 |
 POSITION STATEMENTS |
|
POSITION STATEMENTS |
[ HOME ] [ CONTACT US ] [ CONSULTANT DIRECTORY ] [ ACCC/ABCC BOARD ] [ LINKS ]
[ EDUCATION PROGRAMS ] [ MEMBERSHIP ] [ EBM & DOCUMENTATION ] [ NEWSLETTERS ] [ CONFERENCE INFORMATION ]The following position statements are summaries of the best available evidence as interpreted by the ACCC. They are provided as general guidelines for those that provide quality assurance and utilization review activities. It is essential that each case be assess fairly according to the merits of the case. This work is is also intended to serve the general chiropractic practitioner as an objective and fair source of information regarding procedures commonly employed by the chiropractic profession. The duration of care information in section three is provided for convenient and has not been assessed or endorsed by the ACCC. Bibliographic information supporting each position statement is available to ABCC diplomates.
Position Statement Creation Procedure
SECTIONS
|
|
3. TREATMENT DURATION INFORMATION
|
||||||||||||||||||||||||
|
4. CONSULTING TOOLS & TEMPLATES
|
|
Radiographic
Assessment of Cervical Curves -
Bibliography
Support Information - Cooperstein
R, Perle SM,
Gleberzon BJ, Peterson DH. Flawed trials, flawed analysis: why CBP should
avoid rating itself. J Can Chiropr Assn. 2006;50(2):97-102.
The current literature does
not support the necessity of radiographic studies performed solely for the
purpose of assessment or reassessment of the cervical lordosis and/or
restoration of an optimal curve.
There are insufficient data to support the use of such techniques for the
purpose of outcome assessment or treatment planning.
- Position
Statement of the American
College of Chiropractic Consultants - 2006
The
clinical usefulness is limited because the discriminability of these procedures
has not been fully evaluated.
-
Range
of motion testing is an integral part of a chiropractic examination and
follow-up evaluations. Separate billing (unbundling
or fragmenting) for range of motion assessment is
not generally considered usual or customary.
- Position
Statement of the American
College of Chiropractic Consultants - 2006
Supportive Care - Bibliography
Long-term treatment/care that is therapeutically necessary. This is treatment for patients who have reached maximum therapeutic benefit, but who fail to sustain benefit and progressively deteriorate when there are periodic trials of treatment withdrawal. Supportive care follows appropriate application of active and passive care including rehabilitation and/or lifestyle modifications.
Supportive care is appropriate when alternative care options, including home-based self-care or referral have been considered and/or attempted. Supportive care may be inappropriate when it interferes with other appropriate primary care, or when risk of supportive care outweighs its benefit, i.e. physician/treatment dependence, somatization, illness behavior or secondary gain.
NB: Chiropractic physicians should be
sure and clearly document treatment withdrawal attempts and the results of
those attempts.
- Position
Statement of the American
College of Chiropractic Consultants - 2006
Elective health care that is typically long-term, by definition not therapeutically necessary but is provided at preferably regular intervals to prevent disease, prolong life, promote health and enhance the quality of life. This care may be provided after maximum therapeutic improvement, without a trial of withdrawal of treatment, to prevent symptomatic deterioration or it may be initiated with patients without symptoms in order to promote health and to prevent future problems.
This care may incorporate screening/evaluation procedures designed to identify developing risks or problems that may pertain to the patient’s health status and give care/advice for these.
Preventative/maintenance care is provided to optimize a patient’s health.
NB: Coverage for
preventive/maintenance care is often dependant on the patient's
contract language.
- Position
Statement of the American
College of Chiropractic Consultants - 2006
There
is no high quality literature indicating that electrical stimulation is, or is
not, an effective primary treatment for musculoskeletal conditions. However, it
is plausible that therapies such as heat and electrical stimulation may assist
in the management of pain and/or spasm, and/or tissue softening in preparation
for manipulation or mobilization, thereby augmenting the positive effects of
those procedures. It is therefore, reasonable to apply such therapies to prepare
tissues for tissue elongation, manipulation, and/or mobilization in a clinical
setting.
- Position
Statement of the American
College of Chiropractic Consultants - 2009
The chiropractic
subluxation / vertebral subluxation complex is a theoretical model that has
historical and traditional significance; however, considering the evolution
of scientific research, the term has an ambiguous definition, with no
evident health implications.
While use of the term is
required by federal insurance policies, utilization of the term as a
diagnosis is otherwise not supported by the scientific evidence.
Government, healthcare
decision makers, and chiropractic educational institutions should be
encouraged to update policies requiring the use of the term, and/or the
indication for spinal manipulation, based on evolving scientific evidence.
Chiropractors should avoid unethical exploitation of the public with
unsubstantiated claims regarding the health significance of the chiropractic
subluxation / vertebral subluxation complex.
- Position
Statement of the American
College of Chiropractic Consultants - 2010
 | Guidelines for Chiropractic Quality Assurance and
Practice Parameters : Proceedings of the Mercy Center Consensus Conference
published by Aspen Publishers; 1993, have been recommended for application
in chiropractic practice with the provisions that newer scientific data be
considered. The ACCC recognizes these guidelines and the significance of the
associated proviso. |
| Vertebral Subluxation in Chiropractic Practice
published by the Council on Chiropractic Practice; 1998, have been assessed
as unacceptable for use in clinical practice. This document, and the 2003
Update & Revision, are not recommended by the ACCC. |
| Recommended Clinical Protocols and Guidelines for the
Practice of Chiropractic (ICA guidelines), published by the International
Chiropractors Association; August, 2000, have been assessed as unacceptable
for use in clinical practice and are not recommended by the ACCC. |
| Occupational medicine practice guidelines : evaluation
and management of common health problems and functional recovery of workers.
2nd ed; 2004, published by the American College of Occupational
and Environmental Medicine, have been assessed as acceptable for use in
clinical practice with proviso. The ACCC recognizes that some of the
recommendations made by these guidelines may not be valid due to possible
evidence selection deficiencies and recommend alternative guidelines or best
practice documents of higher quality when possible. |
| The Council on Chiropractic Guidelines and Practice
Parameters' guidelines, reviews, and recommendations reflect the generally
accepted standard of care in the United States of America. |
3. TREATMENT
DURATION *
* This section reports various sources regarding duration
of care.
No single system has been assessed or endorsed by the ACCC.
Chapter 8
Guidelines for chiropractic quality assurance and practice parameters. Proc
Mercy Center Consensus Conference. Haldeman S, Chapman-Smith D, Petersen D.
eds.
Burlingame, CA: January 25-30,1992. Gaithersburg: Aspen, 1993.
CCGPP Chiropractic Management of Low Back Disorders
Duration of care information at: http://www.ccgpp.org/delphi.pdf
4. CONSULTING TOOLS & TEMPLATES
|
Position statement regarding the granting, advertisement
and use of
“certified consultant” designation.
For
example, courses like the diplomate in orthopedics are offered or sponsored by
CCE accredited organizations and board certification is granted by an
independent body. This process eliminates the potential for abuse by
opportunistic entrepreneurs that instruct and certify their participants without
appropriate teaching and examination processes.
It
is the position of the
Those
completing continuing education consulting programs are considered to hold a
"consulting certificate" and should not hold themselves out as a
"board certified" or "certified" consultant.
The ACCC has members throughout the United States who are currently providing consulting services. If you would like additional information on how to become a member of the ACCC or on how a member of the ACCC can help you, please contact us.
Website Disclaimer
This website is a service of the American College of Chiropractic Consultants. It is designed to provided readers with pertinent information concerning the College, its examining board (ABCC) and utilization activities.
All documents and information on the ACCC website are the property of the American College of Chiropractic Consultants, whether or not a copyright notice appears on the screen displaying the information. Users may save and use information contained therein only for personal use. No other use, including reproduction, retransmission or editing, of the ACCC website may be made with out the prior written permission of the ACCC, which may be requested by contacting the ACCC headquarters.
ACCC makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information posted herein, and the ACCC assumes no responsibility or liability regarding the use or misuse of such information.
Links or pointers connecting the ACCC website with other web sites are provided as a courtesy only. The ACCC assumes no responsibility or liability for such other sites' content, accuracy, or compliance with applicable laws.
The laws of the State of Illinois and the United States of America will apply to all matters relating to the ACCC website.
This material is presented for private discussion, research and educational purposes only. Do not publish, broadcast or otherwise distribute this material without prior written authority.
[ HOME ] [ CONTACT US ] [ CONSULTANT DIRECTORY ] [ ACCC/ABCC BOARD ]
[ EDUCATION PROGRAMS ] [ MEMBERSHIP ] [ EBM & DOCUMENTATION ]
[ NEWSLETTERS ] [ LINKS ]
10/14/2010