Letter to the Editor
Risk Management

Letter to the Editor

I am writing to you in response to one of the articles in the Examiner all-case-study issue that I received by email on August 30 titled, “Not Re-X-raying Results in Misdiagnosis.” The title of the article was slightly misleading as later reported; the true negligence in this case was the initial missed radiographic finding of major clinical significance on the initial radiographic study.

As president of the American Chiropractic College of Radiology, representing over 200 DACBRs, I was shocked to see no mention of how this case could have played out drastically different had the chiropractor utilized the services of an expert consultant in radiology.

As you probably know, chiropractors only receive approximately 300–400 hours of training in radiology as part of their chiropractic education. Diplomates of the American Chiropractic Board of Radiology receive approximately 4,000 hours of training during their 3–4 year full-time residency. They are certified by the American Chiropractic Board of Radiology (ACBR), an independent examining body, through a rigorous examination process. They are also required to complete ongoing continuing education as part of maintaining their diplomate status.

As a group, DACBRs exist as a recognized body of experts to further our profession of chiropractic by providing expert knowledge of diagnostic imaging protocols, interpretation, image quality and patient safety. This is all for the ultimate benefit and health of the patient.

In my opinion, an important opportunity was missed in NCMIC’s case study “What Can We Learn” section because it omitted mention of the role of expert consultations by chiropractic radiologists and didn’t further educate the practicing chiropractor of their options in not only reducing their liability but also in providing exemplary patient care.

As a malpractice insurance company, I would assume that limiting the liability of your insureds is one of your main goals. The ACCR is willing to take an active role in helping educate your insureds in any way we can, whether it be by contributing to your publication or presenting lectures on behalf of NCMIC.

Robyn B. Mitchell, DC, DACBR
President, American Chiropractic College of Radiology

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