All right, Pat, thanks for hanging out with me. I appreciate it.
Yep, thanks for having me. Looking forward to the conversation.
So I'm gonna start this off with a bit of a snide comment and that is, I did not know that DACBRs went out in public and talked to other people.
A very rare occurrence. Don't expect it to happen again.
Listen, the thought the only reason you became a DACBR is so you didn't have to go out in public and talk to people.
That's a perk, I would say, but not the main motivation behind.
So the funny thing is like, I never considered being a DACBR when I went to chiropractic college. And when I got out into practice, it turns out my introvert nature, like being in practice really rubs against being an introvert. And I remember thinking back going, maybe that was a mistake.
Right. Right.
It's exhausting as an introvert to constantly be meeting new people, putting your hands on people like that day to day. It really is exhausting.
Conversely, as someone who saw patients for a number of years after radiology training, I'm very thankful for it. It really translates well to what you do in patient care and how you think and how you can best help people.
You're talking about the radiology part.
Radiology training translating to day-to-day patient care.
So I was actually curious, like that's probably a good place to start because there's sort of this heated debate in chiropractic about the use of imaging.
Wow, what a great question. We could spend probably the rest of our time together just chatting about this topic. I think the framing of this question is really, how useful is the tool and what are the questions you're sort of seeking to answer?
X-ray imaging is widely available, low cost, and very specific. If you think someone has a fracture, dislocation, tumor, infection, and you see it on the X-ray, you've made the diagnosis. But there’s an over-reliance and overconfidence in how good X-ray imaging is. You must respect its limitations and the potential downstream effects like overtesting and over-treatment. It all comes down to good shared decision-making with the patient.
I always say about chiropractic practice, if it weren’t for the people, it'd be easy.
No, I agree. And there's clearly ends of the spectrum. There's unethical use, like sales pitch imaging, and then there’s the middle ground, where patient-centered decisions and clear communication are key. Even within technique spaces, we should aim for an informed discussion with patients.
When I practiced upper cervical, we used imaging for listings, but I always evaluated how the patient responded post-adjustment. The X-ray is a starting point, but it’s just one piece of information.
Context is important. Showing patients imaging findings can influence their perception and outcomes. We must avoid creating unnecessary fear and focus on improving patient outcomes.
The practical side of care is focusing on patient function. If it’s not broken, don’t fix it. My joking comment to patients was, “Your body hasn’t read the textbook.”
Recent data shows over-imaging of patients who don’t need it and under-imaging of those who do. We need to do better as a profession.
Young chiropractors often over-correct and avoid imaging altogether because they see others misusing it. But throwing out tools entirely isn’t the solution.
Cone beam CT is an example where radiation concerns are higher. Chiropractors should proceed thoughtfully with such tools and not rush to adopt them without clear evidence.
My philosophy with films was to rule out the “oh craps.” If I wasn’t confident, I sent it to someone else.
Rely on clinical suspicion and professional expertise. Having a professional DACBR review imaging is always a good idea.
I cracked a joke about Kettner rapping in a talent contest. It’s nice to see a different, more approachable side of him beyond his high academic standards.
My new role as VP of Community-Based Clinical Education at UWS focuses on intentional matching of students with high-quality clinical sites. This distributed model gives students geographic flexibility and exposure to diverse practice environments.
Are there red flags when evaluating potential clinical sites?
Sites need to be compliant and willing to provide education. Immersive learning experiences are crucial for preparing students for real-world practice. 30 ... (and so on)