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Sherman College Responds to ACA “Choosing Wisely” X-Ray Recommendations
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The American Chiropractic Association’s “Choosing Wisely” initiative seeks to set standards regarding the appropriate clinical use of x-rays, but the organization’s recommendations have recently drawn comments and criticism throughout the profession. Sherman College of Chiropractic issues the following response to the ACA recommendations:
Sherman College of Chiropractic supports an evidence-informed approach to the use of radiography in chiropractic practice. Doctors of chiropractic are responsible for determining the safety and appropriateness of chiropractic care. This responsibility includes the detection and characterization of vertebral subluxations, congenital and developmental anomalies which may affect the selection of chiropractic techniques and conditions which may contraindicate certain chiropractic adjusting methods. Radiography may disclose conditions requiring referral to another type of health care provider. Sherman College teaches that the decision to x-ray should be based on the patient’s history, clinical presentation, and examination findings. Follow up x-rays to assess patient progress should be based on clinical need. Further, the “Choosing Wisely” campaign’s use of arbitrary time frames to defer x-ray examinations is inappropriate, and not in the best interests of patient safety.
The paper, “An Evidence-Informed Approach to Spinal Radiography in Vertebral Subluxation Centered Chiropractic Practice,” supports x-ray use as taught at Sherman College. Studies from the outpatient clinics of three chiropractic colleges found a high percentage of patients had x-ray findings that could influence the selection of adjusting techniques.
Christopher Kent, DC, JD
Director of Evidence-Informed Curriculum and Practice
Sherman College of Chiropractic
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