59 Digital X-Ray in the Modern Spinal Expert Practice (Pt. 2)
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Dynamic Chiropractic – October 1, 2022, Vol. 40, Issue 10

Digital X-Ray in the Modern Spinal Expert Practice (Pt. 2)

By Steven Kraus, DC, DIBCN, CCSP, FASA, FICC

Editor's Note: Pt. 1 of this article appeared in the September issue.

The Proof Is in the Picture

When you take patient communication to this level with digital X-ray, it extends beyond the four walls of the practice.

Perhaps you have heard of the "significant-other saboteur"? This is the scenario whereby a patient is told their diagnosis and given a care plan. The patient then goes home to their significant other, and this "other" person torpedoes chiropractic and creates doubt in your patient - sometimes leading to discontinuation of care.

But now, with digital X-ray technology brought to bear, those X-ray images, complete with biomechanical drawings and annotations (created for you by software), are brought home on the patient's mobile phone and serve as the powerful proof needed to justify the money and time needed to complete a care plan. And as a result, they not only more often comply with their care plans and receive a good outcome, but are also more likely to refer you to their family, friends and colleagues.

digital x-ray - Copyright – Stock Photo / Register Mark Now that the cost of high-quality digital X-ray technology has dropped below that of operating a film system, not to mention the speed at which X-rays can be taken, the excuses are gone to not modernize. Since digital is integrated directly into your EHR system, using X-rays to validate and help determine the diagnosis and care plan, resulting in helping your patient better understand their condition, it adds up to see how your adjustments can help them return to better health, which becomes an obvious advantage for all involved.

The Modern Practice

Consider the daily experience your patients have in the world. Surrounded by technology, their lives are infused in every way and on every level with innovation. They wake up to a personalized playlist streaming directly from the internet; one that knows the exact type of music they want to hear – and when. They have technology on their wrist that tracks heart rate and exercise routine (including distance, time intervals and location).

They can tell their phone to remind them to buy spinach when they arrive at the store using geofencing technology; and can place a two-way video call from their phone and speak to a colleague 2,000 miles away.

And then they walk into a chiropractic practice. Are they stepping into a time warp? Do they have the same experience as if they were back in the 1980s? The point is this: A modern practice, complete with digital X-ray technology isn't just a plus – it's an expectation.

Practices that show they're equipped with current technology and apply that technology in innovative ways inspire confidence and trust in the patient for their doctor! That first impression is critical, and if they walk into our practices feeling like they've just been transported back in time, they're way less likely to engage in care, follow through with any recommended care plans, or refer to your practice.

Old film-based X-ray systems are costly to maintain, and the entire procedure is time consuming. But when viewed in the context that the most powerful way to discern the health of the spine is through digital X-ray, it's incumbent upon us to use it as a primary tool in our practice.

For less than $280 a month, a practice can retrofit a plain-film or CR-based system into true DR digital system. Plus, the costs of the old X-ray chemicals are gone, which is better for the environment; the film costs are gone, the maintenance on the processor is gone, as is the time to file and pay for X-ray folders and jackets that take up space. To go digital is to go green.

And for those of you who believe the scare tactics that some outdated academicians raise on radiation for plain radiography, the research shows there are no harmful radiation effects from plain spinal X-rays (CT scans are a different category). Even international radiological organizations have debunked the old myth from fear-mongering radiation-phobes.14-19

Practical Takeaway

We all know chiropractic is a powerful way for patients to find better health without drugs or surgery. It has improved quality of life for untold millions over the decades. But it's critical we, as a profession, modernize and claim our rightful status as the spinal-care experts of health care. Digital X-ray technology provides a critical tool in our ability to do just that.


14. Calabrese EJ. How the U.S. National Academy of Sciences misled the world community on cancer risk assessment: new findings challenge historical foundations of the linear dose response. Arch Toxicol, 2013;87(12):2063-2081.

15. Siegel JA, Welsh J. Does imaging technology cause cancer? Debunking the linear no-threshold model of radiation carcinogenesis. Technol Cancer Res & Treat, 2016;15(2):249-256.

16. Oakley PA, et al. The scoliosis quandary: are radiation exposures from repeated X-rays harmful? Dose Response J, 2019 Apr-Jun; 17(2).

17. Nash CL, Jr, et al. Risks of exposure to X-rays in patients undergoing long-term treatment. J Bone Joint Surg Am, 1979;61(3):371-374.

18. Doss M, Little MP. Point/counterpoint: low-dose radiation is beneficial, not harmful. Med Phys, 2014;41(7):070601.

19. Baheti A, Jankharia B. "Radiation Risks From Medical Imaging: Busting the Myths; Epidemiologic Evidence and Bench Research Demonstrate the Truth About Low Radiation Risk to Patients." Carestream.com blog post.

Click here for previous articles by Steven Kraus, DC, DIBCN, CCSP, FASA, FICC.

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