ACA Guidelines What You Should Know

ICA Recognizes Radiographic Studies Are the Standard of Practice in Chiropractic

For immediate Release, September 27, 2017: Since its establishment in 1926, the International Chiropractors Association (ICA) has recognized that radiography is a scientifically proven, clinically valid and appropriate method to evaluate multiple aspects of human spinal anatomy, identify vertebral subluxations, altered spinal biomechanics, postural misalignments, pathology and in providing information and safeguards in rendering chiropractic care in clinical practice. All fifty of the US States have incorporated authority for doctors of chiropractic to apply diagnostic x-ray procedures in their respective scopes of practice and all US chiropractic colleges teach x-ray procedures and analysis. Nationally, since 1972, the federal Medicare program has either required by statute or, recognized and accepted x-rays of the spine as a primary method of identifying and documenting a vertebral subluxation. Recent public statements by some organizations participating in the American Board of Internal Medicine Foundation’s “Choosing Wisely” campaign are recommending that radiographic imaging should not be used to assess adults with acute low back pain until after six weeks, barring the presence of certain indicators termed “red flags”. These same recommendations, originally intended to improve the practice of medicine, will discourage potential patients from seeking the care of a chiropractor when these medical standards are inappropriately applied to the practice of chiropractic. “The ICA believes that these ‘recommendations are out of line with the established standards of chiropractic practice, ignore the large body of clinical and outcomes data that demonstrates the utility, indeed clinical wisdom of such procedures, and clearly can and will, if followed unquestioningly, place patients at risk by delaying or denying diagnostic procedures that have been proven to best serve patients’ needs,” said ICA President Dr. George Curry. “These new “Choose Wisely” recommendations have provoked a massive wave of concern, indeed outrage, on the part of scores of chiropractic organizations and, practitioners in the thousands, as simply an unwarranted, intrusive and harmful set of recommendations that can only reduce the safety and clinical effectiveness record of chiropractic. This amounts to nothing less than an attempt to apply an inappropriate medical standard to the practice of chiropractic” Dr. Curry added. ICA’s Clinical Guidelines Committee has carefully evaluated these so-called “Choose Wisely” recommendations and determined that while these recommendations may be applicable for the medical physician who might only proceed to prescribe or recommend pharmaceuticals, they are out of line for the practicing doctor of chiropractic since in the vast majority of cases, doctors of chiropractic apply a specific, directional force to the spine through the chiropractic adjustment process. Doctors of chiropractic are responsible for assessing the spine to appropriately determine whether or not the patient has a vertebral subluxation and determining if, when and how a chiropractic adjustment may be applied. X-ray studies are a standard clinical tool providing

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