Veterans Affairs debates giving vets direct access to chiropractic care

At issue is whether to require a referral or let patients decide. The policy committee is open to comment until September.

By Damon Adams, AMNews staff. Aug. 18, 2003.

Agreeing on staffing, space and equipment for a chiropractic health program at Dept. of Veterans Affairs medical centers and clinics was easy.

The tough part was reaching a consensus about how patients should access chiropractic care in the VA system, which boasts 163 hospitals and 850 clinics and presently contracts for chiropractic services.

In a draft report filed last month, members of an advisory committee appointed last year to give advice on how to develop and implement the program could not agree whether patients should have direct access to chiropractors or be required to get a referral from a primary care physician.

"The primary care physician is the person responsible for coordinating care," said Warren A. Jones, MD, committee member and chair of the board of directors of the American Academy of Family Physicians.

Members favoring a referral system said access to chiropractic care should require a referral from the primary care clinician that is expedited without barriers. They said allowing direct access for only chiropractic care could create animosity and lead to demands for direct access to medical specialists or other care.

Six committee members favored a referral-only system, and five wanted a more direct form of access, the report said. The committee consists of six chiropractors, three physicians, a physical therapist, and a member of a veterans service group. The report did not break down the preferences of each member.