While access to chiropractic services within the Department of Defense and Department of Veterans Affairs is by no means inclusive, which explains current legislative efforts to expand access to chiropractic care at both military and veterans health care facilities (H.R. 409 and H.R. 329, respectively), the casual observer might be inclined to believe DCs are treated equally in either system. Not so, according to a letter signed by 15 members of the House of Representatives Committee on Armed Services. The letter, sent to Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, suggests distinct disparities exist, with doctors of chiropractic employed by the DoD getting the short end of the bargain. According to the letter:
"We are informed that pay and job classification disparities have resulted in doctors of chiropractic being compensated at much lower pay scale rates than health care providers with comparable, or even lesser, training, skill sets and health care responsibilities for patients within the military treatment facilities. We also understand that certain institutional biases among certain health care provider officials against doctors of chiropractic have resulted in more difficult access to the active-duty military patient population and unnecessary restrictions placed upon such doctors of chiropractic in performing their services for the military."
The letter states that such disparities/biases do not appear to be occurring within the Department of Veteran Affairs (DVA) health care program (according to the letter, DCs within the DVA are Title 38 employees, have an assigned salary grade, a professional standards board and a DC director of the chiropractic program, among other standards and procedures) and urges the DoD "to carefully examine the existing system at the [DVA] for integrating chiropractic into the health programs for veterans and adopt pay, job classification and coordination systems comparable to those under VHA Directive 2009-059 within DoD's chiropractic health care program for our active-duty military personnel."
Two other requests by Committee on Armed Services members who signed the letter: that the DoD consider "having a Doctor of Chiropractic as the chiropractic service leader for each branch of the military, as is done with every other specialty in military medicine." and that the department "look into any instances of supervision of doctors of chiropractic .. to ensure that there are no instances of bias against such doctors of chiropractic in providing full access to chiropractic care at the military treatment facilities."
The American Chiropractic Association and Association of Chiropractic Colleges both supported the committee's letter and commented on its significance in an ACA press release:
"I would like to thank congressmen Mike Rogers and Dave Loebsack for spearheading this effort," said ACA President Dr. Rick McMichael. "The benefit provided by doctors of chiropractic to our brave men and women in uniform is integral to their recovery from injuries and their overall health and well-being. Impeding DCs from providing this care is a disservice to our troops."
"The Association of Chiropractic Colleges applauds this expression of support by members of the House Armed Services Committee for continuing the full integration of the services provided by doctors of chiropractic into the DoD," said ACC President Dr. Richard Brassard. "We are optimistic that this strong letter will spur positive change."
In addition to Reps. Rogers (R-AL) and Loebsack (D-IA), other letter signees included Reps. Todd Aiken (R-Mo.), Robert E. Andrews (D-N.J.), Roscoe G. Bartlett (R-Md.), Madeleine Z. Bordallo (D-Guam), Hank Johnson (D-Ga.), Walter B. Jones (R-N.C.), Larry Kissell (D-N.C.), Frank A. LoBiondo (R-N.J.), Silvestre Reyes (D-Texas), Tim Ryan (D-Ohio), Jon Runyan (R-N.J.), Bobby Schilling (R-Ill.) and Niki Tsongas (D-Mass.).
H.R. 409, the Chiropractic Health Parity for Military Beneficiaries Act (introduced by Rep. Rogers), would require that the Secretary of Defense develop a plan to expand the chiropractic benefit within the DoD to apply to any beneficiary covered under TRICARE, rather than only active-duty service members. H.R. 329, the Chiropractic Care to All Veterans Act [introduced by Rep. Robert Filner (D-Calif.)], would require that the VA staff a chiropractic physician at all major VA medical facilities no later than 2014. Both pieces of legislation are currently in congressional subcommitee; for the latest on either bill, visit www.govtrack.us.
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