ARLINGTON, VA - The U.S. Congress passed the Health Care Safety Net Improvement Act (H.R. 3450) on October 17, 2002 (passed by the Senate as S. 1533). Sec. 301 of the bill deals with amendments to the National Health Service Corps (NHSC), a federally-funded program in existence since 1970, dedicated to serving the health needs of underserved areas of the U.S.
In 1972, Congress passed amendments to the Emergency Health Personnel Act that authorized scholarships for NHSC health professionals in return for service to underserved communities. In 1987, Congress authorized the NHSC Loan Repayment Program, which afforded primary health care professionals reimbursement for student loans in return for establishing and maintaining their practices in geographic areas, both rural and urban, designated by the government as medically underserved.
Sec. 338L of the bill establishes "a demonstration project to provide for the participation of individuals who are chiropractic doctors or pharmacists in the Loan Repayment Program." (Emphasis added.) The inclusion of chiropractic in the program is a policy change that stems from nearly two years of lobbying efforts by the American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC).
President Bush is expected to sign the bill. Once signed into law, the legislation will allow doctors of chiropractic to take part in a three-year pilot program, or test period. At that point, the bill stipulates:
"The Secretary shall prepare and submit a report describing...how the participation of chiropractic doctors and pharmacists in the Loan Repayment Program might affect the designation of health professional shortage areas; and the feasibility of adding chiropractic doctors and pharmacists as permanent members of the National Health Service Corps."
The amendments to the Health Care Safety Net bill are part of a long-planned overhaul of federal legislation governing the Public Health Service Act, which includes the NHSC program.
Having the chiropractic profession eligible to participate in the NHSC has long been a goal of the ACA and the ACC. Both organizations have worked hard toward that inclusion, but were opposed by other health care provider groups also seeking to be included in the program. ACA and ACC worked with key legislators, Senator Tom Harkin (D-IA), and Representatives Billy Tauzin (R-LA) and Michael Bilirakas (R-FL).
ACA Chairman James Edwards,DC, called the legislation "another significant victory" for the chiropractic profession. "It sends a strong signal that chiropractic care should be considered an essential element in the delivery of health care in this nation. Following on the heels of our recent legislative victory to mandate chiropractic care in the Department of Defense and the Department of Veterans Affairs health care systems, it indicates the growing level of acceptance of chiropractic and the effectiveness of our association on Capitol Hill."
"The ACA would like to thank all those doctors and students who contacted their members of Congress on this issue," said ACA President Daryl Wills,DC. "The NHSC loan reimbursement program is an issue of particular importance to our chiropractic students, and these students are to be commended for rallying behind the cause. The lobbying efforts of the Student ACA members really made a difference. This is not only a victory for the ACA, the ACC and the profession, but for the chiropractic colleges as well."
The NHSC reports that over 22,000 NHSC clinicians have dedicated all or part of their careers to providing primary health care in underserved areas. The NHSC currently has 2,300 clinicians providing health care to approximately 3.6 million people.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
