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Am Fam Physician. 2004;69(1):19-20

VHA Committee Makes Recommendations Concerning Chiropractor Issues

The Chiropractic Advisory Committee recently made 38 recommendations to the Department of Veterans Affairs concerning the roles of chiropractors and primary care physicians in Veterans Health Administration (VHA) settings. The committee was appointed by Secretary of Veterans Affairs Anthony Principi in August 2002 and instructed to report on VHA protocols governing referrals to chiropractors, protocols governing scope of practice of chiropractors, protocols governing direct access to chiropractic care, and definitions of services to be provided. The recommendations include the following: a chiropractic scope of practice encompassing patient evaluation and care for neuromusculoskeletal conditions, such as back pain, neck pain, headache, and joint sprains and strains; referral to chiropractic care through consultation with the patient’s primary care physician or another VHA provider; and integration of chiropractic care into the VHA in such a way that the chiropractor, the patient’s primary care clinician, and other VHA providers develop a collaborative treatment regimen for each patient with neuromusculoskeletal and other health problems. The committee is comprised of six chiropractors, four other health care professionals, and one public adviser. “The key here is that the VHA system is going to a primary care model system where everyone has a primary care physician and the care of the veterans is coordinated by the primary care physicians,” said American Academy of Family Physicians (AAFP) Past President Warren Jones, M.D., Ridgeland, Miss., who serves on the committee.

AAMC Report Shows An Increase in Medical School Applicants This Year

According to data released by the Association of American Medical Colleges (AAMC), the number of applicants to U.S. medical schools this year increased by 3.4 percent for the first time in six years. Almost 35,000 persons applied to attend medical school in the 2003–2004 school year compared with 33,625 last year. The main reason for the increase was the number of female applicants (17,672) who made up more than one half of medical school applicants for the first time. The number of black applicants overall rose almost 5 percent to 2,736, but the number of blacks who entered medical school declined by 6 percent to 1,056. Black female applicants increased by almost 10 percent to 1,904. Hispanic applicants increased by less than 2 percent to 2,483, while the number who entered medical school declined by almost 4 percent to 1,089. Included in the applicant pool were 26,160 persons who were applying to medical school for the first time. The data also showed that the sharp decline in male applicants, a trend that started in 1997, leveled off this year with a total of 17,113 applicants, which was slightly more than last year. The number of applicants applying to medical school peaked at around 47,000 in 1996 and reached the lowest point last year.

CDC Study Shows Overall Increase in Diagnoses of HIV Infection

According to results of a study by the Centers for Disease Control and Prevention (CDC), there was an overall increase in new diagnoses of human immunodeficiency virus (HIV) infection in the four-year period from 1999 to 2002. The study included 102,590 people diagnosed with HIV in 29 states during this period, and the results showed that blacks accounted for more than one half of the new diagnoses (55 percent) and that new HIV diagnoses rose significantly in Hispanics (26 percent increase). The study found no significant changes in the number of new HIV diagnoses among Asian/Pacific Islanders or Native Americans. New HIV diagnoses increased 17 percent in homosexual and bisexual men, and 7 percent among men overall. The researchers considered a new HIV diagnosis as being the point at which persons learned of their HIV infection, rather than the point at which they became infected. However, the researchers believe that the rise in new HIV diagnoses represents actual new infections and not persons who have long been infected but only recently received testing. The CDC has launched a new initiative, “Advancing HIV Prevention,” to work with communities, government groups, and health care professionals to help at-risk persons learn of their HIV status, better understand ways of preventing HIV infection and, if infected, receiving treatment and care.

HHS Launches Campaign to Educate Hispanics About Diabetes Prevention

The U.S. Department of Health and Human Services’ (HHS) National Diabetes Education Program recently launched a public awareness campaign to help Hispanics find out if they are at risk of diabetes and to promote ways to delay or prevent the onset of type 2 diabetes through lifestyle modifications. The campaign, “Prevengamos la Diabetes tipo 2: Paso a Paso (We Can Prevent Type 2 Diabetes: Step by Step),” was developed in response to the results of the Diabetes Prevention Program clinical trial that demonstrated that persons could reduce their diabetes risk by more than one half by losing a modest amount of weight, getting 30 minutes of physical activity five days per week, and eating healthier. Components of the campaign include fact sheets on diabetes; diabetes patient education materials; a recipe and meal planner booklet; and print, radio, and television public service announcements. “With ‘Paso a Paso,’ we want to share the good news that Hispanics can prevent diabetes, and it doesn’t take a starvation diet to do it,” said HHS Secretary Tommy G. Thompson. “The key is regular physical activity and a little weight loss. I want to encourage people to take this message of good health to their families and their communities.” To learn more about the campaign, go online to

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Copyright © 2004 by the American Academy of Family Physicians.

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