IACP Supports X-Ray and Croft Whiplash Guidelines

Clinical Practice Guidelines (CPG's) inevitably affect health care providers including Chiropractic Physicians. Insurance companies invariably will adopt coverage determinations based at least partially upon findings from generally accepted and published Guidelines. In the past this led to animosity toward what are perceived by many to be restrictive guidelines within the Chiropractic profession, as many of you remember with the “Mercy Guidelines”. It is also true that even fair and impartial guidelines can be misinterpreted and applied inappropriately.

The IACP has reviewed several guidelines over the past 5 years, declining to “support” or the findings due to the likelihood that the guidelines would lead to practice restrictions and ultimately denial of medically necessary care. This is often based upon the source of the document, who wrote it, as well as the methods used to collect the data, rate the quality of the evidence, etc.

Recently the IACP was asked by the International Chiropractors Association to review and consider a guideline on the use of radiography specifically in the chiropractic practice (versus utilization recommendation in a medical setting where pharmaceutical intervention serves as the primary treatment approach). The document titled, Practicing Chiropractors' Committee on Radiology Protocols (www.PCCRP.org) was reviewed and found to be clinically relevant to practicing chiropractors. This guideline has been accepted for inclusion at the National Guideline Clearinghouse (NGC).

The board of directors of the IACP unanimously voted to support the findings of the PCCRP X-ray Guidelines as a possible guideline that chiropractors in Idaho may choose to reference and help guide their radiological usage in clinical practice. This particular guideline supports those doctors using Xray only in “Red Flag cases, but also supports other doctors taking X-rays for biomechanical assessment of the subluxation. The IACP hopes that by supporting the findings of this guideline it may serve to defend the right of Idaho chiropractors to use radiography in their offices as they were taught in Chiropractic college and in continuing education courses.

The other guideline considered by the IACP board was the “Croft Whiplash Guideline”. This document is most well-known for its publication in a textbook by Foreman and Croft titled “Whiplash Injuries. The Cervical Acceleration/Deceleration Syndrome”. Since publication within the famous textbook, this guideline has been adopted and incorporated into at least two guidelines accepted for inclusion at the National Guideline Clearinghouse. This guideline may serve as a useful guide for Chiropractic Physicians handling “whiplash” cases in their practices.

IACP is working diligently to help protect your practice privileges in Idaho. We believe that supporting these guidelines is yet another action that you will find benefits your practice. If you have any questions regarding these documents, you can email Dr. Joe Betz, the Insurance Committee Chair at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .