Historical influence on the practice of chiropractic radiology: Part I - a survey of Diplomates of the American Chiropractic College of Radiology (original) (raw)
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Journal of chiropractic humanities, 2014
The purpose of this study was to evaluate publicly available information of chiropractic technique systems that advocate radiography for subluxation detection to identify links between chiropractic technique systems and to describe claims made of the health effects of the osseous misalignment component of the chiropractic subluxation and radiographic paradigms. The Internet and publicly available documents were searched for information representing chiropractic technique systems that advocate radiography for subluxation detection. Key phrases including chiropractic, x-ray, radiography, and technique were identified from a Google search between April 2013 and March 2014. Phrases in Web sites and public documents were examined for any information about origins and potential links between these techniques, including the type of connection to BJ Palmer, who was the first chiropractor to advocate radiography for subluxation detection. Quotes were gathered to identify claims of health eff...
Health and History, 2016
Chiropractic fi rst adopted the X-ray in 1910 for the purpose of demonstrating tiny misalignments of spinal bones, theorised to cause all disease, which they called chiropractic subluxations. This paper explores the apparent contradiction and resultant controversy of a system of natural healing adopting a medical technology. It centres on the actions of B.J. Palmer, the fi rst chiropractor to use X-rays. It also clarifi es details of Palmer's decision to incorporate the technology and interprets the change in the sociological context of boundary work. The continuing use of the subluxation paradigm for radiography by chiropractors has had a lingering effect on the profession, a metaphorical hangover of vitalism that is not consistent with modern healthcare practice. As a result of this confl ict, arguments within the profession on the use of X-rays contribute to the continuing schism between evidencebased and subluxation-based chiropractors.
Chiropractor's use of radiography in Switzerland
Journal of Manipulative and Physiological Therapeutics, 2003
Objective: In this article, we investigate the use of diagnostic radiology by chiropractors in Switzerland, with the aim of determining their contribution to the annual radiation collective dose. Methods: We approached 138 chiropractors possessing radiologic equipment and asked them to provide, among other information, the frequency of radiographic examinations. The dose associated with each type of radiographic examination was established separately. The collective dose was determined by convolution of frequency and dosimetric information. Results: The number of chiropractic radiographic examinations performed in Switzerland in 1998 was 60,000, mainly spinal and pelvic examinations. The associated annual collective dose was found to be 144 Sv (an annual effective dose of 20 Sv per capita). The chiropractic contribution to the total dose due to conventional radiography in Switzerland is about 6%. Conclusions: Considering the number of chiropractors in Switzerland (less than 200), their contribution to the collective dose is relatively high. This is due to the high effective dose associated with the main types of examinations performed (eg, lumbar spine). It is therefore necessary to develop and apply guidelines for the use of this type of radiographic examination, as well as quality control programs, in order to optimize the radiographic technique and hence reduce the doses. (J Manipulative Physiol Ther 2003;26:9-16)
The Journal of the Canadian Chiropractic Association, 2005
Radiography has been part of chiropractic diagnostics since shortly after its discovery in 1895, the same year D.D. Palmer discovered chiropractic. In fact, it was B.J. Palmer who brought x-ray to chiropractic in 1910. 1 This is what led to a very interesting and rich chiropractic history of technique innovators with their varied radiographic biomechanical analysis systems. Many different x-ray analysis systems are used today in clinical practice and research as well as taught in the chiropractic colleges around the world. In fact, use of radiography for structural data is an integral component to the practice of chiropractic. 2,3 With the recent concerns about the profession's future (i.e. to remain a separate entity or be incorporated into mainstream medicine), 4 there has been pressure to restrict the use of radiography in clinical practice. 5-10 In fact, recent proposed guidelines suggest that except for ruling out "red flags" (i.e. serious medical conditions such as cancer, infection etc…) no radiographic imaging should be taken for treatment management of patients presenting with uncomplicated low back pain. 11-15 To no surprise, the current practice trend is much higher than this. 15-18 This commentary is written to present to the profession, and specifically to the advocates of continued restrictive use of radiography in clinical practice and research (i.e. DACBRs), that at low doses of ionizing ra
Chiropractic & manual therapies, 2014
Chiropractic technique systems have been historically documented to advocate overutilization of radiography. Various rationales for this have been explored in the literature. However, little consideration has been given to the possibility that the healthcare belief system of prominent early chiropractors may have influenced the use of the diagnostic modality through the years. The original rationale was the visualisation of chiropractic subluxations, defined as bones slightly out of place, pressing on nerves, and ultimately causing disease. This paradigm of radiography has survived in parts of the chiropractic profession, despite lacking evidence of clinical validity. The purpose of this paper is to compare the characteristics of the chiropractic technique systems that have utilised radiography for subluxation detection with the characteristics of religion, and to discover potential historical links that may have facilitated the development of those characteristics. Twenty-three cur...
Radiograph utilization and demographics in a chiropractic college teaching clinic
Journal of Chiropractic Medicine, 2012
The purpose of this study is to present radiograph utilization at a chiropractic college teaching clinic, the associated patient demographics, and the utilization rates by body region. Methods: Data for outpatient services over a 3-year period were extracted from a college clinic administrative software program. Radiographic data were matched with patient demographic information providing the age, sex, and financial class for all patients. Results: The overall radiograph utilization rate was 8%, with the highest frequency occurring in the spine in the order of lumbar, cervical, and then thoracic regions. Spinal radiographs made up 66% of the total radiographs taken. The utilization rate increased as the age of the patients increased. The average patient age was 46, and 48% were female. Conclusion: The radiograph utilization rate at this teaching clinic was lower than previous studies. This study provides new information regarding overall and regional radiography rates and associated patient demographics from an American chiropractic college.
Journal of Clinical Medicine
Plain Radiography of the spine (PROTS) is utilized in many forms of healthcare including the chiropractic profession; however, the literature reflects conflicting opinions regarding utilization and value. Despite being an essential part of Evidence-Based Practice (EBP), few studies assess Doctors of Chiropractic (DCs) clinical opinions and experience regarding the utilization of (PROTS) in practice. In this study, DCs were surveyed regarding utilization of PROTS in practice. The survey was administered to an estimated 50,000 licensed DCs by email. A total of 4301 surveys were completed, of which 3641 were United States (US) DCs. The Clinician Opinion and Experience on Chiropractic Radiography (COECR) scale was designed to analyze survey responses. This valid and reliable scale demonstrated good internal consistency using confirmatory factor analysis and the Rasch model. Survey responses show that 73.3% of respondents utilize PROTS in practice and 26.7% refer patients out for PROTS. ...
Adherence to Radiography Guidelines for Low Back Pain: A Survey of Chiropractic Schools Worldwide
Journal of Manipulative and Physiological Therapeutics, 2008
Objective: This study describes instruction provided at chiropractic schools worldwide on the use of spine radiography and compares instruction with evidence-based guidelines for low back pain. Methods: Individuals responsible for radiology instruction at accredited chiropractic schools throughout the world were contacted and invited to participate in a Web-based survey. The survey included questions on the role of conventional radiography in chiropractic practice and instruction given to students for its use in patients with acute low back pain. Results: Of the 33 chiropractic schools identified worldwide, 32 (97%) participated in the survey. Consistent with the guidelines, 25 (78%) respondents disagreed that "routine radiography should be used prior to spinal manipulative therapy," 29 (91%) disagreed that there "was a role for full spine radiography for assessing patients with low back pain," and 29 (91%) disagreed that "oblique views should be part of a standard radiographic series for low back pain." However, only 14 (44%) respondents concurred with the guidelines and disagreed with the statement that there "is a role for radiography in acute low back pain in the absence of 'red flags' for serious disease." Conclusions: This survey suggests that many aspects of radiology instruction provided by accredited chiropractic schools appear to be evidence based. However, there appears to be a disparity between some schools and existing evidence with respect to the role of radiography for patients with acute low back pain without "red flags" for serious disease. This may contribute to chiropractic overutilization of radiography for low back pain. (J Manipulative Physiol Ther 2008;31:412-418) Key Indexing Terms: Public health; Chiropractic M ore than 90 000 chiropractors practice internationally, and this number is expected to grow to 150 000 by the year 2010. 1 Most practicing chiropractors are graduates of one of approximately 30
Journal of Chiropractic Humanities, 2019
Objective: The purpose of this article is to describe the development of radiology as a specialty in chiropractic with a comparison to the development of the specialty of radiology in medicine. Discussion: Specialization in medicine has been notably successful, with advanced training and enhanced capabilities in specialized skills leading to better outcomes for patients and increased prestige for practitioners. However, with chiropractic, as with other complementary and alternative medicine professions, no specialization has been recognized within it. Specialist radiology training in chiropractic bears a resemblance to that of medicine, with competitive entry for residencies, certification exams, and the creation of a journal and specialist professional organizations. To facilitate the comparison, I have divided the development of radiology into 4 phases from the chiropractic perspective. Phase 1 started with the discovery of x-rays in 1895, in which medicine adopted them but chiropractic did not. Phase 2 began in 1910 when B. J. Palmer introduced radiography to show chiropractic subluxations. Phase 3 started in 1942 when Waldo Poehner advocated for the mainstream diagnostic use of radiography in addition to subluxation analysis. Phase 4 started in 1957 when an examining board for certification in diagnostic radiology was assembled and many chiropractors began to embrace the mainstream medical use of radiography. Conclusion: In this tale of 2 professions, radiology gained official specialty designation in the field of medicine. The medical profession had a monopoly on health care, and thus had few internal and external barriers to overcome. Chiropractic was oppressed by organized medicine, which helped to create the unofficial specialty of chiropractic radiology but which also later helped to limit the specialty. Chiropractic radiology has maintained its independence and autonomy, but also remains on the fringe of mainstream health care.
Divergent beam: A history of the use of x-rays in chiropractic
2018
The use of diagnostic x-ray is controversial in chiropractic, due to different groups in the profession holding conflicting opinions on its main utility. This thesis is a historical study of the effects the x-ray has had on the practice of chiropractic from its introduction in 1910 until the present day. It examines the influence of the founders of the profession, other prominent chiropractors, medical and chiropractic professional associations, as well as the role of the state in defining the paradigms for diagnostic imaging. The study adopts a biomedical perspective which prioritises the use of historical evidence in contextualising epistemologies of healthcare methods. In doing so it questions traditional chiropractic depictions of health and disease, which have not changed significantly since the profession’s inception. Historically, chiropractic has been divided along traditional/biomedical lines, and the exacerbating effect of the adoption of x-ray technology on the schism in ...