiotherapists and about sixty civilian physiotherapists working in CAF clinics across Canada.
Serving as a Physiotherapy Officer with the CAF
Although Adam has many responsibilities and duties as an officer related to leadership, management, and other military tasks, he has one career.
“I am a Physiotherapy Officer. I have training as a military officer, but my career involves delivery of health care, specifically physiotherapy,” explains Adam. “I provide clinical care, manage the physiotherapy section, and advise on musculoskeletal care in Western Canada.”
Physiotherapy services within the military environment
Adam explained that in the CAF physiotherapy is delivered in primary care clinics. Primary care consists of smaller sections called Care Delivery Units (CDU). Each soldier is rostered to a specific CDU which provides the soldier with a more consistent care team (e.g., physician, nurse practitioner, physician assistant). Each CDU operates a walk in-service daily. Physiotherapists are embedded in the CDUs at many bases and following triage are often the primary point of contact for acute and subacute musculoskeletal injuries. The physiotherapist operates as a physician extender, determining the initial management strategy. There are also more “traditional” style physiotherapy clinics within many of the CAF clinics.
I asked Adam how this service model benefits military personnel seeking health-care services. He replied that the CAF has a unique patient population with respect to personal expectations, personal liability, and employment requirements. The CAF population is typically healthier and more active than the general population. In his experience, having a physiotherapist as the primary point of contact for musculoskeletal issues tends to reduce the need for referrals to community-based physiotherapy services for treatment. This can facilitate the management of these complaints without requiring a significant modification of the patient’s physical training or physical activity routine. At the Edmonton Health Services Centre, a significant percentage of the patients seen as walk-ins are managed by the physiotherapist in primary care without generating a secondary referral.
Are there challenges with this model?
“Personally, I have encountered very few challenges working in Primary Care. I think this may reflect the fact that CAF members are used to working in small teams consisting of different occupations. I have seen some small issues when there were new staff that were unaccustomed to working in a primary care setting with direct physiotherapy support,” says Adam. “But the focus is always on providing the best quality care possible so, once everyone understands what the different professionals can offer the team, things tend to go very well.”
Common misconceptions about his role
In Adam’s experience, many people have a hard time understanding that while PTO’s are officers in the military, their primary role is to provide clinical services, manage those services and lead practice. Others do not understand that the CAF has its own health-care system and without that background they have a difficult time reconciling that there is such a thing as a PTO rather than simply physiotherapists providing treatment to injured personnel.
Considering serving within the Canadian Armed Forces?
“My deployments have been a highlight. On those occasions I have had the opportunity to use every single skill I have learned,” says Adam.
In Afghanistan he provided outpatient MSK care, worked on the ward and in the ICU. There were many days when Adam was required to go from treating acute MSK injuries in the outpatient clinic to providing early mobilization and assisting with airway clearance in the ICU and then to working with post-operative poly-trauma cases on the wards. He felt it was an honour to work with multidiscipline health-care teams and have professionals from other countries ask CAF members to assess and treat their nations’ soldiers.
“Serving in the CAF is an honour as well as a privilege and is both challenging and rewarding. The Canadian Forces Health System is unique and offers an opportunity to work and do things most physios, and other health-care professionals, would not even consider possible,” says Adam.
Adam identified the CAF recruiting website as a good place to start looking for information but said most PTOs are more than happy to share their experiences with anyone who is interested.