Our Letter to the VA

RE: Newsweek Article: How the VA Fueled the National Opioid Crisis and is Killing Thousands of Veterans by Art Levine, 10/12/17


To whom it may concern,

My name is Dr. Travis McKay and I am a healthcare practitioner here in the state of Delaware.  I read the above article by Mr. Levine over the weekend and was obviously distressed by its contents.  My unease when reading it was primarily fueled by what is happening to our country’s veterans and how many of them are affected by this opioid epidemic that we are currently dealing with.  However, I was also upset about the idea of how this negatively paints the members of the VA, and the staff that works tirelessly there to serve our veterans.  I know, and have actually treated, some of your staff members before, and never have I met one who I didn’t feel cared about their patients and was doing whatever was in there power to treat them the best they could, with the tools at their disposal.  This is why I’m writing to you.  Not to chastise or cast blame your way, but rather to discuss those tools that your facility uses to deal with your patient’s pain.

At my office in Newark, we specialize in dealing with mechanical spine pain patients, both acute and chronic.  What makes us different from most pain management offices in Delaware though is that we only provide non-pharmacological treatment options for our patients.  These obviously include the standard physical therapy and massage therapy but, unlike others, our main treatment tool is chiropractic.  With regards to the tools that the VA is using to treat your spine pain patients, chiropractic has been drastically underutilized.  In a time when all of the focus has been on reducing the use of pain medication, it seems readily apparent to me that all non-drug forms of pain management should be evaluated and discussed.

This discussion needs to take place and it needs to take place soon.  I understand more than most that the medical profession and the chiropractic profession haven’t always seen eye to eye.  Now is the time for that to change.  Chiropractic treatment for spinal pain is not just a potential ancillary option.  Instead, it should be viewed as a first line treatment standard for certain musculoskeletal conditions.  For example, the current clinical research indicates that chiropractic treatment leads to greater reductions in self-reported pain and disability than usual medical care1, and that when compared with conventional medicine for spinal pain treatment, chiropractic patients demonstrated decreases of 60.2% in hospital admissions, 59.0% less days in the hospital, 62.0% less outpatient surgeries and procedures, and a staggering 85% less pharmaceutical costs for treatment of certain conditions.2  The fact that opiates have been used as a primary treatment form for mechanical spine pain instead of chiropractic needs to be addressed, especially considering that there is scant evidence for the  efficacy of opiates and they do not improve functional outcomes of acute back pain in primary care.3

I know from talking to some of your patients and staff that the current, in-house conservative treatment protocol for your mechanical spine pain patients is some combination of medication, injections and/or physical therapy.  All of these are crucial and should remain in place, but the absence of chiropractic as part of this treatment protocol will always yield less than optimal clinical results when dealing with a particular set of musculoskeletal conditions and diagnoses.

This isn’t an occurrence that is unique to the VA though; the national average for utilization of chiropractic care is about 7% of the population.  However, my opinion is that the VA may be much lower than that, most likely less than 1%.  My rationale for this is that the patients of the VA are a particularly specialized cohort, in that for them to utilize their veteran benefits and limit out of pocket costs, their first stop for treatment will most likely always be the VA.  A private citizen with private insurance has the ability to shop around, do their own research, and still utilize their medical benefits whereas a veteran with VA benefits needs to go to the VA or experience out of pocket costs.  Due to this, if there is no chiropractic option at the VA, then there will be little to no chiropractic treatment for patients of the VA.  However, there is the CHOICE program, which will refer patients to specialists outside the VA for treatment at the recommendations of the VA’s clinical staff.  Our office is a member of that.  We’ve been practicing in the same location for thirty years, we’ve been voted Delaware’s best chiropractor by the News Journal for the past three years in a row, and we’ve seen clinical success rates between 80-90% for our patient base.  However, since being part of the CHOICE program, we’ve only seen four VA patients and one of them was already coming to us prior to us officially being a CHOICE option.

This isn’t strictly a professional mission for me; it’s a personal one.  In March of this year, one of my childhood friends overdosed and died from opiates.  His story is almost clichéd at this point.  Upper middle class teenager finds an unused bottle of percocets in a friend’s parent’s bathroom and decides to try one, fast forward fifteen years of battling addiction, switching to heroin, and game over.  After that, I decided to use whatever tools I had at my disposal to try and prevent it from happening to someone else, and for me, that tool is chiropractic.  We created a non-profit that had two main goals; the first is to offer affordable chiropractic care to anyone, regardless of insurance or financial ability, and the second was to educate people and organizations about how chiropractic can and should be used as a first round option for treatment of certain conditions.  With proper utilization of chiropractic, the need to prescribe opioids will be reduced.

I wanted to send this letter to start a dialogue with your office.  If there’s even a ten percent chance that what I’m saying is true, and that there is a potentially underutilized, effective, safe and affordable pain treatment out there that can reduce the use of opioids, then you need to pursue it as an absolute certainty and investigate it’s application as much as possible.  I would feel privileged to help make that happen, and to help the VA avoid any more headlines like the one I read last weekend.




Dr. Travis McKay

President | Hands For Life – Omega Dr.

54 Omega Dr., Suite F

Newark, DE 19713

(302) 368-1300 | www.handsforlifeomega.org




  1. Schneider M, Haas M, Glick R, Stevans J, Landsittel D. A comparison of spinal manipulation methods and usual medical care for acute and sub acute low back pain: a randomized clinical trial. Spine. 2014 Nov 21;[Epub ahead of print].
  2. Sarnat R, et al. Clinical utilization and cost outcomes from an integrative medicine independent physician association: an additional 3 year update. J Manip Physiol Ther. 30(4);263-269.
  3. Deyo RA, Von Korff M, Durkhoop D. Opioids For Low Back Pain. BMJ. 2015;350:g6380.

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