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Dynamic Chiropractic – June 21, 1991, Vol. 09, Issue 13

George McAndrews Responds to DOD

By Editorial Staff
The April 24, 1991 issue of "DC" featured a front page story on the response of Edward Martin, M.D. (deputy assistant to Secretary of Defense Richard Cheney) to letters from DCs Craig Benton and Michael Lynn who wrote the secretary of defense to ask for his support of bill S.68 (commissioning DCs in the military).

These two DCs, and Dr. Charles Downing, president of the ACA, received letters from Dr. Martin that were nearly identical. Excerpts of Dr. Martin's letter follow:

... The Department of Defense is on record as opposing such action because the scope and manner of practice of chiropractic would not add to the care of our beneficiaries.

... The treatment of musculoskeletal ailments ... is currently well covered by physicians and physical therapists. Definitive medical and surgical care is available which cannot be provided by doctors of chiropractic medicine.

... In addition, there is great variation in the educational levels, the curricula of the schools, and the licensing standards among the states.

... Our position and concerns in this regard are supported by the American Medical Association, the American Osteopathic Association, the American Physical Therapy Association, and other professional organizations.

George P. McAndrews, Esq., general counsel for the ACA responded to DOD's assistant deputy with a 15-page letter that quoted evidence from the Wilk et al. case, scientific studies proving chiropractic's effectiveness, and letters from MDs praising chiropractic over other health care professions. Excerpts from Mr. McAndrews letter follow:
... To say the least your letter is remarkably ill-researched, is contrary to the facts and most modern research, and, in its reliance on the AMA and the American Osteopathic Association for support for your opposition to commissions for doctors of chiropractic, borders on ludicrous.
The AMA and the American Osteopathic Association were sued in 1976 for attempting to destroy the profession of chiropractic through an illegal boycott. On September 25, 1987 the United States District Court for the Northern District of Illinois found the AMA guilty of a "lengthy, systematic, successful, and unlawful boycott." This finding was affirmed by the United States Court of Appeals for the Seventh Circuit in Wilk et al. v. AMA et al., 895 F.2d 352 (7th Cir. 1990).
... In 1975, a 1972 retrospective study of California workmen's compensation cases ("Industrial Back Injury," by C. Richard Wolf, M.D.) was published. Note the almost linear two to one advantage of chiropractic over medical physician care at every level of severity.
"Average lost time per employee -- 32 days in the M.D.-treated group, 15.6 days in the chiropractor-treated group.

Employees reporting no lost time -- 21 percent in the M.D.-treated group, 47.9 percent in the chiropractor-treated group.

Employee reporting lost time in excess of 60 days -- 13.2 percent in the M.D.-treated group, 6.7 percent in the chiropractor-treated group."

... I believe the recently published, multi-year, prospective study by a medical research council in Great Britain, comparing chiropractic care to care rendered in eleven hospital out-patient clinics for back pain and published in the British Medical Journal for June, 1990, should give you pause when you make your unsubstantiated claims that your medical physicians and physical therapists are fulfilling the health care needs of the men and women of the armed forces.
"Conclusions -- For patients with low back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain. Introducing chiropractic into NHS should be considered."
... Each and every study of the subject matter to date, including those formerly suppressed by the AMA, indicates that the men and women of the armed forces denied chiropractic care (and subjected to inadequate and unskilled medical physician and physical therapeutic care for non-surgical neuromusculoskeletal problems), are subjected to unnecessary, extended pain and suffering leading to debilitation.

... We ask that the matter of commissions for doctors of chiropractic in the armed forces be turned over to someone who does not have an anticompetitive, narrow-minded professional bias. Someone must represent the men and women who receive as well as deliver care. Only the armed forces will benefit from such a course.

Mr. McAndrews' letter is certainly a document that the DOD will not be able to ignore. But the battle for DCs to be commissioned in the armed forces has not ended. It will continue in the United States legislature, and will require the combined efforts of the ACA, the ICA, and many other chiropractic organizations. It will also be necessary for DCs all over America to contact their senators and representatives on behalf of the profession. The victory will be well worth the effort.

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