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Veterans hospitals offer students opportunities to treat complex cases in multi-disciplinary settings

Thursday, May 27, 2021

Detroit VA Medical CenterVeteran hospitals are among the many integrated health care centers that continue to add chiropractors onto their medical teams. Before graduation, NUHS students have the opportunity to work on these teams at seven different Veteran hospitals across the country.

Earlier this year, John D. Dingell Veterans Affairs (VA) Medical Center in Detroit became the latest to offer a preceptorship for students in the NUHS chiropractic program.

At VA hospitals, students can expect to handle more comorbidities and complex cases, said Daniel Tominello, DC, a staff chiropractor at the Detroit VA.

“I see more medical complications in a week than I saw in years of private practice,” said Dr. Tominello.

After initially volunteering at the Detroit VA, Dr. Tominello eventually decided to join the team as a full-time employee. “As a veteran myself, I felt compelled to do it,” he said.

In Detroit, students will encounter a wide spectrum of patients diverse in age, genders and socioeconomic backgrounds.  Like other VA internships, students have the opportunity to interact with various disciplines in a cooperative and collaborative manner.

Dr. Tominello said students work in Integrated Clinic Services or what is commonly called the pain clinic. In addition to chiropractors, it is comprised of a pain psychologist, acupuncturist, yoga expert, pain specialist medical doctor and Masters-level nurse practitioners, who all work together to bring relief to chronic pain patients.

According to Dr. Tominello, part of the purpose of the clinic is to provide alternatives to opioids and a more holistic approach to health care. As DCs become more common within the VA system, they have also helped to lower health care costs and provide more efficient treatment of musculoskeletal conditions, Dr. Tominello said.

While the Detroit VA currently has two chiropractors on staff, other Veterans hospitals can have more.

Ian Le, a NUHS chiropractic student currently participating in a clerkship at the Bay Pines Veterans Hospital in Florida, works alongside three staff chiropractors. He’s also been able to shadow specialists in pain management/physical medicine and rehabilitation units.

“We treat patients in a comprehensive and interdisciplinary way, often co-managing with other providers, like neurology, physical or occupational therapy, and orthopedics,” he said. “We learn about their treatments and how we can work in conjunction with one another.”

Le said he was eager to apply for the clerkship after hearing about the positive experiences of other students. On a typical day, he sees 12-18 patients who are in their early 20s all the way to patients in their late 80s. Le helps assess their condition, their progress, and provide their treatment. Since starting the clerkship, Le has been able to become more comfortable with evaluating patients and developing various techniques. He encourages other students to participate in similar VA opportunities too.

“This clerkship is singularly the most valuable part of my student experience so far.  I have learned so much in my short time, and I’ve realized how many resources are available to continue growing,” he said. “ No matter what your ultimate goal is, this clerkship will provide you with the skills and experience to make you a better provider.”

Currently, NUHS offers 4-12 week rotations at VA sites in Illinois, North Dakota, Indianapolis, and Florida, as well as Scott Air Force Base in Illinois.  Applications are currently being accepted for Detroit VA preceptorships and others.

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