A comparison of chiropractic service integration within the Military Health System and the Veterans Health Administration

Introduction: The inclusion of chiropractic services into the Department of Defense (DoD) and Department of Veterans Affairs (VA) medical facilities is the most systematic and wide spread example of the integration of chiropractic care in the United States. While both the DoD and VA are federal health care systems, there are many differences in the integration of chiropractic services into these systems and those differences extend far beyond variations in the population demographics unique to each environment. The purpose of this paper is to compare chiropractic integration within these two systems and to identify practices and policies that may either support or challenge chiropractic integration.

Methods: Providers within these systems, as subject matter experts, reviewed legislation, policies, and the literature pertinent to chiropractic practice in VA or DoD medical facilities.

Results: We identified eight areas wherein there were potential barriers and catalysts to integration, including the following: legislative history, employment status of providers, programmatic growth, leadership, patient demographics, clinical care, education, and research.

Conclusion: This comparison should contribute to a higher level of understanding about the current state and future direction of chiropractic service integration within these health care systems. The views expressed in this presentation are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, Department of Veterans Affairs, or the United States Government.