that I'm sure Jennifer and Bryan will go into into more detail. I don't need to go into that right now. The first part of the discussion is let's narrow this down to what we're talking about. We're talking about acute low back problems in adults, so less than six weeks and low back is the geography that's involved, and adults is the age group involved, 18 and over. The second consideraDon that we need to talk about it from our perspecDve as chiropractors. We appreciate the guidelines that other bodies and groups within healthcare developed and have recommended. We appreciate the literature base that's out there relaDve to what's going on. It's important for us to understand that there's nobody else that promulgated guidelines of this nature that does what we do. I think that's a very, very important issue for us to make sure we have a firm handle on is that if I'm an internist and I'm looking at somebody with low back pain the quesDon about pu^ng a thrust into that spine to change the architecture of the spine, to change the posiDoning of the spine that could potenDally affect issues related to bone structure as a result of density or lack thereof that don't even cross my mind. Now I think the unique perspecDve of the chiropractor in relaDonship to this quesDon is the second category we need to get to. First thing, let's frame the problem. We're talking about a very narrow area of acDvity in general. Number two, we need to look at it from our perspecDve as chiropractors and what do we bring to the discussion that is unique in comparison to the discussion that the internist might have, or even an orthopedist might have. So that's how... Your point is so well taken about the narrow scope of this. But we've been around long enough to know when, as an example, the mercy guidelines came out all those years ago it was also narrow in scope. It was interpreted by many, many people outside of the chiropracDc world as well as people inside the chiropracDc world to pigeon hole us in what we can and can't do. That is where some of the concerns have been expressed about these guidelines is yes maybe it's low back pain, but as an example, Blue Cross interpreDng that as pain not low back pain is state board of examiners over Dme going to take that and have a wider view based on overuDliDzaDon concerns, things of that nature. You are so right on about the fact that we're dealing with a unique environment why we would team up with internists to come up with guidelines for chiropractors. I'm not even sure why that came to be but it's certainly a different mechanism. We're not looking to take an x-ray to give somebody an anD-inflammatory or a pain killer, we're talking about pu^ng in a thrust whether it be a drop table adjustment, a Thompson technique, or even SOT. It's not just, and we have two DACBR's coming on, but from my perspecDve it's not only looking at pathology potenDal but it's also looking at the actual structure itself. Do you have any concerns that I shared in terms of us being pigeonholed based on yeah that's just low back pain but is that where it stays or is that just where it begins? [crosstalk 00:06:46] problem. ... Back it up. Yes sir?
Dr. Hoffman:
Dr. Clum:
Dr. Hoffman:
Chiropractor Malpractice Insurance - ACA X-ray Guideline 3 Drs. Clum, ...
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