On the heels of the American Chiropractic Association's "Choosing Wisely" recommendations regarding chiropractic procedures / tests DCs should think twice about performing, the International Chiropractors Association has issued a statement calling the recommendations into question, specifically the recommendation relative to the use of X-rays for acute low back pain patients:
While the ICA does not name the ACA specifically, it does state: "Recent public statements by some organizations participating in the American Board of Internal Medicine Foundation's 'Choosing Wisely' campaign are recommending that radiographic imaging should not be used to assess adults with acute low back pain until after six weeks, barring the presence of certain indicators termed 'red flags.' These same recommendations, originally intended to improve the practice of medicine, will discourage potential patients from seeking the care of a chiropractor when these medical standards are inappropriately applied to the practice of chiropractic."
ICA President Dr. George Curry emphasized: "The ICA believes that these recommendations are out of line with the established standards of chiropractic practice, ignore the large body of clinical and outcomes data that demonstrates the utility, indeed clinical wisdom of such procedures, and clearly can and will, if followed unquestioningly, place patients at risk by delaying or denying diagnostic procedures that have been proven to best serve patients' needs."
The statement also notes that the ICA's 2006 Practicing Chiropractors' Committee on Radiology Protocols (PCCRP) for Biomechanical Assessment of Spinal Subluxation in Chiropractic Clinical Practice "provides the chiropractic profession with an extensive, rigorous review and appraisal of radiology protocols and their utilization in the context of chiropractic care settings, in conjunction with an exhaustive evaluation of the chiropractic and biomedical literature, including risk benefit ratios, measurement and patient positioning, and patient population applications."
You can access the entire ICA statement by clicking here. To read our recent article on the ACA's five recommendations (two of which mention X-rays) and background on the ABIM's Choosing Wisely initiative, click here.
Because they have yet to pass national legislation protecting the chiropractic profession, Japanese DCs are in a similar situation that U.S. DCs faced. We were fortunate enough to be able to pass chiropractic licensure state by state. The DCs in Japan must accomplish this nationally, which has proved to be an extremely difficult task. And in spite of their efforts, Japanese DCs are currently faced with two chiropractic professions.
This article focuses on nine severe injuries that are generally not diagnosable until the third to fourth week following the date of injury, including how to diagnose these severe injuries. The discovery of any of these injuries early can make a significant difference in the case outcome.
There has long been an attempt by those who are not legitimate doctors of chiropractic to usurp the title of chiropractor from those who have earned their degree from an accredited chiropractic program. This generally happens in countries where the local doctors of chiropractic have yet to pass legislation requiring a degree from an accredited institution. The result is essentially two chiropractic professions. Nowhere is this danger more pronounced than in Japan.
