1.1 INTRODUCTION
Chiropractic services and chiropractic itself has changed greatly over the years. Now for example, chiropractic services have been largely or fully integrated with medical and other mainstream health care services in a number of countries. Students of chiropractic and medicine at the University of Southern Denmark have to complete their first three years of study of basic sciences together before branching into their separate clinical training. In the US chiropractic services are now available in the military and veterans’ administration hospital and health care systems and through Harvard University’s health care network. Wayne Jonas, MD, Founding Director, Office of Alternative Medicine, US National Institutes of Health stated [1]:
‘The chiropractic profession is assuming its valuable and appropriate role in the health care system in this country and around the world. As this happens, the professional battles of the past will fade and the patient at last will be the true winner.’ (p. 1).
There are various forms of traditional, alternative, complementary or non-conventional medicine, such as acupuncture, homeopathy, phytotherapy, osteopathy, chiropractic, shiatsu, reflexology, anthroposophical medicine, ayurvedic medicine and traditional Chinese medicine. These, among others are gaining fame and recognition across Europe. A significant and growing proportion of the public and health care professionals are actively choosing to integrate them into their health care provision and practice. These types of medicine are being chosen by increasingly well-informed patients and health care professionals as either alternative or complementary approaches to the mainly technological and pharmaceutical based interventions of mainstream medicine [2]. This is not to say that all of these healing disciplines wish to become ’integrated’. Integration, as far allopathic medicine is concerned, has usually meant subjugation.
Busse et al [3] touch upon the fact that in the United States, chiropractic has become integrated within the health care system of both the Department of Defense (DoD) and the Department of Veterans Affairs. Within the DoD, the Military Health System coordinates health care delivery for active duty military personnel. Chiropractic integration within the DoD began with the Chiropractic Health Care Demonstration project (CHCDP) originating at 10 military treatment facilities in 1995. There is currently chiropractic services provided at 49 military facilities within the United States. Chiropractic services are available for active duty military personnel, not dependents, at facilities where chiropractic care is offered. As military personnel retire or are discharged from active duty, they transition to veteran status and become eligible for health care services within the Veterans Health Administration (VHA). Chiropractic services were made available through legislative means to veterans through the VHA within the Department of Veterans Affairs.There is no such coverage in the health insurance system of the United Kingdom.
Different countries have different systems although a number of European countries and Australasia [Australia and New Zealand] do have long standing comprehensive tax supported health care services [3].Surprisingly, as shown by Karen Davis et al [4] despite having the most costly health system in the world, the United States consistently under-performs on most dimensions of performance, relative to other countries.
REFERENCES
- Smith DC. The Chiropractic Profession: Basic facts, independent evaluations. Common questions answered. The Chiropractic Report 2008; 22(5) 2010; 22(5). [Online]. Available from: http://chiropracticreport.com/portal/images/back_issues/200809.pdf [Accessed July 2010].
- European Public Health Alliance. Integrated health care in Europe. Update 62 [Online] Available from: URL:http://www.epha.org [Accessed July 2010].
- Busse R, Schreyögg J, Gericke C. Analyzing changes in health financing arrangements in high-income approach. [Online] 2007 Feb [cited 2010 Jul]; Available from: URL: http://siteresources.worldbank.org
- Davis K. Schoen C. Stremikis K. Mirror, mirror on the wall: How the performance of the US health care system compares internationally, The commonwealth fund, 2010 Update [Online] 2010 [cited 2010 Jul] Available from: URL : http://www.commonwealthfund.org
