Chiropractic's Place in the National Health Service Corps

At the time of this writing, Senate bill S. 1533 (the Health Care Safety Net Improvement Act) awaits the signature of President Bush. Section 338L of the bill describes a demonstration project which will ultimately determine if doctors of chiropractic will become a permanent part of the National Health Services Corps.

In addition to offering DCs the chance to work off a portion of their student loans by practicing in underserved areas, the bill accomplishes a number of other important victories for chiropractic, some of which may have been overlooked:

• Taking Chiropractic to the Underserved - Our profession has moved to a place in our history where the federal government recognizes that some areas of this country lack access to necessary chiropractic care. This law will reimburse student loan expenses for those chiropractors who are willing to take chiropractic care to people who can't get the care they need.

  One can only imagine what early DCs would think if they knew what was about to happen. Think about it for a moment: The U.S. government wants to encourage chiropractors to reach people who haven't had the opportunity to enjoy the benefits of chiropractic, and is willing to reimburse their student loans to make it happen. We've come a long way.

• Primary Care Chiropractic - DCs who enter this program are not doing so as second-class citizens. The law specifically states that the results of this demonstration project will be reported based upon "the manner in which the demonstration project described in this section has affected access to primary care services, patient satisfaction, quality of care, and health care services provided for traditionally underserved populations." (Emphasis ours.)

  The law specifically protects participating DCs from interference by any domineering medical doctors who may also be involved in the program:

  "Nothing in this section shall be construed to require or simply that a (medical) physician or other health professional licensed to prescribe drugs must supervise an individual receiving assistance under the demonstration project under this section, with respect to such project."

• Chiropractic's on the Team - The act does require an allopathic physician to also be working at the service site. This accomplishes two things:


1. Professional Exchange - New DCs and new MDs will be working side by side. They can exchange philosophies, share cases and get to know each other's strengths. When the MDs leave the National Health Service Corps, not only will they have less debt, but they will be accustomed to working with a doctor of chiropractic.


2. Another Inclusive Model - Depending on the success of this demonstration project, the federal government may recognize the value of employing a model of health care delivery that includes chiropractors as part of the team. This could impact how DCs are included in other government programs.


• Student Loan Reimbursement - This is the obvious benefit of the demonstration project, but it could translate to the private sector. As more people demand chiropractic, there could be an incentive offered by companies that want to supply chiropractic care in underserved areas to their customers and policyholders. You may think this a long shot, but we are a few steps closer now.


• Normal Inclusion - Historically, this profession has never asked for special treatment from anyone. All we ask is to be included at the same level as the other health care providers: nothing more; nothing less. Adding chiropractic to the National Health Service Corps continues a very healthy pattern of inclusion.

It's important to remember just how the battles for equality and recognition are won. Yes, there are dramatic moments that "change the course of history," but more often the change is slow, hallmarked by quiet victories that affect the lives of millions.

This is one of those seemingly subtle events that will make a big difference over time.

DMP Jr.