Re: X-rays by Chiropractors

[Joel Baumbaugh <baumbaug@nosc.mil>]

	Elizabeth,

	I have had the "pleasure" of evaluating  a number of Chiropractic machines
over the years.  The following opinions are just mine and mine alone, and
do not necessarily reflect the opinions of my current or any former
employers (whew!!).  That said:

	In the State of California one turns to the Calif. Rad. Control Regs
(Title 17), 30305 General Provisions for chiropractic (and other) "Healing
Arts" for the majority of regulations.

	I don't know about your state, but in the State of California (IMHO) the
restrictions placed on Chiropractor's use of x-ray machines are very few .
 In general,  you'll find that Chiropractors use old(er) machines.  In
California, machines manufactured before  July, 1974 (probably the majority
of machines in use by this group) even have an "exemption" regarding
maintenance requirements to keep the equipment in compliance with CFR's.
After checking a number of machines, one comes to the conclusion that
linearity/reproducibility of kVp or mA is seldom a concern.   Technique
charts - what Technique Charts?   Use Logs - what Use Logs?...Automatic
exposure control?  Only if the "patient" is lucky.  Unless they're pretty
experienced, if they don't have automatic exposure controls get up off of
the table and leave.  About 25 years ago I went with a girl friend to a
Chiropractor.  All three of us stood in the room while the operator  keep
fiddling with the "dials" (kVp, mA and time) - taking "shot after shot"
until he could get a clear enough result to read.  Chiropractors are
working to make a profit.  The more x-rays they take, the more money they
can charge. They most often use cheaper/slower film, no image intensifiers,
have little(if any) training in use of the machine or in ionizing radiation
protection practices.  Collimators - they're just there, i.e. "it came with
the machine and we've never moved them" - unless they get in the way - then
they're gone ( I personally only saw this happen just one time - but I've
heard other stories).  

	I am quite sure that the majority of Chiropractors are conscientious
individuals.  Most of my experience with Chiropractic machines was more
than 10 years ago, so the "industry standards" may have improved recently,
but I myself would be very hesitant to have a series of x-rays performed by
any entity other an a major medical center where maintenance
records/calibrations, etc., etc., are part of their certification process.

	 Remember,  this is only MY opinion (grin)... Ok, I'll stand back while
people throw mud...

	Joel Baumbaugh (baumbaug@nosc.mil)
	SSC-SD

At 10:54 AM 6/11/99 -0500, you wrote:
What average dose is received as a result of chiropractic x-ray imaging to
patients? Just curious because they take several spinal images. Also, are
there
special regulations for chiropractors vs. other health care entities regarding
use of x-ray imaging devices? And what about training requirements? I know a
chiropractor bases a great deal of his/her diagnosis and treatment
recommendations on x-ray images. 

Realizing this may be a controversial subject,
I appreciate any comments.

Elizabeth Algutifan 
Weldon Spring Site
Elizabeth_Algutifan@wssrap-host.wssrap.com

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