September 2008

VA expands chiropractic program

The Veteran's Health Administration (VHA) has taken steps to incorporate and expand chiropractic into its healthcare system. As the largest healthcare system in the United States, and boasting more than 7.9 million enrolled veterans, the integration of chiropractic will be facilitated by the VHA's National Director of Chiropractic Services, Anthony J. Lisi, DC, Chief of Chiropractic at the VA Connecticut Healthcare System, and Associate Professor of Clinical Sciences at the University of Bridgeport, Conn.

"The opportunity for Dr. Lisi to incorporate chiropractic into the VHA came to the forefront when leaders of the chiropractic profession -- many of whom are veterans themselves -- advocated that chiropractic services be incorporated in the VHA," says Gerard W. Clum, DC, president of Life Chiropractic College West and spokesperson for the Foundation on Chiropractic Progress. He noted that Lisi takes a patient-centered, evidence-based approach.

"The chiropractic program was established in late 2004 in response to legislation that required at least one chiropractor in each of the 21 VHA geographic regions. Currently, there are now 38 chiropractors working in 32 VHA sites, and the number is growing, a trend that represents the biggest large-scale implementation in the VHA to date.

Nationally, Chiropractic Care Services is part of the Rehabilitation Services Strategic Healthcare Group, within the Office of Patient Care Services.

Although vehemently fought against by the World Chiropractic Alliance and the International Chiropractors Association, the VHA chose to make chiropractic care -- and all other "specialty clinics" available only through referral from a medial primary care provider.

"The patient referral policy may seem an undesirable arrangement to many private practitioners, but in the VHA it works exceptionally well," claimed Lisi. "The evidence of collaboration between chiropractors, medical physicians and other providers speaks volumes. In the VHA environment, collaboration replaces competition and leads to better healthcare for our patients."

With an ever-growing number of members in the VHA, including over 263,000 veterans from Iraq and more than 7.9 million veterans in total, the need for a wide range of health services becomes a strategic imperative. Chiropractic care can play a role in major traumatic injuries resulting from explosive devices; less severe injuries resulting from motor vehicle accidents or other situations; and the back pain associated with and common to deployment.

To facilitate the growth of chiropractic in the VHA system, 12 VHA facilities have an academic affiliation with a total of nine different chiropractic schools. Under the supervision of staff chiropractors, students complete rotations in the VHA facility. More than 300 chiropractic students have undergone training in a VHA facility. Medical students or medical residents may also rotate through a VHA chiropractic clinic to facilitate collaboration.

The chiropractic program's ongoing commitment to quality improvement also includes research leading to improved function, health and quality of life for veterans.

"The real challenge is learning how to optimize our efforts and to find the best way to collaborate for the patient's best interest," Lisi concluded.

SOURCE: The Foundation for Chiropractic Progress