Imaging

I was asked this week why I do not x-ray all of my patients. A woman asked me, "Well how do you know what's going on if you can't see it?" She went on to explain that her daughter goes to a chiropractor who takes an x-ray of all of his patients and then reviews it with them. This is a great patient education tool and it also allows the doctor to detect conditions that he or she otherwise would not find while performing an examination.

Asking why I do not practice this myself is a great question, there is such diversity within our profession that we are often faced with questions of this nature. I appreciate the diversity within our profession, it proves that we are capable of effectively treating a wide variety of conditions. I answered this woman's question by explaining that if I do not feel that imaging will change my treatment plan then ethically I cannot order the imaging. A detailed history and examination will often give me the information I need to develop an appropriate treatment plan. If it is not needed then I would prefer to treat the patient rather the image. There is also the argument that when unnecessary it is not the standard of care to expose a patient to radiation. Unnecessary imaging also comes with a financial burden, costing billions each year.

Reference:
 Bartoszewski, Melissa DC. "The Clinical Necessity of Imaging". Aug 2014 ACA News. <http://www.acatoday.org/content_css.cfm?CID=5527>.