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.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
