By J.C. Smith
Special to The Telegraph, August 8, 2014
At the centerpiece of the “Veterans Access, Choice and Accountability Act of 2014” is a “Choice Card” to increase veterans’ access to services. The Congressional Budget Office projected that tens of thousands of veterans who currently are not treated by the VA would likely seek VA care if they could see a private doctor paid for by the government. Acting Secretary Sloan Gibson also proposed hiring 1,500 more doctors to care for our veterans.
Rep. Jeff Miller, R-Fla., chairman of the House Armed Services Committee mentioned the need to give vets choices in their health care. “The VA has caused this problem and one of the ways that we can help solve it is to give veterans a choice, a choice to stay in the system or a choice to go out of the system” to get government-paid health care from a private doctor.”
However, what good is a Choice Card if there is no difference among the choice of doctors and treatments, especially for back pain, the No. 1 disabling condition in the military?
Simply adding more MDs will be equivalent to a statement attributed to Albert Einstein: “Insanity is doing the same thing over and over again and expecting different results.”
The lack of non-drug choice of treatments for chronic back pain has now created a huge opioid prescription painkiller drug problem and the pill mill mentality where opiates are indiscriminately handed out like Halloween candy to veterans and active duty service members alike.
The first obstacle to choice occurs when vets and ADSM request chiropractic care but are forced to take opioid drugs and muscle relaxors or have epidural steroid injections before they will be referred to doctors of chiropractic.
Unquestionably, a patient should not be forced to take narcotics and steroids before seeking a non-drug solution for back pain. Just as these drugs are banned in sports, they should also be banned in chronic pain cases except for terminally ill cancer or intractable pain cases as they were originally designed.
This VA protocol is backwards to the international spine care guidelines that recommend spinal manipulative therapy and clearly do not recommend as first-line treatments narcotic painkillers, muscle relaxors, or epidural corticosteroid injections for acute or chronic back pain.
The answer to the epidemic of back pain is not more pills, shots, or surgery. If the Department of Veteran Affairs offers a true choice care, it must refer to or hire more chiropractors as primary spine providers to give vets a real choice in their own health care.
J.C. Smith, MA, DC is a Warner Robins chiropractor.