that benefits the chiropractor or the paEent, and that's a concern. Let's just shiU a liSle bit Joe to re-X-ray, because when I was in acEve pracEce, I re-X-rayed every adult. You said when ge^ng through school everyone got x-rayed. Well, in my pracEce everybody got X-rayed but then they got re-X-rayed because we actually educated the paEents and spoke about correcEon. And I'm not talking about making a perfect spine model because that's not realisEc in some people, but we can certainly reduce the effects of the physical manifestaEon that we get to see on X-ray of the subluxaEon or the SubluxaEon Complex. And everyone would get re-X-rayed so that we would have a direcEve of what we've been doing and whether we want to or need to modify our technique, our procedure or potenEally even a referral. So I know you deal with re-X-rays and how do you see this from that perspecEve? And again when they referenced ... Again when I read this number two, and it was striking that the first two things out of five things are recommended to the public on this big massive stage having to do with the uElizaEon of X-ray. And when I read the second one having to do with checking a paEent's progress with X-ray which to me using CBP technique is kind of common sense, it's like why wouldn't you? Just to what you said. And all of it comes back to really stuff that was published 10 years ago but has been the thought process for decades, but went to the guideline world in chiropracEc 10 years ago and that was done with the CCGPP guidelines, they came out with this exact same statements, that they use in number two. With the excepEon of scoliosis there basically saying you shouldn't be doing follow-up X-rays. Why do they choose scoliosis? That's what the orthopedics choose. And scoliosis is also the only condiEon that orthopedics really follow mechanically and measure lines and everything, so that's okay as an excepEon there as well. So they make excepEons where the orthopedics are using the follow-up X-rays but not for chiropractors. And they basically are using statements that come from, again a 2007 study ... 2008 actually, was published two months and 10 years ... It was two months ago, that study wriSen by a [inaudible 00:20:11], he references and says that spinal alignment has no relaEonship with health and improvement including pain, and there's been a research to show that changing that improves anything. And so they referenced a study that was done ironically the month prior in the same journal JMPT wriSen by ChrisEan [inaudible 00:20:35], and they did a systemaEc review, it was called Spinal Curves and Health, A SystemaEc CriEcal Review of The Epidemiological Literature Dealing With AssociaEons Between Surgical Spinal Curves and Heath. Now here's the thing about their paper, and this is the problem with all research, is that, when you're doing a systemaEc review you're basically looking at all the data, all the papers that have ever been published and then you narrow it down with this inclusions and and exclusion criteria. And so your paper only includes or your overall number of documents is really equal to how stringent those criteria are. You make those up. So their criteria was so strict that they reviewed 12,000 papers. Now they found 54 that they ended up looking at. We went back because they had missed papers when this came out. Chiropractor Malpractice Insurance - ACA Guidelines Part 4 Page ! of ! 5 9
Dr. Betz:
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