military-corner

MILITARY CORNER

The F4CP launched its Military Corner to provide educational information about chiropractic care and the military. Military Corner provides in-depth and topical information including current care integration at military health facilities, policy and accessing rights, DOD/VA news, and the latest developments regarding chiropractic and the military. Additionally, guidelines are provided for both veterans and doctors of chiropractic about referrals, gaining access to care, even if initially denied, and how to help further care integration or attain employment within military health facilities.

INTEGRATION

Integration of Chiropractic Care and VA/Military Facilities
dod

Department of Defense (DOD)

In recent years, in recognition of the value and benefits of chiropractic care, Congress has passed, and the President has signed into law, legislation establishing a permanent chiropractic care benefit for both active duty military personnel and veterans. Furthermore, a doctor of chiropractic is now stationed in the U.S. Capitol to provide necessary care to members of Congress

To date, there is a doctor of chiropractic at 60 military bases around the country; however, according to a 2005 Government Accountability Office report, only 54 percent of servicemen and women eligible for chiropractic care can reasonably access the benefit. It is still necessary more is done to increase chiropractic access and availability.

Chiropractic Clinics in DOD Facilities

Veterans’ Affairs

A Department of Veterans Affairs policy enforces that veterans have access to chiropractic care. How this service becomes available will depend on the availability of a chiropractic doctor on staff. If a chiropractor isn’t on staff, a veteran can ask for a referral to a chiropractic doctor outside the system. While a referral from a physician is necessary the veteran has certain appeal rights.

The Department of Veterans Affairs (VA) has initiated the process of providing veterans with access to chiropractic care by placing chiropractic doctors on staff at VA hospitals.

The VA now provides chiropractic care (via hired or contracted staff) at approximately 40 major VA treatment facilities within the United States. Unfortunately, an overwhelming majority of America’s veterans still do not have access to chiropractic care because the VA has taken no action to provide chiropractic care at approximately 120 of its major medical facilities.

Chiropractic Clinics in VA Facilities

veterans_affairs
patriot_project

The Patriot Project

The Patriot Project is a grass roots movement to provide chiropractic care to all Active Military, their Families, Wounded Warriors & All Gold Star Dependents. Click below to learn more.

Click here to Become a Patriot Project Chiropractor

Information for chiropractors interested in Veterans Health Administration positions The Veterans Health Administration (VA) administers a network of 21 geographic regions called Veterans Integrated Service Networks (VISNs). http://www.va.gov/directory/guide/home.asp?isFlash=1 Public Law 107-135, the Department of Veterans Affairs Health Care Programs Enhancement Act of 2001, required VA to provide chiropractic care to all Veterans. This was required to be on- site at a minimum of one facility in each VISN, and by using private DCs in other regions.

In June 2004 openings at an initial 26 sites were announced, and by late 2004 the first chiropractic clinics were established. As of January 2012 there are 45 VA facilities providing chiropractic care: each of the 21 VISNs has at least one site, and some VISNs have multiple sites. This represents an expansion of over 73% since the program’s inception. It appears to be consistent with the natural expansion of any new clinical service added to a large healthcare system, and suggests successful program implementation. This expansion has occurred without VA receiving any additional legislative requirement to do so. Although over the past few years both the Senate and the House have passed bills requiring further VA chiropractic program expansion, none of these efforts have moved on to become law. VA continues to monitor chiropractic use and adds resources accordingly to improve patient care. Decisions on adding new chiropractic clinics are currently made at the facility level.

Since 2007 VA has added approximately 3 new sites per year. There is no central office coordination of such decisions. There is no central office contact to which interested parties may submit applications or CVs. A given facility that wishes to start a chiropractic clinic may bring on a DC as a staff appointment (employee) or contractor, full or part-time. This decision is made at the facility level based on local needs and resources. Facilities wishing to hire DCs may solicit applicants through various means, most commonly by posting openings on the VA Careers website: http://www.vacareers.va.gov//job-search/index.asp Although opportunities continue to emerge, there is no standing process for a chiropractor to plan for and obtain a VA position. DCs interested in such future positions are advised to consider this as requiring an intersection of two processes:

1. An opportunity to open up at a VA facility This will happen as a result of decisions made inside VA. It is extremely unlikely that an individual DC could contact a VA facility and convince that facility to start a chiropractic clinic. Many have tried this and so far none have been successful. It is not recommended that you cold-call a given VA facility or attempt to send a CV when no job is posted. This makes one appear naive and does not lead to good results. It is not recommended that you cold-call or attempt to send a CV to VA Central Office. This makes one appear naive and does not lead to good results.

2. Developing your professional competencies so that you are an attractive candidate when a position opens This aspect is in your control. You can consider this preparation for future opportunity. Following are attributes that many would look for when hiring a DC to work in a hospital setting.

  • Practice experience in a hospital or another integrated setting; a track record of working with other providers
  • Training experience in a hospital, which can also include attending CME presentations at medical facilities.
  • Commitment to professional growth as seen by attending high quality conferences such as: Association of Chiropractic Colleges-Research Agenda Conference (ACC-RAC), American Public Health Association (APHA), North American Spine Society (NASS), etc.
  • Firm grasp of evidence-based medicine and patient-centered care
  • Peer-reviewed publications in indexed journals.
  • Academic experience o Exceptional clinical skills
  • Professional appearance/demeanor
  • Excellent communication skills (written, spoken, PowerPoint, etc)

It is difficult (and indeed very rare) for a DC to obtain experience in all of those areas. However these are the types of features that make one stand out as an applicant, and also make one best suited to be successful within a medical system. There appears to be strong interest in VA positions among the chiropractic profession, and we have seen that new job openings are extremely competitive. It would be very unlikely for a new graduate to be chosen for a position at a facility that is starting a new chiropractic clinic (that is, a facility with no other chiropractors on board). A DC with an established track record would likely be better suited for such a situation. However a new graduate may be suited for a position at an existing chiropractic clinic that is expanding, where he/she would be part of an established department.

VETERANS’ RIGHTS

Learning About a Veterans’ Rights Chiropractic services are part of the standard medical benefits package available to all veterans. 1. By having an on-site chiropractic clinic 2. By sending veterans to a private chiropractor using the “fee-basis” approach where the VA pays the bill Currently there are 40 VA facilities with chiropractic clinics. Over the past years thousands of veterans have received chiropractic care at VA clinics as well as through the fee-basis procedure Many VA primary care providers are routinely discussing chiropractic care as an option with their patients. If your PCP has not discussed this with you, bring it up and explain why you think chiropractic treatment can be a good option for your particular problem.

Download the official VA document designed for patients interested in exploring chiropractic treatment. This document is to be shared with healthcare providers in the field and/or at the medical site. The following are reasons to consider chiropractic treatment, and some of these may apply to you: I have tried it before and it worked for me I have a friend or relative with similar problems and chiropractic care helped them I prefer to avoid unnecessary pain medication for my problem Chiropractic treatments such as spinal manipulation have as much scientific evidence as NSAIDs, opiods, muscle relaxants and exercise for managing back pain Chiropractic treatments such as spinal manipulation are part of current VA/DoD guidelines on treating back pain Remember that chiropractic services are part of your standard VA benefits and no VA facility can tell you that they “do not provide” chiropractic care. Some veterans have found that their VA is very reluctant to send them for fee-basis chiropractic care, and have required that they jump through many hoops to get a referral for chiropractic. This is against VA policy and does not go along with VA’s own stated mission to be “veteran-centered.” You should be very concerned if your PCP refers you for fee-basis chiropractic care and someone else at the facility denies that referral. If you suspect that you were unfairly denied chiropractic care you should make a complaint with the patient advocate at your facility. If that is not successful you should bring it to the attention of a VSO such as VFW, Wounded Warrior Project or others. The more veterans that make this known, the more likely it is that positive change will occur. The VA determines healthcare eligibility based on a number of factors, including the type and extent of military injuries, military service and a Veteran’s financial status

SUPPORTED BY