[3][4] In the 2000s, Rampersaud began speaking out about a problem in the health care system: many of the people with back pain who were referred to him by their family doctors were not candidates for spinal surgery.
In 2010, Rampersaud took part in a pilot project at TWH which determined that a specially trained nurse practitioner could assess patients with back pain as accurately as the surgeons at the hospital.
[8] The proposal pointed out that pre-screening could save money by cutting down on the number of unnecessary visits to specialists and MRI tests, as well as helping patients receive appropriate care sooner.
[9] In 2013, Rampersaud began organizing a project to set up a series of Inter-Professional Spine And Assessment Clinics, staffed with diagnostic experts and therapists.
The clinics have been able to reduce wait times, unnecessary diagnostic tests, and referrals to specialists, while providing patients with more targeted and effective treatment.