recommendaEons is referencing guidelines that have been published. For example, the first two recommendaEons that they make seem to be the ones that are drawing the most aSenEon in the profession, having to do with uElizaEon of X-rays. Whether it's taking X-rays on paEents with acute pain, which is the first one. And the second one is doing repeat imaging with follow-up X-rays to monitor progress. But they're referencing guidelines, and from a guideline developer point of view, I look at their references, that's the first place I go. And when we look at the references for their recommendaEons, they're relying on essenEally a few research papers and two guidelines. One of the guidelines was wriSen by the CCGPP, which is the Council on ChiropracEc Guidelines and PracEce Parameters , that was formed under the auspices of COCSA, the Congress of ChiropracEc State AssociaEons. And so those guidelines were published 10 years ago next month, in JMPT. They were actually a really short task guideline that referenced some other papers and such, but they also referenced the ACR guidelines and the ACR is the American Culture of Radiologists, which is a medical group. So, we're using these medical guidelines predominantly. Those are the only newer ones that they reference to support their conclusion. And so I know last week Dr. Clamp made some good points about, and you did as well Stu, about essenEally shoving a square peg in a round hole using medical guidelines for the pracEce of chiropracEc. And it doesn't make a whole lot of sense and I really loved your analogy of the dental pracEce. And they don't follow medical guidelines for taking X-rays to find caviEes and of course chiropractors shouldn't be held to the same types of guidelines as medical doctors. If we were just prescribing meds then it would make sense. So, that's where this Facebook post went, Joe. It was preSy interesEng and revealing to me because, again I started out by saying, "Hey, I'm open. Share with me some raEonale and how this all came to be." And what I was told from numerous ACA members because, we take care of the actors all over the country, whether they're ICA, ACA, no-CA, it doesn't have a significant effect here. And I said, "How does it go without ge^ng to the membership of to a full authority of the ACA?" Because what this gentleman indicated was that it was a commiSee, I'm not 100% sure of the numbers but I thought it was 11 doctors on a commiSee for the ACA, to work with the Choosing Wisely guidelines. And they formed a consensus, what kind of crap is that? How do you have a consensus of 11 people on a commiSee that are all looking to accomplish the same thing? It makes no sense whatsoever. This guy was talking about evidence based in scienEfic, well what they just did has nothing to do with evidence or science when you have 11 people forming an opinion. And not taking it to the profession by the way. There is more going on behind the scenes here. I said to him. "We're dealing with situaEon that you grouped up with internists and consumers reports, who has never been anything posiEve about ChiropracEc." And he said, "This is nothing to do with internists. 'Oh, really? ABIM, American Board of Internal Medicine.'" Well there was no response aUer that.
Chiropractor Malpractice Insurance - ACA Guidelines Part 4
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