Update: Public Consultation on the Review of Clinical Utility of Routine Spinal Radiographs

At their September 23, 2020 meeting, the Board of the College of Chiropractors of British Columbia received an update about the public consultation on the use of routine and repeat radiography by BC chiropractors. Over 1000 responses were received by the September 8th deadline from hundreds of patients, dozens of practitioners, and several chiropractic profession and health advocacy organizations. On behalf of the CCBC, the Board extends their sincere gratitude to all of those who took the time to prepare responses for submission to the consultation.

The CCBC acknowledges that X-rays are an important tool of which chiropractors are competent to apply and interpret. The CCBC fully supports the use of radiography by chiropractors where appropriate. The consultation feedback suggested that a small number of practitioners, and a larger number of patients, concluded that the proposed amendments would eliminate a chiropractor’s authority to utilize any radiography in their practice. There is no intention by the CCBC to eliminate the use of radiography in a chiropractor’s practice. The review and consultation are analysing the clinical utility of routine and repeat spinal radiographs.

While a thorough analysis of the responses is still underway, the Board noted a few themes which included:

  • Ensuring that any policy changes more clearly include the clinical judgement of the chiropractor;
  • A request that the College further define “red flags” that a chiropractor may use in determining the need for radiography and what factors are necessary in leading to determining the need for radiographs;
    • Factors such as a thorough history and examination leading to a determination of the necessity of further testing and/or radiographs.
  • Clarifying the literature/studies that were considered by the independent researchers, and why other studies were not included in the rapid review; and
  • Providing more information about and safety concerns regarding the use of radiography.


The Board directed staff to further investigate the themes from the consultation responses and report the results at a future meeting. The College is committed to ensuring that a fulsome analysis of all of the public consultation feedback is completed prior to the implementation of any policy changes.

The College appreciates this opportunity to engage with the public, patients and registrants. We look forward to sharing more details about the development of this policy in the future.

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