For the first time in the VA's history, veterans will be able to receive certified chiropractic care at 26 selected Department of Veterans Affairs (VA) facilities.
National Aeronautics and Space Administration (NASA) wants to expand man’s exploration of space. What they also want is a chiropractic opinion on how spaceflight will affect the spines of the astronauts.
In a release dated August 2, 2012, and published in several news outlets, the Foundation for Chiropractic Progress (F4CP) noted that NASA was addressing concerns about the heightened risk of musculoskeletal injuries threatening astronauts. To address these concerns, NASA conducted the Spinal Deconditioning Injury Risk Summit, in which chiropractic input was sought.
The F4CP release reported that "During the Summit, a multidisciplinary panel of experts addressed various issues including identifying impacting factors — such as microgravity exposure, flight weight and landing forces — and defining potential protection and prevention options. Going forward, NASA expects to develop and test new measures to counteract spinal deterioration in space crews, based on the panel's recommendations."
John Mayer, DC, PhD, a chiropractor from south Florida, participated on the panel and added input from a chiropractic perspective. He believes chiropractic represents advancement in prevention and protection protocols.
"Deconditioning — the breakdown of the spine's musculoskeletal support system — is a very common and serious condition occurring in astronauts," said Dr. Mayer, Lincoln College Endowed Chair in Biomechanical and Chiropractic Research, and associate professor, School of Physical Therapy and Rehabilitation Sciences at USF Health. "It is crucial that NASA continues to aggregate data and develop strategies to mitigate this problem. More times than not, this initial breakdown leads to other debilitating health concerns, such as disc herniation — an ailment space crews are five times more at risk for than average individuals."
"Possible options to enhance safety measures for astronauts can include everything from developing new equipment to altering spaceflight exercise procedures to new healthcare practices," says Dr. Mayer. "The use of an effective specialized musculoskeletal care, like chiropractic, may ultimately prove to be effective in reducing the incidence of injuries for individuals exposed to a variety of physical demands, such as astronauts."
An interesting article appeared on the March 1, 2006 CNN.com health website, that came from the CNN partner MedPageToday.com. The story is of a Chiropractor, Dr. William Morgan who is the first chiropractor to receive hospital privileges at the National Naval Medical Center in Bethesda Maryland.
The story starts of by saying, "When a Supreme Court justice is nursing an aching back or a senator has a crick in the neck, Dr. William Morgan is the man they may call for help." Dr. Morgan is not new to the military. His history noted that after high school, he joined the Navy where he received training as a hospital corpsman, He was assigned to a Marine Corps reconnaissance unit and a Navy special warfare unit.
After his time in the Navy, Morgan did not know what career to follow. That is where fate seemed to step in.Â The story notes that he found a career after he injured his back. "For months I tried traditional treatments and had no relief," he said. "Finally, when I could barely walk, I went to a chiropractor. I was 90 percent better in just a week."
His experience led him to attend chiropractic school and he received his Doctor of Chiropractic degree. After school he started his chiropractic career with a three-month missionary team in western Africa. He then practiced for 13 years in California when he heard that the National Naval Medical Center was looking for a chiropractor. He commented, "From my time in the Navy I knew that Bethesda was a world-class medical center and that working there would be something very special."
With his history in the military, and his desire to serve at Bethesda, Dr. Morgan packed up his family and moved to Maryland, where he became a contract employee of the U.S. Navy. Since then he has enjoyed his time of being the chiropractor to many government officials. Dr. Morgan concluded the article by saying, "I have the best job in the hospital and I get immediate gratification for what I do. When people come to me they are at the end of the line. They have tried everything and nothing worked. So, when I try something and it works, I am gratified."
Above is the headline of a USA Today story published on July 20, 2012. The article is based on a Memorandum Report issued by the Department of Health and Human Services, Office of the Inspector General, from Stuart Wright, the Deputy Inspector General for Evaluation and Inspections. The title of the memorandum report is, "Few Adverse Events in Hospitals Were Reported to State Adverse Event Reporting Systems."
The memorandum report, and the USA Today article highlight the fact that hospitals seem to be ignoring state regulations that require them to report cases in which medical care harmed a patient. The USA Today article noted that this makes it almost impossible for health care providers to identify and fix preventable problems.
The Memorandum Report begins by stating that previous studies show that "…an estimated 27 percent of Medicare beneficiaries hospitalized in October 2008 experienced harm from medical care." Many of these events were classified as serious adverse events, defined as events resulting in prolonged hospitalization, permanent disability, life-sustaining intervention, or death. Other events were classified as temporary harm events, defined as events requiring intervention but not resulting in lasting harm.
The report further stated that "…an estimated 60 percent of adverse and temporary harm events nationally occurred at hospitals in states with reporting systems, yet only an estimated 12 percent of events nationally met state requirements for reporting." This meant that most events falling into this area did not get reported because they were not required to be reported.
Also alarming was the fact that hospitals often do not even recognize adverse events. The report stated, "We also found that hospitals reported only 1 percent of events. Most of the events that states required to be reported, but that hospitals did not report, were not identified by internal hospital incident reporting systems. This suggests that low reporting to state systems is more likely the result of hospital failure to identify events than from hospitals neglecting to report known events."
For the past several years Medicare administrators have made doctors of chiropractic and their patients a target for selective enforcement and regulatory restriction under Medicare because of a medical prejudice that is a gross disservice to both the patient and doctor of chiropractic. On May 16th, 2002, before a packed congressional hearing room, that trend was significantly exposed and debated.
At that hearing Small Business Committee Chairman, The Hon. Donald Manzullo (R-IL) and over a dozen other Members of the U.S. House of Representatives, pounded Medicare Administrator Thomas Scully for that program's ongoing policy of provider harassment. In a four-hour hearing, witness after witness, including ICA's Central Regional Director Dr. Michael Hulsebus (above) of Rockford, Illinois told the Committee how Medicare had conducted completely unjustified and overtly hostile and prejudicial attacks, post-payment audits and other strong-arm activities aimed at hurting non-MD providers.
Dr. Hulsebus addressed the issue succinctly with his testimony in which he stated, "Chiropractic providers and patients alike find it alarming when Medicare administrators take it upon themselves to use program policies to force health care decisions onto beneficiaries that ought to be left to the patients themselves. How else can you characterize policies that restrict access to one form of care, in this case chiropractic care, regardless of the clinical realities, and force those beneficiaries onto second-choice, specialist-based care that is far more expensive than the chiropractic care that is being denied? This is not only offensive in terms of personal liberties and control over one's own health care; it is also very poor public policy."
This historic hearing marks a major change in the role Congress is willing to play in protecting Medicare providers and Medicare patients from the heavy handed, arbitrary and prejudice driven operations of the Centers for Medicare and Medicaid Services (CMS). Formerly known as the Health Care Financing Administration (HCFA), the May 16th hearing was titled: "CMS, New Name, Same Old Game?" The anger and outrage of the Committee reached a peak when it was revealed that witnesses at earlier hearings on Medicare harassment had been subjected to snap Medicare audits on the very day they appeared before the Small Business Committee. Chairman Manzullo immediately called for an investigation of what he described as intimidation and witness tampering by Medicare and set a July 17th hearing date for a full review of this "horrific and frightening" abuse of power by Medicare authorities.
This legislative initiative was the product of many years of discussion, negotiations and education and came only after numerous attempts by the chiropractic profession and the Congress to persuade the U.S. Department of Veterans Affairs (DVA) to develop and implement a meaningful chiropractic program on their own. The bill now moves to the U.S. Senate for consideration and action. Some of the highlights of the bill include:
The establishment of on-going, regular chiropractic care as a routine benefit at all DVA facilities, and the establishment of a chiropractic oversight committee to assist in the rapid implementation of full chiropractic availability within the DVA.
A mandatory schedule for deploying in-facility doctors of chiropractic at all DVA medical centers, adding on-site practitioners at 30 sites per year until all locations have in-facility coverage. The first 30 sites are to be identified within sixty days of final passage of the bill.
The securing of primary care provider status for DCs so that all eligible veterans can have direct access to chiropractic care without the need for a referral from a medical doctor.
The appointment of a senior doctor of chiropractic to serve as a Director of Chiropractic Services within the DVA. This key individual would be directly responsible to the Secretary for Veterans Affairs and thus able to by-pass a historically hostile and obstructionist medical bureaucracy.
The establishment of an effective program of training and education to inform and orient other providers and beneficiaries as to the important role and availability of chiropractic services within the DVA.
News of a pilot program to expand chiropractic coverage in Medicare was reported in the April 7, 2005 issue of the Senior Journal. According to the report the Centers for Medicare and Medicaid have announced the start of a two-year demonstration to expand Medicare coverage of chiropractic services in five states. The purpose of this pilot program is to determine the impact on satisfaction, use of services, and costs for Medicare beneficiaries.
The states involved in the pilot program involve areas in Maine, New Mexico, Illinois, Iowa, and Virginia. In the areas of this pilot program, chiropractors are able to offer Medicare Part B patients an expanded array of services that they are allowed to provide by state law to their entire list of patients, but that were not previously paid for by Medicare.
Normally, only chiropractic adjustments are a covered service under Medicare. In the pilot program the services that will also be covered will include diagnostic and therapy services, including extraspinal manipulation or adjustment of a body part other than the spine, x-rays, EMG and nerve conduction studies, clinical lab tests, and certain additional procedures.
The program is designed to last for two years and evaluate the possibility of expanding chiropractic coverage in Medicare across the entire program.Â Centers for Medicare Services Administrator Mark B. McClellan, M.D., Ph.D noted, "Medicare currently only pays for a limited number of services from doctors of chiropractic, even though chiropractic services may be less costly alternatives to other types of medical care. He continued, "By expanding chiropractic coverage in this demonstration, we are reducing out-of-pocket costs for seniors who visit chiropractors, and we will learn whether paying chiropractors for delivering these additional services can help improve health outcomes and keep Medicare costs down."
In a recently passed bill, the US House and Senate agreed on language that sets up open access to chiropractic care in the VA (Veterans Administration). This new law, when enacted, will open access for all US military and veterans to receive chiropractic care under that program. The details and implementation of the program have still to be worked out but the intent was clear.
The bill contains the following language, "at least one site for such program (chiropractic) in each geographic service area of the Veterans Health Administration" (VHA). The chiropractic care specifically includes subluxation care, as well as a training program to orient the VHA personnel regarding the benefits of chiropractic care and services and employment of doctors of chiropractic. This means that chiropractic care should be made available through the hiring of chiropractors at each geographic location that the VA has a health care facility.
Chiropractic organizations have been attempting get a law such as this passed that gave these benefits to US veterans since 1936. In response to the law passage, the International Chiropractors Association released the statement, "This represents a great victory for the chiropractic profession and the veteran beneficiary alike, and comes in the face of massive opposition from competing professions as well as agency bureaucrats who have opposed and obstructed any meaningful access for veterans to chiropractic services for decades."
Although it is not entirely clear how the VHA will fully implement this new law, or how long it may take to be up and running, the language of the law does ensure that care will be provided. Probably one of the most telling portions of the law reads, "The chiropractic care and services available under the program shall include a variety of chiropractic care and services for neuro-musculoskeletal conditions, including subluxation complex."
On April 2, 2002 the US Supreme Court ruled unanimously to uphold a Kentucky law known as an "Any Willing Provider Law". Although this ruling did not get much press coverage, this ruling will have a profound effect on how health care is offered to the general public. Additionally, the law will have a considerable impact on the availability of chiropractic care in managed care programs.
This ruling upholds state laws that force HMOs to open up their doctor networks, allowing regulations in about half the states to give patients broader health care choices. The ruling is a blow to the managed care industry, which argued that closed networks are more cost-effective because doctors and hospitals that join agree to accept lower fees in return for a guaranteed stream of patients.
State "Any Willing Provider" laws basically allow all licensed doctors who agree to the terms of the HMO to become participating doctors in the HMO. This prevents HMO's from limiting the number of doctors in their network. According to many state laws HMO's are not allowed to discriminate against chiropractors.
This ruling upholds those laws and opens up networks allowing more chiropractors to participate in various health plans.
The laws affect HMOs in all areas, but are particularly helpful to patients in rural areas or small towns, where health care choices are limited. In those areas, patients sometimes have to drive many miles to see an in-network health care provider. The Kentucky statutes were challenged by a group of HMOs and an industry trade association. The case turned on whether the laws regulate insurance, which states are allowed to police, or regulate employee benefits, an area reserved for Congress. The Bush Administration, had asked the court to uphold the Kentucky laws.
A report of the U.S. Department of Defense (DOD) on the Chiropractic Health Care Demonstration Project was finalized by DOD consultants Birch and Davis and was submitted to the U.S. Congress. The report authors, were cautious at best with their recommendations but the results of the study speak for themselves. The following are some of the statistics of patient responses to chiropractic care verses medical care.
How satisfied are you with improvement in your condition: Excellent - Chiropractic care, 81.5% v. 55.6% for medical care. How satisfied are you with the practitioner's willingness to spend time with you: Excellent: Chiropractic care, 93.7% v. 77.5% for medical care.
How satisfied are you with the explanation of your treatment: Excellent: Chiropractic care, 95.1% v. 81.1% for medical care. What best describes you today? Not restricted: Chiropractic care, 48.5% v 32.1% for medical care. Somewhat restricted Chiropractic care, 44.1% v. 50.0Â for medical care. Very restricted: Chiropractic care, 7.4% v. 17.9% for medical care.
What is your current level of activity: * Not restricted: Chiropractic care, 73.4% v. 53.9% for medical care. Somewhat restricted: Chiropractic care, 19.2% v. 29.4% for medical care. Very restricted: Chiropractic care, 7.4% v. 17.7% for medical care. I feel better now * Strongly agree: Chiropractic care, 78.5% v. 49.2% for medical care. Somewhat agree: Chiropractic care, 14.6% v. 22.0% for medical care. Strongly disagree:
Chiropractic care, 6.9% v. 28.8% for medical care.
I had good results from the treatment * Strongly agree: Chiropractic care, 82.9% v. 50.7% for medical care. Somewhat agree: Chiropractic care, 12.6% v. 24.8% for medical care. Strongly disagree: Chiropractic care, 4.6% v. 24.6% for medical care. The pain is worse now * Strongly agree: Chiropractic care, 4.4% v. 9.9% for medical care. Somewhat agree: Chiropractic care, 7.6% v. 19.6% for medical care. Strongly disagree:
Chiropractic care, 88.0% v. 70.5% for medical care.
Days off duty (0 days) Chiropractic care, 87.1% v. 66.1% for medical care. (1-4 days) Chiropractic care, 9.6% v. 25.8% for medical care.(5+ days) 3.3% v. 8.0% for medical care. Days on restricted duty (0 days) Chiropractic care, 71.5% v. 51.1% for medical care.(1-4 days) Chiropractic care, 4.2% v. 8.2% for medical care, (5+days) Chiropractic care, 2.3% v. 40.7% for medical care.
A research report from the November 8, 2006 issue of the Journal of Vertebral Subluxation Research shows the benefits of chiropractic care for patients suffering from vertigo. In this study 60 patients who were diagnosed by their medical physicians as having various forms of vertigo, received chiropractic care and the results were documented and published.
Vertigo is a condition characterized by dizziness with a sensation of spinning. Because of the feeling of movement or rotation, many sufferers also feel nausea and can experience lightheadedness and balance problems. The diagnosis of vertigo is typically based on the symptoms of the patients as there are not specific lab tests and the patients may have a variety of situations that seem to be related. In this study, the nervous system was looked to for a causal relationship.
Of the 60 patients in this study, 56 reported having some form of physical trauma prior to the onset of their vertigo. Of these 25 had reported having automobile accidents, 16 had suffered a sports injury including skiing, bicycling, or horseback riding, and 6 slipped and fell on ice. It was noted that all of these individual's suffered trauma to either their head or neck area.
Upon initial examinations of the subjects, it was reported that vertebral subluxations were found in all 60 patients. Analysis procedures using paraspinal digital infrared imaging and laser-aligned radiography, were performed in order to have a consistent means of measuring subluxation findings and progress of correction.
Specific chiropractic care for the correction of subluxations was rendered to all 60 subjects in this study. The results showed that all of the patients in this study responded positively to the chiropractic care. The time frame for the responses varied from between one and 6 months. Of the original 60 patients, 48 were totally symptom free within six months. The remaining 12 patients had also shown good improvement by either decreases in severity or frequency in episodes of vertigo.
In the conclusion, the author of the study noted, "A causal link between trauma-induced upper cervical (neck) injury and the onset of vertigo appears to exist. Correcting the injury to the upper cervical spine through the use of IUCCA protocol (a form of chiropractic care) appears to improve and/or reverse vertigo disorders."