While rejections of the American Chiropractic Association's adoption of the so called "Choosing Wisely" x-ray standards continue to come in almost daily at this point, the Georgia Chiropractic Council (GCC) was one of the first to issue a rejection of the ill advised standards that represent a threat to public health. Since then over two dozen state, national and international organizations, schools, foundations and techniques have joined in and issued condemnations of the ACA's actions.
The following is a list of the current groups, technique organizations, state and national associations, foundations and schools that have rejected the ACA's actions:
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The following is the full text of the GCC's Resolution:
Marietta, Georgia, February 21, 2018– The Officers and Board of Directors of the Georgia Council of Chiropractic have voted to unanimously adopt a resolution rejecting the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® x-ray protocols and supporting the evidence‐based science for appropriate radiologic evaluations of patients seeking chiropractic care developed by the International Chiropractors Association’s (ICA) Practicing Chiropractor’s Committee on Radiology Protocols (PCCRP).
The resolution reads as follows:
Georgia Council of Chiropractic Resolution supporting best clinical practice with regards for radiology of patients under chiropractic care.
Whereas, the Georgia Council of Chiropractic (GCC) is a professional organization dedicated toward promotion and protection of public health through the best application of the science, art and philosophy of chiropractic. and,
Whereas, the GCC believes that each individual patient deserves the best analysis, diagnosis, and clinical application based upon their needs and the best judgment of their doctor of chiropractic. and,
Whereas, the State of Georgia practice act for chiropractic contains the phrase, “The doctor of chiropractic must bring to the exercise of that person's profession a reasonable degree of care and skill, which shall include the determination of the need for chiropractic care, as defined in paragraph (2) of Code Section 43-9-1,”which includes the use of x-rays. and,
Whereas, utilization of diagnostic radiology is a scientifically proven component of the chiropractor’s clinical practice, as the role of diagnostic radiology is clinically useful in evaluating multiple aspects of human spinal anatomy, biomechanics, postural faults, misalignments, vertebral subluxation complex, and other anomalies or pathologies; and,
Whereas, the GCC recognizes the need for scientific evidence to support chiropractic care provided by chiropractors across the state and the nation, and that the utilization of rational, evidence‐based clinical guidelines and “best practice” documents are critical ways to implement research findings into clinical practice; and,
Whereas, the GCC also recognizes that clinical practice guidelines have the potential to streamline health care delivery, improve patient outcomes, and increase safety by using best available scientific evidence and broad consensus to develop appropriate care parameters; and,
Whereas, the GCC further recognizes that clinical practice guidelines do not, cannot, and should not represent a “set‐in‐stone” mandate of care, as they do not take into account such critical factors as the judgment of the doctor of chiropractic and the individual circumstances and values of the patient; and,
Whereas, the GCC is aware of recent publications from the American Board of Internal Medicine (ABIM) Foundation, as part of the ABIM Foundation’s Choosing Wisely® campaign, regarding the appropriateness of radiological spinal imaging for patients with low‐back pain during the six weeks after onset in the absence of red flags; and,
Whereas, the GCC recognizes that entities such as insurance companies and insurance claims reviewers are using this publication to deny the use of radiographic studies to patients and deny reimb ursement for such studies to doctors of chiropractic; and,
Whereas, the GCC Board of Directors, while stipulating that no guideline can replace the clinical decisions made by the doctor of chiropractic in the course of rendering care to an individual patient, voted unanimously to support the evidence‐based science for appropriate radiologic evaluations of patients seeking chiropractic care developed by the International Chiropractors Association’s (ICA) Practicing Chiropractor’s Committee on Radiology Protocols (PCCRP); and,
Whereas, the GCC Board of Directors has not been made aware of any subsequent evidence‐based radiological guidelines or protocols that would supersede or render obsolete the PCCRP’s Guidelines, including the Choosing Wisely® document from the ABIM Foundation;
Now, therefore, be it resolved
That the GCC Board of Directors, vote to reject the ABIM Foundation’s Choosing Wisely x-ray protocols, and instead affirm as best practices the ICA’s Practicing Chiropractors’ Committee for Radiology Protocols as published by the ICA in 2017.
Also, be it further resolved
That the GCC Board of Directors, encourage all Georgia doctors of chiropractic who utilize radiologic evaluations in their practice, to familiarize themselves with the PCCRP X‐ray Guidelines, which can be accessed online at www.pccrp.org.
The Georgia Council of Chiropractic, founded in 1982, serves the Chiropractic profession in Georgia and is comprised of chiropractors, chiropractic students, and chiropractic assistants from all over the state of Georgia and several other states.
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