One of the most common questions a new patient will ask is whether or not x-rays will be necessary prior to being treated. The answer is in most cases x-rays won’t be medically necessary. The last two words of the previous sentence is what I want patients to take home, medically necessary. In my opinion, any imaging or advanced testing should only be required when it’s medically necessary. Most patients will not require x-rays prior to being treated in my office. One of the biggest reasons why I can say this because I listen very carefully to them. Yep, it’s that simple. Patients tell us about 95% of their diagnosis! The rest comes from orthopedic, neurological, functional movement, and special testing. So, what makes any imaging medically necessary?
In my profession we are always looking out for what we call “red flags.” These are potentially serious issues that need to be addressed as quickly as possible. There are many examples of red flags but some include: sweating at night, severe and debilitating pain, history of a previous injury to the current location of pain, history of cancer or other severe illness, red and swollen areas around the pain, and severity of initial injury. When these red flags occur it’s important to rule out serious and life-threatening issues. This is when it’s extremely important to get diagnostic imaging and special testing done.
When imaging is necessary, I will refer out to the appropriate provider or imaging center. It’s important to build relationships with other healthcare providers in the area so when a patient comes in and needs additional help you can provide them with the best options. After an x-ray is taken, I always recommend the patient get a copy of the radiograph for their own personal records. I will help review the images with the patient so that they can fully understand what’s going on because reading the radiology reports can be really confusing!
In conclusion, x-rays generally aren’t medically necessary. Putting patients through unnecessary exposures to radiation and having an extra out-of-pocket expense isn’t something I want my patients to go through for an adjustment.