Billing / Fees / Insurance

DOD's Response to Commissioning DC's

Editorial Staff

In the February 15, 1991 issue of "DC" we ran a front page story of Senator Strom Thurmond introducing bill (S.68) to commission DCs in the military. The bill was thereafter referred to the Senate Armed Forces Services Committee.

We recently received letters from two DCs, Craig Benton of Lampasas, Texas and Michael Lynn of Exeter, California, who both wrote to Secretary of Defense, Richard Cheney to ask for his support of S.68.

The response they received was from an M.D., Edward Martin, deputy assistant secretary. Both letters from Dr. Martin were nearly identical in content. Below is the complete text of the letter to Dr. Benton; we've added italics to highlight certain sentences that you may find of particular interest.

 



Dear Dr. Benton

This is in response to your letter of February 11, 1991, to the Secretary of Defense regarding the commissioning of Doctors of Chiropractic in the Armed Forces to provide chiropractic care.

The Department of Defense is on record as opposing such action because the scope and manner of practice of chiropractic would not add to the care of our beneficiaries. The unique and primary mission of the military medical departments is to provide treatment of disease and injuries arising from combat. The treatment of musculoskeletal ailments within this mission is currently well covered by physicians and physical therapists. Definitive medical and surgical care is available which cannot be provided by doctors of chiropractic medicine. This care is available both during armed conflict, such as Operation Desert Storm, and during our peace time mission. Therefore, to employ chiropractors, who have a limited and narrowly focused scope of practice, is believed to be a manpower and financial expenditure that would be of little benefit to the beneficiaries of the military health care system.

Further concerns regarding the inclusion of chiropractic medicine in military medicine arise from the belief that insufficient scientific evidence exists to support the theory of chiropractic, and that the quality control of training and practice within this community may not approach those currently seen in other medical professions. The statement by the International Chiropractors Association that "the philosophy of chiropractic is based on the premise that disease or abnormal function is caused by interference with nerve transmission and expression, due to pressure, strain or tension upon the spinal cord or spinal nerves, as a result of body segments of the vertebral column deviating from their normal juxtaposition" is not supported by the substantial body of modern scientific investigation. In addition, there is great variation in the educational levels, the curricula of the schools, and the licensing standards among the states. Chiropractors, depending on their training and personal outlook, vary from those who advocate chiropractic solely for musculoskeletal disorders, to those who advocate chiropractic for a wide range of ailments. Our position and concerns in this regard are supported by the American Medical Association, the American Osteopathic Association, the American Physical Therapy Association and other professional organizations.

For the stated reasons, focus of care, and lack of scientific justification, commissioning of chiropractor in the Armed Forces is not required.

Sincerely,

Edward D. Martin, M.D.
Deputy Assistant Secretary
(Professional Affairs & Quality Assurance)

 



There are several telling points regarding the bill: In 1988, the DOD's Military Health Service Systems (MHSS) reported a shortfall of 337 non-M.D. health care personnel; physical therapists are commissioned in the Armed Services, yet are direct access providers in only 21 states, whereas DCs are licensed as primary entry health care providers in every state and the District of Columbia. A final point of interest, albeit ironic: The GI bill covers education in chiropractic colleges, but a graduate of one of these colleges cannot provide chiropractic care in the military. (The Voice, Vol. 5, No. 3, pg. 7)

As of this writing the bill has not been acted on and may not reach the Senate floor for a vote without significant pressure from the chiropractic profession.

April 1991
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