Stop the CCBC from restricting your chiropractor’s ability to take X-rays

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On July 15, 2020 the College of Chiropractors of British Columbia (CCBC) advised that it was in the process of analyzing the use of routine and repeat spinal radiography, including X-rays, and as a result,  anticipates amendments to the Professional Conduct Handbook (PCH).

As representatives of the public, Health Action Network Society (HANS) and Canadians for Chiropractic (CFC) are concerned that amendments to current X-ray guidelines are likely to have unintended consequences to the health of patients who depend on the full scope of chiropractic practice. 

Access to X-rays is Crucial

Although X-ray analysis of the spine is a fundamental diagnostic tool of several chiropractic techniques, the proposed amendments eliminate the use of X-ray for anything beyond red flag (fractures, etc.) concerns.  The amendments would severely restrict a chiropractor's ability to take X-rays when evaluating bio-mechanical alignment problems.  They would also eliminate follow up X-rays that are often vital in evaluating and modifying treatment.  

Restriction to access of X-rays will make it difficult, if not impossible, for chiropractors to diagnose several conditions, including fusion of a vertebrae (congenital or cause by injury or disease including osteoarthritis, which is exceedingly common in seniors); and previously undiagnosed injuries, including vertebral fractures. 

For those suffering with osteoarthritis, a near-universal chronic degenerative disease, routine chiropractic x-rays provide the opportunity to receive a baseline evaluation, treatment programs, and progress assessment over following years.

Additionally, there have been many incidents of chiropractors identifying serious, unexpected issues through the use of X-rays, including aneurysms and cancerous tumors.

There is No Adequate Reason for this Extreme Proposed Amendment

There seems to be no relevant impetus for the proposed amendment, other than its contribution to the erosion of scope of practice.  The CCBC has associated the proposed amendment with a study that concluded that "we found no evidence that the use of routine or repeat radiographs to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients. Given the inherent risks of ionizing radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine."  Canadians For Chiropractic questions the reason for the study.

The risks associated with ionizing radiation are disproportional to the potential for misdiagnosis or missed diagnosis.  Note that a single CT scan emits 100-200 times the amount of radiation as a single X-ray. Therefore, even in the unlikely event that a chiropractor were to take X-rays weekly, it would still take 2-4 years' worth of X-rays to equal the amount of radiation in a single CT scan.  Furthermore, the odds of a single CT scan resulting in a fatal cancer is one in 2,000; accordingly, the odds of routine X-rays resulting in a fatal cancer is 100 - 200 times that.

Additionally, if exposure to ionized radiation is the impetus for the proposed amendment, why are the same restrictions of use not being imposed upon medical doctors?

Patients Have the Right to Informed Choice

The CCBC claims to endorse an evidence informed model for patient care. An evidence informed model considers scientific evidence, doctor experience, and the patient’s choice or preference. Another serious implication is the removal of informed choice for patients who understand the importance of X-rays to their diagnostic process and want to make their own fully informed choice in the interest of their best health.

What You Can Do

The purpose of this petition is to send a clear and strong message to the CCBC that you, a member of the public who may or may not be a patient of chiropractic, have the right to your practitioner of choice's full scope of practice and the safe and standardized tools that support it.

The CCBC has invited unprecedented public consultation on this matter. Comments must be submitted in writing prior to 4:30 pm on September 8, 2020. How can you make yourself heard on this issue?

  1. Sign and submit this petition.
  2. Use this template or your own composition, to submit your message to the CCBC at consultation@chirobc.com no later than 4:30 pm on September 8, 2020. Please ensure all following recipients are copied on your submission: HLTH.Minister@gov.bc.ca; norm.letnick.MLA@leg.bc.ca; sonia.furstenau.MLA@leg.bc.ca; paul.manly@parl.gc.ca; angie@bcchiro.com; Naida@hans.org
  3. Additionally, please copy the MLA in your riding.  You can find your MLA by visiting this link: https://www.leg.bc.ca/Pages/BCLASS-Search-Community.aspx?PlaceFirstLetter=A&

Thank you for supporting Chiropractic and your right to uncompromised treatment!

Canadians for Chiropractic is a Health Action Network Society initiative designed to inform Canadians of increasing chiropractic censorship and imposed limitations to practice and the potential impacts to Chiropractic clients.  You can find us on Facebook at https://www.facebook.com/Canadians-For-Chiropractic-101607294915850