Morgan Price, DC, is a staff chiropractor at the Veterans Administration’s (VA) Puget Sound Health Care System. She will participate in “Integrative Care for Underserved Populations: A Comparative Discussion,” which is one of several virtual education programs available at Engage 2022. In this ACA Blogs Q&A, we learn more about Dr. Price’s experience in integrative care systems and how chiropractors’ presence in these settings can help the profession reach underserved populations that will benefit from a conservative approach to care.
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How is the topic you are presenting relevant to today’s doctor of chiropractic?
Dr. Price: The opportunities for the modern-day chiropractor are drastically different from what they were 20 or even 10 years ago. The integration into hospital settings, both VA and private hospitals, continues to expand exponentially year after year.
In the VA specifically, this has not only been encouraged by the congressional mandate in recent years but has grown above and beyond the mandate levels organically. Additionally, the VA residency program continues to be the only accredited residency option available to chiropractors and was expanded from five to 10 sites in 2020. For the early-career chiropractor or student, it is integral that they be trained to fill these opportunities and continue to promote the expansion of the field in this sector.
The patient populations that we can help with through integration into the hospital setting are worth highlighting. This is specifically important for earlier access to patients with acute pain via direct referrals from the emergency department or urgent care in an attempt to reduce the transition to chronicity of pain or reliance of pain medications such as opioids. Being integrated into a hospital setting also opens more opportunities for co-management and high-value care for the patient. Most importantly, there are a variety of underserved populations (veterans, low socioeconomic status patients, etc.) that may not have been able to access chiropractic care as an independent specialty provider. By being a part of the healthcare team, chiropractors can offer improved access to guideline-concordant conservative care.
How does your background make you an expert in this area?
Dr. Price: In my young career, I have spent an extensive portion of it in the VA system. My first exposure started my last year of chiropractic school, where I was able to complete an eight-month clerkship in Bay Pines VA Healthcare System in Florida. Subsequently, I was hired on as a per diem provider after graduation and would go on to apply for the VA residency program and match as the inaugural chiropractic resident for the VA Puget Sound location. After my residency graduation, I was hired into the same hospital system as the first chiropractor to be at the main VA hospital in Seattle, Wash., where I continue to work closely with the chiropractic residency program as one of the attendings.
During my time as a resident, I was fortunate enough to spend a month on rotation with a variety of specialty departments including, but not limited to, the emergency department, neurosurgery, neurology, spinal cord injury, primary care, physical medicine and rehabilitation, comprehensive pain management, neuroradiology, orthopedic surgery, and rheumatology. I have presented and continue to present in-services to a variety of these departments as I work toward building awareness of our new chiropractic expansion and educating other providers on the services we can provide for the patient.
What practical knowledge or skills can attendees take away from your presentation?
Dr. Price: Most importantly, setting the stage for the future of the chiropractic profession as being an expected and normal part of the healthcare team is paramount. We will discuss what it takes to be a team player in an interdisciplinary setting and crucial knowledge/skills that are not necessarily taught in the traditional chiropractic school curriculum. We will also discuss the variety of underserved populations that are commonly underrepresented in the patient population that the average chiropractor would see, and how integration into the hospital setting can gain better access to reaching these patients. My co-presenter, Maithy B. Ta, DC, will discuss how you can support the current Medicare bill and how it can promote the aforementioned mission of integration, as well.
Can you share an anecdote from your own career to demonstrate how greater knowledge/understanding of your topic can make a difference for patient care and/or professional success?
Dr. Price: Being a player on the patient’s healthcare team supports the best possible outcomes for the patient. Due to my time rotating through various departments and providing in-services, I had a working relationship with many of the providers and best understood the patients best suited for their services. This was put to the test when on my resident chiropractic schedule, I was referred a patient from their primary care provider who, upon physical exam, was found to be myelopathic. With the help of my residency director, I was able to identify the myelopathy, refer the patient appropriately to the spine clinic physicians for a cervical MRI, where he was then subsequently referred to neurosurgery and received an anterior cervical discectomy and fusion (ACDF). By the time he consulted with neurosurgery, the patient’s symptoms had progressed in neurological weakness and worsening hand dexterity, which was not apparent during our initial visit. Because of my training, the patient got the care he needed and had a successful surgery with full recovery. These working relationships with other specialists cannot be overstated. The neurosurgeon that performed the surgical procedure ended up writing up this case with me to highlight the importance of physical exam acuity for all providers and having a firm competency in diagnosis and appropriate referral pathways.
What do you enjoy about presenting educational programs?
Dr. Price: I enjoy being an advocate for the VA residency program and, generally speaking, on hospital-based chiropractic services.
Engage 2022 offers an unmatched education program, featuring 19 virtual and in-person sessions that offer high-quality, innovative presentations. Up to 21 CE credits are also available through several programs. Learn more and register here.
