The Portland, Ore., VA Medical Center has hired its first full-time chiropractic physician, Dr. Samantha Stolzel, who will help reduce use of harmful pain medications by our honored veterans. Her hiring is a victory for chiropractic (and veterans) in my home state, and also represents the obligation our profession has to ensure chiropractic is available to veterans nationwide.
The Oregon Example
In 2013, the full Oregon Legislature passed House Joint Resolution 201 (HJR 201) without a single "no" vote, recommending the Portland VA Medical Center hire a full-time chiropractic physician. HJR 201 was signed by Co-Speakers Reps. Arnie Roblan (D) and Bruce Hanna (R), and then-Secretary of State (and now Oregon Governor) Kate Brown. Congressman Kurt Schrader, former Governor John Kitzhaber, MD, as well as Bronze Star winner, Army veteran and Oregon State Senator Brian Boquist all played a role in prompting the Portland VA Medical Center to hire its first chiropractic physician.
Exposing the VA "Pill Mill"
In 2014, scrutiny into the U.S. Department of Veteran Affairs (DVA) reached its peak when supposed reforms of the DVA by former VA Secretary, Eric Skinseki, were deemed "a stunning period of dysfunction" by U.S. Senate Majority Leader Mitch McConnell (R-Kent.). One of the serious dysfunctional administrative issues within the DVA was the "pill mill" mentality, resulting in abuse and addiction of veterans to harmful pain medications such as oxycontin, hydrocodone, and Percocet.
In 2014, the VA treated approximately 650,000 veterans with opioid narcotics and one in three veterans polled at the time said they were on 10 or more medications. Abuse of prescription narcotics among active-duty servicemen and women were also three times more likely to be prescribed those addictive drugs than civilians.
Why Vets Need Chiropractic
Helping to push the VA toward chiropractic, a 2009 Johns Hopkins study revealed that musculoskeletal injuries such as back injuries were one of the most common reasons for evacuation of soldiers from combat, with only 13 percent being returned to duty following standard medical care.
A 2013 study published in Spine revealed that when chiropractic care was combined with standard medical care, a whopping 73 percent of patients said their lower back pain was "completely gone," "much better" or "moderately better." In contrast only 17 percent of patients receiving merely standard medical care rated their improvement as high.
More recently, in 2017 a systematic review and meta-analysis of 26 randomized, controlled trials (RCTs) published in JAMA found 15 RCTs revealed moderate-level evidence spinal manipulation reduces low back pain and 12 RCTs that showed spinal manipulation improves function.
Congress Opens the Door Wider
In March of last year, Congress passed the Consolidated Appropriations Act of 2018 (omnibus bill), and with it chiropractic's nondrug approach to pain relief for veterans (many of whom suffer from back pain and other musculoskeletal conditions) was significantly expanded.
Supported by several veterans groups and championed by Senators Jerry Moran (R-Kan.), Jon Tester (D-Mont.), Johnny Isakson (R-Ga.) and Richard Blumenthal (D-Conn.), the act requires the DVA to expand the availability of chiropractic services at no fewer than two medical centers or clinics in each Veterans Integrated Service Network (VISN) no later than Dec. 31, 2019, and at no fewer than 50 percent of all medical centers in each VISN by Dec. 31, 2021.
Progress Requires Action
Currently, there are only two other doctors of chiropractic at the American Lakes VA facility near Seattle, so with the addition of a DC in Portland, a total of three in all of VISN 20 (Oregon, Washington and Alaska).
Nationally, the VA currently provides chiropractic care (via hired or contracted staff) at 70 major VA treatment facilities, leaving nearly 100 major medical facilities without chiropractic care. Thanks to the Consolidated Appropriations Act, this will be changing.
For colleagues in other states whose local VA medical centers do not currently offer on-station chiropractic services, now is the time to lobby for those services to be added.
