The Australian Medical Association (AMA) has proposed capping the number of spinal imaging requests made by chiropractors, citing a concerning trend in diagnostic imaging usage. Chiropractors account for an overwhelming 90% of allied health diagnostic imaging requests, far surpassing the utilization by physiotherapists and osteopaths. This has sparked a debate on the need for policy interventions to streamline the healthcare system and ensure patient safety.
According to the AMA, the volume of imaging requests from chiropractors has risen significantly from 473,922 in 2020 to 624,613 in 2024. The association suggests that this high utilization warrants action, but emphasizes the importance of a policy response that focuses on education, compliance, and clarity in claiming, rather than creating new items in the schedule.
The AMA proposes frequency controls to discourage repeat, low-value imaging and reduce radiation exposure. They recommend limiting chiropractor-requested spinal items to three per patient per 12 months, with exceptions for patients with complex conditions like progressing scoliosis or fractures with evolving symptoms, which could be authorized by a patient's regular GP.
However, the AMA also highlights the need to prevent medical radiation practitioners from splitting services across multiple claims and to clarify the responsibilities of radiologists in advising on alternative imaging and communicating with a patient's treating doctor. This includes emphasizing the role of radiologists as leaders in the diagnostic imaging team, responsible for clinical decisions and medical and legal accountability.
The AMA's proposal has sparked a discussion on the balance between chiropractor-led care and the need for policy interventions to ensure patient safety and streamline the healthcare system. What do you think? Do you agree with the AMA's proposal, or do you believe there are alternative solutions that could address the issue without imposing caps on chiropractor-requested spinal imaging?
