Just a year ago, the ACA had a tough decision to make regarding the composition of the U.S. Department of Veterans Affairs (VA) Chiropractic Advisory Committee. Should the ACA continue to fight the appointment of NACM member Charles Duvall, Jr., DC, and five medical members to the VA committee - or gamble that the three mainstream members would prevail and get the job done?
In my former role as chairman and as board liaison to our ACA Veterans Committee, I attended the initial VA Committee meetings, in order to give the Board of Governors a clearer picture of what was happening and what actions were needed. After attending the first meetings and watching the dynamics, my report was: "Even though the deck is stacked against them, I am confident that Drs. Reed Phillips, Cindy Vaughn and Rick McMichael can build a consensus among the diverse members that will result in the committee being successful." The ACA Board of Governors concurred with my judgment and immediately ceased all efforts to have Dr. Duvall removed from the committee.
Now, one year later, the chiropractic profession is tantalizingly close to the biggest victory in our history: If VA Secretary Anthony Principi accepts the recommendations of the VA Chiropractic Advisory Committee (and I believe he will), Dr. B. J. Palmer's dream in 1937 - chiropractic care for veterans - will finally become reality!
The VA Committee recommendations, in their current form, represent an important step toward ensuring that America's veterans have access to the chiropractic health services they need and deserve. If fully implemented, the VA will employ hundreds of doctors of chiropractic and provide chiropractic care to tens of thousands of former servicemen and women.
Some may criticize the recommendations of the VA Committee as not being "philosophically pure" enough in regard to direct access; if they do so, they will have sorely missed the point. This is not about "direct access" for our profession; this is about veterans being "able to access" chiropractic care! There is a big difference. In other words, it's not about us - it's about veterans! As long as veterans are able to reasonably access chiropractic care without having to jump over artificial barriers, that's good enough!
I am also encouraged that the VA Committee recommendations provide a roadmap to:
- complete integration of full-scope chiropractic care into all missions of the VA health care system, including patient care, education, research and response to disasters and national emergencies, and its major facilities;
- adoption of the successful "Bethesda National Naval Medical Center model" of full scope of practice and full integration of doctors of chiropractic as partners in health care teams and managers of patient care for neuromusculoskeletal conditions;
- continuity of chiropractic care/direct access for newly discharged veterans who have been receiving chiropractic care through the U.S. Department of Defense health care system;
- inclusion of chiropractic into the VA's funding of research into treatment of service-connected conditions; and
- inclusion of chiropractic colleges and students in training programs at VA facilities.
In addition to helping veterans access the care they want and need, the recommendations (once accepted by Secretary Principi) will also have a tremendous positive effect on the chiropractic profession and the other patients we serve. This additional benefit will occur because the VA Committee has created a new full-scope federal model - one that I believe will eventually replace the limited Medicare federal model we have today. I also believe that in time, state legislatures across the country will use this the VA model as the template for chiropractic coverage and reimbursement at the state level.
Clearly, certain recommendations still need to be clarified and improved before the process is complete. As this process continues, the ACA will continue working with concerned veterans and pro-veterans organizations to educate VA leadership - at the highest levels of the department - about the history of bias and discriminatory treatment endured by doctors of chiropractic and chiropractic patients, and the qualifications of DCs to provide comprehensive health care services demanded by millions of veterans and civilians across America.
James Edwards, DC
Treasurer, District VI Governor
American Chiropractic Association
Austin, Texas
jamesedwards@jamesedwards.com
