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According to Paul Oakley DC, the lead author of the paper: “Radiation risk from radiography is assessed using a linear model, called the ‘linear no-threshold’ model (LNTM). This is an assumption or hypothesis that all radiation is harmful regardless of dose level. But, shockingly, there is no data that supports the LNTM for low-dose radiation risk assessment for exposure from radiography.”
In fact, according to the paper, the current research is so overwhelming that a resolution of the controversy regarding the carcinogenicity of low dose radiation appears to be imminent.
On the surface it seems reasonable that if a health care provider is going to put forces into the spine to try and correct something then they may need to see inside the body to determine exactly what’s wrong. Just as importantly they need to make sure there isn’t something there that shouldn’t be there like cancer, an infection, or a broken bone for example.
“Chiropractic techniques require that the doctor know what the structure of the spine looks like before trying to change it” stated Deed Harrison DC another author of the paper. Harrison continued: “Once you know what the problem is and you do something to fix it then need to make sure you actually fixed it. Never mind making sure that there isn’t something life threatening that caused the patient to seek care. X-rays are a safe, low cost and clinically necessary procedure in chiropractic.”
Unfortunately, x-rays cost money and since may times those x-rays are supposed to be paid for by insurance companies they go out of their way to find ways not to pay for them. Insurance companies and the consultants they hire go to great lengths to publish opinion pieces and influence the standard of care in ways that improve their bottom line.
Making matters worse is that some trade organizations in chiropractic go along with such dangerous recommendations that put the public at risk for injury when chiropractors do not take x-rays.
Recently, the American Chiropractic Association (ACA), which represents a minority of the chiropractic profession, published guidelines that say x-rays are often not necessary prior to chiropractic care and that follow-up x-rays looking for improvement in spinal structure are not necessary.
The ACA group is closely aligned with an insurance based model of short term treatment of back pain and some other types of musculoskeletal pain. The ACA believes chiropractors are primary care providers the same as medical doctors. The ACA supports a “state’s right” policy, where state laws would permit chiropractors to prescribe drugs for pain and other problems.
The authors of the recent research paper conclude by stating “As opposed to current x-ray reduction efforts and traditional beliefs, the weight of the current evidence substantiates the fact that x-rays are not harmful to patients and they should be a routine part of the comprehensive spinal assessment necessary in order to deliver optimal and contemporary chiropractic care.”
According to the most up to date best practices - health care providers should be practicing a patient centered approach and acting in ways that minimize risk and enhance health outcomes for the patient instead of making decisions that benefit the insurance company and put the patient at risk.
Contact Information:
Matthew McCoy DC, MPH
Annals of Vertebral Subluxation Research
https://www.vertebralsubluxationresearch.com
matthewmccoy@vertebralsubluxationresearch.com
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