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April 3, 2019

Chiropractic Society of Texas Response to H.B. No. 2733

The current law, as it pertains to the practice of Chiropractic is found in the Occupations Code, entitled, “Sec. 201.002. PRACTICE OF CHIROPRACTIC.” In this code, it is currently stated that the practice of chiropractic is “to improve the subluxation complex”.

As previously discussed in past legal proceedings, the CST stands by the well-known and widely accepted definition of the vertebral “subluxation complex”, which includes the nervous system.

Therefore, there is no need to change the current scope of practice. The practice of chiropractic has and always will include the nervous system. Under the current scope, chiropractors have been locating, analyzing and correcting Vertebral Subluxations, with no legal issues.

Furthermore, the continuing legal issues against the Texas Board of Chiropractic Examiners (TBCE) stem from their misinterpretations of the law, thus leading to ill-informed rulings attempting to broaden our chiropractic scope into other healthcare professions’ scope of practice.

Continuing to change, modify or “clarify” the role of chiropractic practice in Texas by individuals that clearly do not understand the simple definition of chiropractic only serves to feed more legal proceedings from other health professions over time.

-CST Board 2019

 

____________________________

 

January 11, 2019

 

RE: X-rays in Chiropractic

 

BACKGROUND:

On August 15, 2017 the American Chiropractic Association (ACA) released a press release entitled, “American Chiropractic Association Releases Choosing Wisely® List of Tests, Procedures to Question”. Among these tests, were the following related to spinal imaging:

“In the absence of red flags, do not obtain spinal imaging (X-rays) for patients with acute low-back pain during the six weeks after the onset of pain.  Do not perform repeat spinal imaging to monitor patients’ progress.”

Since this initial release, the ACA claims a large amount of support for this initiative within and outside the chiropractic profession.

 

CHIROPRACTIC SOCIETY OF TEXAS RESPONSE:

The CST opposes the ACA in this endeavor to assert control and oversight to the chiropractor in his/her care for the public for the following reasons:

  1. Chiropractic Technique: Currently practiced within multiple chiropractic clinics in Texas are techniques that utilize X-ray as part of a core method to assessing the Vertebral Subluxation. These techniques are foundational techniques that are taught in accredited chiropractic schools throughout the country. Removing X-ray from these clinics would be detrimental to the proper care of the patient, as well as detrimental to the proper teaching of these fundamental techniques within chiropractic schools.
  2. Public Health: Each individual patient deserves the best analysis, and clinical application based upon their individual needs. X-rays should be taken per discretion of the practitioner as clinically indicated, as a matter of public health, and based upon a thorough clinical evaluation within the lawful scope of the chiropractor in Texas.
  3. Clinical Outcome: Follow-up X-rays allow for oversight in a patient’s care. X-rays are a method of valid, reproducible, and scientific measurement of outcome, post-chiropractic care. Without this method to measure outcome, the practitioner is restricted from a reliable method of outcome measurement in practice. Restriction, suppression, and governance in this manner is not conducive to best patient health outcomes.
  4. Professional Control: There is a need for scientific evidence to support chiropractic care. The utilization of evidence‐based clinical guidelines are useful for clinical practice. However, practice guidelines should have scientific claim, and should not produce a mandate of care.

 

The Chiropractic Society of Texas (CST), is a professional organization that supports principled, neurologically-based wellness care in a vertebral subluxation centered model. Thereby, the CST tasks itself with supporting best clinical practices for the chiropractic profession.

 

The CST fundamentally rejects the ACA endorsement of the Choosing Wisely campaign as it relates to spinal imaging (X-ray).

 

Sincerely,

CST Board January 2019

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