Sherman College Responds to ACA “Choosing Wisely” X-Ray Recommendations
The American Chiropractic Association (ACA) launched the “Choosing Wisely” initiative to set standards for the clinical use of x-rays. However, these recommendations have sparked discussion and criticism within the profession. Sherman College of Chiropractic issues the following response:
Evidence-Informed Approach
Sherman College supports an evidence-informed approach to radiography in chiropractic practice. Doctors of chiropractic are responsible for determining the safety and appropriateness of care. This includes:
- Detecting vertebral subluxations
- Identifying congenital or developmental anomalies that may affect technique selection
- Recognizing conditions that may contraindicate certain chiropractic adjustments
Radiography can also reveal conditions requiring referral to other healthcare providers.
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Clinical Decision-Making
At Sherman College, the decision to x-ray is based on the patient’s history, clinical presentation, and examination findings. Follow-up x-rays to monitor patient progress are determined by clinical need, not arbitrary time frames. The “Choosing Wisely” initiative’s recommended delays for x-ray examinations are seen as inappropriate and not in the best interest of patient safety.
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Supporting Research
Sherman College’s position is supported by the paper, “An Evidence-Informed Approach to Spinal Radiography in Vertebral Subluxation Centered Chiropractic Practice.” Studies from outpatient clinics at three chiropractic colleges found that a high percentage of patients had x-ray findings that influenced the selection of adjusting techniques.
Christopher Kent, DC, JD
Director of Evidence-Informed Curriculum and Practice
Sherman College of Chiropractic