When President George W. Bush signed into law the hard-fought bill that provides for chiropractic benefits in the Veterans Affairs health system, the profession celebrated a great victory. Not only did it make significant progress in establishing chiropractic as a separate and distinct discipline, but it proved that the various chiropractic organizations could work together toward common goals.

Shortly afterwards, however, a related issue arose that disrupted the delicate balance achieved within the National Chiropractic Leadership Forum (NCLF) – the question of who would serve on the VA Chiropractic Advisory Committee.

The bill calls for the establishment of a committee to oversee the implementation of the new law's provisions. The committee's responsibilities will be similar to those of the one instituted to oversee the Department of Defense chiropractic demonstration program.

Since the bill did not specify the composition of the committee, the federal government invited various organizations to submit names of potential candidates to the Secretary of the Department of Veterans Affairs. The World Chiropractic Alliance (WCA) and International Chiropractors Association (ICA) both submitted names of well-known and highly respected D.C.s who were deemed capable of protecting chiropractic's interests in the VA system.

The submissions were considered particularly important since the National Association of Chiropractic Medicine (NACM) had reportedly submitted several applications as well. The NACM has repeatedly argued against the premise of chiropractic and the very existence of subluxations.

The American Chiropractic Association (ACA) and Association of Chiropractic Colleges (ACC) however, protested the WCA and ICA actions, stating they were in violation of an "agreement" made last year by all four groups.

Differing interpretations of the meaning and intent of the agreement have led to a dispute among the organizations.

The members organizations of the NCLF had made another agreement as well – to try to work out their differences before publicly airing the profession's "dirty laundry." Doing so would reduce tension between the groups, eliminate the need for "posturing," and deprive our enemies of ammunition to use against us. This agreement was an essential element of our quest for unified action.

Yet, the ACA and ACC violated this critical part of the NCLF's ethical code by sending correspondence about this dispute to Dynamic Chiropractic (DC) DC publisher Mr. Don Petersen – a media member of the NCLF – also broke the code by publishing it.

Although the article claimed to present information from each of the organizations involved, DC severely edited the response from the World Chiropractic Alliance.

Given this situation, the WCA felt it imperative to respond to the spurious allegations made in the DC article. Both the WCA and the ICA feel strongly that this matter should have been resolved privately by representatives to the NCLF, as called for by the confidentiality agreement.

Even given the apparently improper actions by the ACA, ACC and DC, the WCA and ICA still call for unified action and intra-professional cooperation.

Below is the full response submitted to Dynamic Chiropractic, explaining the WCA position on the issues involved.

A: No. The agreement related to the submission of draft legislation by the ACA, ACC, ICA, and WCA. The entire text of the agreement follows:

"As per the staff discussions this memo is to confirm that the aforementioned organizations are in agreement regarding language for VA legislation as distributed. Please sign this memo and fax back to me at (number).

"Also in addition to the language as distributed, the aforementioned organizations will write a letter to the Secretary of the Department of Veterans Affairs at the appropriate time supporting the addition of a second ACC member to the Oversight Advisory Committee. Dr. Carl Cleveland will be nominated."

The House of Representatives and Senate did not accept the draft legislation, and substantially modified it. Among other changes, the Congress chose not to "reconstitute" the DoD committee. Instead, the law provided for an open process to form a new Advisory Committee. It is clear from this action that Congress wanted a new committee, with appointees selected by the Administration on the basis of merit.

At no time did WCA ever agree to refrain from submitting nominees. We merely agreed to support the nomination of Dr. Cleveland, and are prepared to do so. However, our recommendation of Dr. Cleveland does not preclude our submission of other candidates. WCA will not oppose the candidates proposed by ACA and ACC.

WCA has confidence that the open process provided by Congress provides the best opportunity for fair and balanced representation of the entire chiropractic profession.

A: On March 11, 2002, WCA sent e-mail to ACA and ACC officials proposing, "that a joint list of recommended candidates be submitted by the ACA, ACC, ICA, and WCA. The list would include the six candidates proposed by the ACA/ACC, as well as the candidates proposed by the ICA and WCA."

ACA and ACC rejected this proposal, preferring instead to promote their own political agenda to the exclusion of others, and to the detriment of the profession.

WCA accepts the principles of the National Chiropractic Leadership Forum (NCLF), which provide for "unity in diversity." Furthermore, the NCLF has reached consensus on the following key issues:

>>> We should bring the profession's internal conflicts into this open forum (NCLF) for resolution (and not air them in public).

>>> The quest for unity does not require sacrificing institutional autonomy.

The unilateral actions of the ACA and ACC are inconsistent with these principles. The ACA and ACC are fostering conflict and divisiveness. WCA feels that doctors in the field are tired of associations trying to force their ways on others. For this reason, WCA encourages fair and equitable representation in all government programs.

A: Yes. When we were given ultimatums, we acted to ensure balanced representation on the VA Advisory Committee. WCA's nominees all have experience as chiropractic practitioners. All have dealt with "hostile" situations. All are experienced in politics, and have worked with interdisciplinary groups. Their backgrounds include education, publication, research, and clinical practice guideline development. We have individuals who have worked with senators, congressional representatives, the VA, and Medicare. Our nominees include the first chiropractor ever appointed to the White House Commission, and the first chiropractor elected to chair the NGO Health Committee, whose members are affiliated with the United Nations. Our nominees are well qualified, and committed to "unity in diversity."

A: Certainly not. Those ICA officials who were involved in the negotiations corroborate our recollection of the "spirit" of the agreement. The actual agreement is cited above.

Question 5. Do you believe the lack of solidarity among the four organizations will allow the DVA to appoint a member of the NACM or representatives from other so-called "anti-chiropractic" groups?

A: No. The DVA is likely to appoint one or more "anti-chiropractic" individuals regardless of what the chiropractic profession does. WCA believes the best way to ensure proper representation of the chiropractic profession is to submit a pool of highly qualified applicants from all four organizations. We have a much better chance of getting pro-chiropractic appointees if each organization presents a slate of candidates.

A: No. We believe the attempts of the ACA and ACC to exclude ICA and WCA members from the VA Advisory Committee indicate that the ACA and ACC have placed their political agenda above the best interests of the chiropractic profession.

WCA and ICA are not asking ACA and ACC to support our nominees to the exclusion of theirs!

The VA statute provides that, "The chiropractic care and services under the program shall include a variety of chiropractic care and services for neuro-musculoskeletal conditions, including subluxation complex."

The intent of Congress was that a variety of chiropractic services be provided to eligible veterans, including care for neuromusculoskeletal conditions, and that care for the subluxation complex is explicitly included. Therefore, representation on the VA Advisory Committee should include a balanced, diverse array of qualified chiropractors.

A: WCA supports unified action in chiropractic. One of the first organizations to endorse the ACC Paradigm was the WCA. WCA is confident that the profession will see through these attempts to distort our intent and actions. All we are asking is fair and equitable representation.

While we promote tolerance and diversity, we will not be bullied or intimidated. WCA is realistic enough to acknowledge that there will be times when all chiropractic organizations cannot reach agreement. This does not mean that we should abandon unified action in areas where we can agree. All chiropractic organizations must have the maturity and tenacity to realize this.