Dr. Gowan is a 1991 graduate of the University of Houston and a 1995 graduate of Cleveland Chiropractic College – Kansas City. After three years of private practice in Houston, he was a full-time faculty member at Cleveland College from 1997-2005, and has remained an adjunct member of the faculty since joining the VA in 2005.

Gowan is married and has four children. He is active in church and scouting activities. He also coaches junior high boys’ basketball for Center Place Restoration School in Independence, Missouri.

Tell us about your typical day at the Kansas City Veterans Administration Hospital?

It is mostly filled with patient interaction. We see patients about every 15 minutes on return visits, with about an hour for new consults. The consult includes the history and exam, and in some cases an initial treatment as well. The one thing that’s unique about the VA is that we’re a specialty clinic. We’re not a portal-of-entry clinic in the sense that all the patients we see are screened beforehand, either by the primary care physician or another specialty clinic that is referring the patient for chiropractic.

That differs from private practice, which is the way most chiropractors in the United States function. It sounds like one advantage of your setup is when you first see the patient, you already know that the worst case scenario diagnoses have been screened out. Does this allow you to focus more quickly and intently on the sorts of things that are central to most chiropractic cases?

First, I want to emphasize that it is important for the chiropractors to remain a “direct access” and portal-of-entry profession. It is vital that we maintain this traditional role of chiropractic care while at the same time expanding our opportunities to integrate chiropractic services within the standard medical model at institutions such as the Veterans Administration.

Now, to answer your question, I find that the screening process works in our favor in the sense that it narrows our focus down to the typical musculoskeletal complaints that we deal with most in chiropractic. There are occasions where something comes up, where there’s a bit more of a nuance. When it does, we communicate this via our electronic medical records system, which is an open system that all providers at the VA can access information from. So that allows us to communicate concerns about, maybe, a patient having a visceral type of problem, or a deeper neurologic diagnosis that is invading into our musculoskeletal complaint. So we’re able to communicate that back and forth.

Since the VA setup as a specialty clinic differs from private practice, in that you are only seeing patients who are referred to you by their primary medical physicians, how is collaboration and cooperation among the different health professionals fostered and encouraged at the VA?

I did some of this preemptively. When I was first hired, I made it a point to go and communicate particularly with the primary care providers, because that’s where our initial source of referrals was going to come from. I also prepared a PowerPoint educational program on chiropractic that would be self-administered and I put that on the employee education system on the intranet at the VA. I think that actually got posted in such a way that it could be accessed by people at other VA facilities. That allowed other physicians throughout the specialty clinics, and even the residents rotating through in primary care, to access and view some basic information about chiropractic, our educational standards, our background, and our focus. It also provided the pathway on how to make a consult and gave an introduction to chiropractic and to chiropractic services within the facility.