Dear Member,
DIAGNOSTIC IMAGING REVIEW
Current President Marc Muncila and immediate past President Paul McCrossin recently met with Nick Jones CEO and Registrar of the GCC on January 21st to discuss the draft guidance on diagnostic imaging and the UCA’s submission to November’s consultation. The meeting was productive and the UCA has had sight of a revised draft document which is a significant improvement over the original proposal. The UCA provided a robust response to the original guidance, and we appreciated that Nick Jones was prepared to engage in a frank discussion about varying aspects of the review.
As such we commented on the revised draft and our main reservations were two fold. The first revolves around the expert groups comments around the terms routine, repeat and scheduled. We agree with the expert group that X-rays should not be routinely taken as a matter of course without justification after consideration of the individual circumstances of the patient. Ultimately registrants should always have reasonable justification for any imaging they request, irrespective of where in a patients’ care that may fall. The decision to X-Ray is a collaborative decision between the Chiropractor and patient. We made the point that it was unwise for a regulator to be overly prescriptive as it will impinge on scope of practice. The regulator should not be specifically dictating which circumstances or conditions (fractures, malignancy, scoliosis) when a Chiropractor should or should not be using diagnostic imaging. This will result in an increase in fitness to practise hearings rather than a reduction with the concomitant stress and costs.
The other issue with the updated draft was also around communication with the patient. The thrust of which is that the guidance states that Chiropractors must not overstate findings in particular related to age related degenerative changes and mild postural deviations. This follows on from some of the accusatory tone in the preceding documents in our opinion which we felt had no place in the guidance. As such we made the point that it is inappropriate to overstate findings being a breach of the current code. A Chiropractor should be informed in a positive manner via the guidance that imaging should be communicated accurately as part of the overall findings and plan of care in a relevant and evidence informed manner incorporating all aspects of a patients case history and examination.
Overall this updated draft guidance is far more in line with what the UCA feels would be appropriate in order to assist members in their decision making. We welcomed the expert group confirming that they did not intend to state that diagnostic imaging should be restricted to “Red flag” conditions only. We look forward to receiving further revised guidance incorporating our feedback in the coming weeks.
Yours in Health,
UCA Head Office Team
