The IPSCA today issued a Position Statement regarding the recent controversial x-ray guidelines being promoted by the American Chiropractic Association (ACA). The ACA released a list of five tests it states are commonly ordered but not always necessary in chiropractic care. The recommendation includes the admonition to not take spinal x-rays in acute low back pain patients unless there are so called Red Flags and to never take repeat x-rays to monitor progress. Teaming up with ABIM Foundation and Consumer Reports, the ACA’s President David Herd DC referred to these as “unneeded or overused services” and that following these recommendations would yield the “best possible care”.

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The following is the text of the IPSCA Position Statement:

"The Board of the IPSCA, on behalf of its membership, strongly disagrees with the recent ACA’s support of the American Board of Internal Medicine Foundation’s “Choosing Wisely” position on the use of radiographs. Many Chiropractic techniques (taught at accredited colleges) are dependent on Spinographs in order to determine the how and where to adjust the patient. X-rays also gives the practitioner the important information as to when a patient can’t be safely adjusted. Radiographs are often vital in work comp, personal injury and malpractice court cases. Without X-rays D.C.s can be hampered in the decision making process critical to being a good Chiropractor.

The ACA has a long history of proposing policies which are deleterious to the Chiropractic profession:

1. Blind siding the ICA when there was an agreement by both associations to jointly work with the USOE in setting up accreditation for US Chiropractic Colleges. The ACA went in independently with their entity (the CCE) to the USOE and that became the standard bearer for Chiropractic education. With the CCE came huge compliance expenses for the schools and low and behold startling increases in student debt.
2. The ACA single-handedly got the X-ray requirement (against all logic) in Medicare removed. This turned out to be a victory for the American Physical Therapy Association as they claimed this equated their ability to manipulate with a Chiropractic Adjustment.
3. The ACA has stood against line drawing on X-rays for years, throwing out the research and patient results which are directly a result of the efficacy of such practices.

The ridiculous support of this “Choosing Wisely” campaign needs to be answered by the Chiropractic Majority. The IPSCA calls for a joint statement by the ICA, IFCO, Foundation for Vertebral Subluxation, appropriate Chiropractic Technique organizations, Chiropractic Colleges and State Organizations denouncing this anti X-ray crusade. We need to affirm the right of the individual Chiropractor to make the clinical decision when radiographs are necessary for a patient."

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