OBJECTIVE: The chiropractic profession has traditionally had little or no direct influence on health policy. Conversely, every chiropractor is impacted daily by health policy decisions promulgated by government agencies, health purchasers, managed care organizations and others. This discussion provides an overview of health policy constituencies important to chiropractors, reviews processes currently being used to assess health care technology and develop policy and offers strategies for the profession to more actively engage in constructive policy development.

METHOD: Descriptive overview of key issues based on qualitative selective overview of literature and author's observations based on two years employment in a government health policy position.

CONCLUSIONS: The chiropractic profession's traditional approach to influencing health policy has focused on public relations, political lobbying for favorable legislation and litigation, which has increased public awareness and resulted in a number of legislative successes. However, for the most part, the momentum of decision-making at agency levels and in policy staff positions continues to occur without involvement of chiropractors trained or experienced in policy-making. This is in contrast with medicine and other allied health fields, whose ranks hold such positions routinely. Additionally, methodology for policy decision-making is increasingly evidence-based. Strategies for the chiropractic profession to more actively participate in this arena are offered.

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