Chiropractic in the Military
PL 102-484
President Bush signed the Defense Authorization Bill (HR 5006) into
law on October 23, 1992. Section 505 authorizes the Secretary of Defense
to "appoint chiropractors as commissioned officers in the armed forces
to provide chiropractic care within the military health system."
On May 27, 1993, an Army Information Paper indicated that
chiropractors would be commissioned as officers in the Medical Services
Corps.
As of January 2000, no chiropractor has been commissioned as a
chiropractor in any branch of the military.
Chiropractic in the United States
There are two major schools of thought in the chiropractic
profession. The first considers chiropractic to be a limited medical
specialty for the treatment of certain musculoskeletal disorders.
Proponents of this position embrace a broad array of therapeutic
interventions including manipulation and physical therapy modalities.
This necessarily encroaches on the practice of medicine and physical
therapy.
The second school of thought is committed to positioning chiropractic
as a separate and distinct discipline in the healing arts, which does
not duplicate existing medical services. It is directed toward the
correction of vertebral subluxations, which interfere with the function
of the nervous system.
Chiropractic in Medicare
Chiropractic has been included as a Medicare benefit for over 25
years. 42 USC 1395x(r)(5) provides for chiropractic services limited to
manual correction of spinal subluxations. The Medicare benefit does not
include physical therapy services. The only "condition" covered is
spinal subluxation.
This position is consistent with the school of thought which
positions chiropractic as a separate and distinct profession.
Recommendations
Our recommendation is that the military be directed to immediately
commence commissioning chiropractors as officers in all branches of the
military. This should include:
1. Create a Chiropractic Corps providing chiropractic examinations
and adjustments to correct vertebral subluxations.
Rationale: A separate Dental Corps exists, recognizing that
dentistry is a service separate and distinct from medicine. Chiropractic
does not belong in the Medical Specialist Corps. Physical therapy and
rehabilitation services are already available within the military
system; chiropractic examination and adjustment to correct vertebral
subluxations are not. This provides consistency with the other existing
Federal program, is the more cost-effective approach, and satisfies
legislative intent.
2. Direct access to chiropractic care.
Rationale: Only a chiropractor is qualified to determine the
appropriateness of chiropractic care. Direct access would also eliminate
the costs associated with a screening process by other providers.
3. Adoption of Council
on Chiropractic Practice Clinical Practice Guideline Number 1--Vertebral
Subluxation in Chiropractic Practice.
Rationale: This evidence-based guideline is current, and was
distributed to US chiropractors in 1999. It was produced by an
interdisciplinary expert panel, and underwent peer review by 195
chiropractors in 12 countries. The Guideline is included in the AHCPR
National Guideline Clearinghouse.
The World Chiropractic Alliance
The World Chiropractic Alliance (WCA) is an international, non-profit
professional membership organization. The WCA is concerned with health
promotion, wellness, and quality of life issues. It is committed to
positioning chiropractic as a separate and distinct discipline in the
healing arts. WCA’s vision of chiropractic is directed toward the
correction of vertebral subluxations, which interfere with the function
of the nervous system.
WCA was accredited as an NGO (non-governmental organization) by the
Department of Public Information of the United Nations in late 1998.
The World Chiropractic Alliance urges the military to promulgate a
policy which provides for the creation of a Chiropractic Corps.
Furthermore, there should be no further delay in commissioning
chiropractors as officers.
