The World Chiropractic Alliance explains its position on the Veterans Affairs Chiropractic Oversight Committee

by Terry A. Rondberg, D.C., President, World Chiropractic Alliance

We all celebrated when President Bush signed the bill making chiropractic available to U.S. veterans through the Veterans Affairs health system.

The victory was even sweeter because the World Chiropractic Alliance (WCA) managed to save the specific reference to subluxation correction rather than let the bill go through with mention only of "treatment of neuromusculoskeletal conditions."

Now, however, we have begun work on the second phase of the V.A. process.

The legislation, after all, didn't throw open the doors of the V.A. hospitals and invite D.C.s to stop by and give adjustments. These things take time and planning and Public Law 107-135 calls for the establishment of a "Chiropractic Advisory Committee" which will help develop and implement the V.A. new chiropractic health care program.

The composition of this committee is very important because it will shape the role chiropractors will play in the V.A. health system.

For the WCA, this is an excellent opportunity to show how far the major chiropractic organizations have come in their quest for cooperation and unified action. A committee consisting of representatives from all groups would ideally reflect the diversity of the profession as a whole. It would also help eliminate any friction which might arise from any one group having too much influence on the process.

At first, it was proposed that the same people picked for the Department of Defense (DOD) Oversight Advisory Committee -- including Drs. Reed Phillips, George Goodman, Ronald Evans, Peter Ferguson, and Rick McMichael -- serve on the V.A. Committee.

The WCA had even acquiesced to such a plan (with the proviso that Dr. Carl Cleveland be added to the Committee), if the bill passed with the stipulation that the DOD panel also serve as the V.A. committee.

Since the bill did not include that stipulation, the WCA was not bound by its agreement to back the original plan. We felt, given the present situation, the chiropractic profession and our veterans, would be best served if the VA Advisory Committee contained a broader representation of the entire chiropractic profession.

If all major organizations had a chance to nominate one of their members, each would have a personal stake in the success of the Committee and would be able to more fully report on and support its activities and recommendations.

Furthermore, we think the selection of the same individuals for the VA Advisory Committee might easily be interpreted as the work of a "good old boy network." The profession is filled with doctors who have the expertise, ability, and dedication to serve on the VA Advisory Committee and should be provided an opportunity to make their own contributions to the profession.

There are other good reasons why new names should be put forth.

As Ronald M. Hendrickson, executive director of the International Chiropractors Association (ICA) astutely pointed out, "We at the ICA have determined that those individuals are far less likely to receive approval by Secretary Principi BECAUSE of their DOD service, having been appointed under President Clinton. The partisan nature of the new Administration all but precludes recycling Clinton appointees for any position."

There is another important issue involved in the selection of V.A. Committee members.

Back in 1995, when the DOD Oversight Committee was formed, few people fully realized the extent of the profession's rejection of the Mercy Guidelines. That may be one reason why three of the five people picked had served as Mercy Commission Members or on the Steering Committee.

Obviously, the committee was far too heavily weighted with Mercy supporters. In fact, a report published in Dynamic Chiropractic stated that the DOD's Chiropractic Demonstration project must "Follow practice guidelines as established in the Guidelines for Chiropractic Quality Assurance and Practice Parameters: Proceedings of the Mercy Center Consensus Conference, Aspen Publishers, Inc., Gaithersburg, Maryland, 1992 (or its successor)."

Later, the American Chiropractic Association (ACA) stated that the report was in error and the rules never mandated that the project follow the Mercy Guidelines.

Still, the project was limited to "spine-related neuromusculoskeletal disorders," and specifically excluded "patients under 17 years of age and female patients who are, or may be, pregnant." Further, the project rules never once referred to subluxation correction or included any allowance for that type of care.

It's certainly reasonable to assume these DOD committee members would have followed the Mercy guidelines even if they weren't forced to. After all, they developed them!

Given the fact that the Mercy document has been so solidly rejected throughout the profession, the WCA feels it would be unwise to nominate doctors so closely aligned with its formulation.

Although the WCA, ICA and ACA are not yet in full agreement on the composition of the Veterans Affairs Advisory Committee, I'm confident the three groups will once again work together to reach a mutually acceptable solution.