muscle relaxers, maybe some restricDon of duDes and ABLs, maybe bedrest, possibly even some physical therapy and that's normally the course of care for six weeks. Now if we stop, and we turn the magic prism for a chiropracDc doctor, a doctor of chiropracDc, if a paDent comes in with low back pain, there are of course guidelines that everyone recognizes, about the examinaDon, the case history, and everything, and the one thing that I think a lot of people haven't even brought up yet is what the one thing I definitely want to bring up right away is when a doctor of chiropracDc has a paDent who's new that's coming in with severe low back pain and it's acute and you're going to plan on doing a thrust into that area, you be`er know what's in that area if you're gonna do a thrust. Doing a thrust is totally different than having some paDent lay in bed on drugs. I totally agree and that may, is one of the reasons that we have you on today and we want to talk about this because it affects our ability to defend a doctor when it comes to malpracDce. But one of the things that you pointed out was you know, in the medical model, communicaDng what makes sense from an x-ray or not, means nothing. From a chiropracDc point of view, even going back to 1993 when the AHCPR guidelines for low back pain were published by the federal government, there were only two things that were indicated to have worked for low back pain, chiropracDc adjustments and exercise. No medical procedure showed any effecDveness whatsoever as I recall, and here we are having the ACA teaming up with the medical community that has nothing that has been successful in this area to determine what a chiropractor should do or shouldn't do in their pracDce. What about even the doctors that are upper cervical doctors? They need those x-rays to get an exact line of drive and to have a pre and post x-ray, not even just a beginning point. As you said, you're gonna put a thrust in. You know to me, I prefer to have that informaDon of what is going on before I actually take care of somebody, so I think you're right on and all of this comes back to, you know are you now going to listen to a ridiculous guidelines like this or arDficial guideline and put yourself in jeopardy and at risk for a potenDal malpracDce. Well, I don't think anyone obviously is a fan of malpracDce and the one thing I think that we all need to do on this parDcular issue is sort of again, step back and look at the magic prism. You know, we've had, we have so many different techniques, and each technique has its own requirements. To me, the issue of x- ray should be le\ up to the individual doctor of chiropracDc. It depends on their technique, it depends on the paDent's complaints, it depends definitely what the doctor finds in the examinaDon and again, there are so many variables here and like you menDoned, the x-ray line analysis. I don't care if you pracDce blair, gonstead, upper cervical whatever, chiropracDc is based for over 100 years on being specific. Which means, you're supposed to do a specific CMT, an adjustment.
Dr. Hoffman:
Dr. Murkowski:
What really someDmes comes up in malpracDce cases is when there isn't a proper workup, there may not be a proper work up. There may not even be x- rays and somebody's going in there and doing manipulaDon on vertebrae going Chiropractor Malpractice Insurance Dr. Ken Murkowski The ACA X-ray Gui... Page ! of ! 2 9
Made with FlippingBook flipbook maker