DIGITAL X-RAY CASE STUDY`

Avoiding Drugs and Surgery, and a Path to All-Natural Healing

Sponsored by ChiroSight

Patient Jane Doe, age 42, entered the practice as an established patient that had not been seen for nine months. Her new presentation of neck pain and headaches represented a different condition than her previously encountered lower-back pain.

She was seen for three visits involving spinal adjustments and electrical muscle stimulation, including some deep-tissue techniques. She had some minor, temporary relief, but the condition was still significantly present on that third visit when she expressed some discontent on the continuation of her symptomatology and moderate pain with headaches. She indicated her desire to seek medical attention and essentially was telegraphing that she was going to go to another provider along the medical route. She stated her husband was pushing her to go to their family medical doctor.

The digital X-ray difference

Although the DC explained cervicogenic headaches and the loss of range of motion (ROM), as well as the tight musculature and joint fixation found on the basic examination from her first visit the week prior, she seemed reluctant to continue with care even though it had only been three visits. The chiropractor had always been a successful communicator, and the majority of times patients would follow his recommendations — especially at this stage of care.

It was suggested to Jane that further diagnostics were required to determine the exact alignment in both the upper-cervical spine as well as the mid-cervical region, since her posture demonstrated forward head carriage. Since prior X-rays had not been taken on her cervical spine, it would help to get an accurate assessment of her spine to determine the exact involvement with her condition. She said she didn’t have time, but when it was explained that the entire process would take only five minutes, she agreed.

Since she sits at her desk much of the day working at a computer with a notable loss of extension ROM, it was clear that a five-view cervical series that included flexion and extension views would be needed. The DC used their digital X-ray system and obtained all of the images in just a few minutes.

The findings demonstrated a severe reversed cervical curve with degenerative changes at the C5-C6 level with anterior osteophytes, and significant disc degeneration at the C5-C6 level. In addition, her C2 vertebrae was rotated significantly to the right side and counter-rotation on the C1 to the left, causing biomechanical alterations and cervicogenic HA causation involvement. In addition, significant loss of extension was also evident.

Some of these findings were previously unknown by examination. Utilizing annotations on the digital X-rays, we were able to illustrate for the patient a direct comparison between what her X-rays revealed in contrast to a normal cervical spine.

Life-changing visual patient communication

That day was significant for the patient. It changed her life. The digital X-rays, complete with those annotations, empowered her in a way that simple explanations could not. She could literally see her condition, and after sharing the annotated digital X-rays with her husband, committing to the recommended care plan was a no-brainer.

Over the next 14 visits, more specific adjustments were provided to the patient. Specific corrective exercises were also provided with home instruction. The headaches that had been ongoing the past several months had now abated 100%. And the need for future care was better understood by the patient after having seen the X-rays. Tellingly, preventative care was something the patient requested (before the DC even had the chance to suggest it), making reference several times to the digital X-ray findings.

Successful care communication and new patient referrals

The result after five weeks of care: the husband, who was the actual facilitator to go elsewhere, became a new patient to the clinic for his back complaints. The positive experience from both the husband and wife resulted in two other patient referrals over the next six months. And from a practice profitability standpoint, the net effect was $4,300 in total care revenue from Jane Doe, her husband, along with the two other referrals.

All of this because of one critical factor: digital X-rays and annotated line measurements gave the patient a perspective she could not otherwise have had – one that empowered her to make the right decision and complete her recommended care. Plus, the X-rays altered the approach to care from the provider to a more specific approach that resulted in a better outcome for the patient.

Studies have shown that three out of four people (read: patients) are visual learners. But what do most of us do when seeing a patient for the first time? We tell them our diagnosis and recommended care plan instead of showing them. Many patients base their continuation of their care plan not on what we say, but rather on how they feel.

And for tens of thousands of us, it’s been one of their biggest headaches. Patient compliance affects practice profitability directly, as patients stop paying or drop out after partial pain relief. It also effects patient referrals and even practice efficiency as many simply don’t show up for their appointments once they perceive they are “better” or they simply don’t trust your recommendations — but aren’t telling you that.

And I changed all of this by using digital X-ray. When I shared my diagnosis and care plan using an annotated digital X-ray, patient compliance went through the roof. Why? Because they could visualize their condition and could see the biomechanical science for the “why,” and not have doubts wondering if I really knew what was happening to the spine. I only can have X-ray vision if I take the images.

With the cost of a digital X-ray system now less ($277/month for retro-fit) than what it costs to maintain a film-based X-ray system (developer processing chemicals that expire and harm the environment, film costs, time wasted,  storage and film jackets, staff filing and retrieving time, etc.), and given that the vast majority of people are visual learners, adopting digital X-ray truly becomes a “no-brainer.”

Steven Kraus, DC, DIBCN, FIACN, FASA, FICC