Chiropractors are ordering nearly 90% of all diagnostic imaging requests from allied health professionals—a staggering statistic that raises serious questions about overuse and patient safety. But here’s where it gets controversial: The Australian Medical Association (AMA) is now calling for strict limits on how many spinal imaging requests chiropractors can make per patient per year. Should chiropractors really have free rein to order as many X-rays or MRIs as they want? Or is it time to rein in what some might call excessive—and potentially harmful—practices?
In a recent submission, the AMA proposed capping chiropractor-requested spinal imaging to just three scans per patient annually. This recommendation comes after data revealed that chiropractors accounted for a whopping 89% of all diagnostic imaging requests from allied health workers in 2024—far outpacing physiotherapists and osteopaths. To put that in perspective, the number of imaging requests from chiropractors jumped from 473,922 in 2020 to 624,613 in 2024. That’s a 32% increase in just four years. And this is the part most people miss: repeated imaging not only drives up healthcare costs but also exposes patients to unnecessary radiation, which can pose long-term health risks.
The AMA isn’t just stopping at caps. They’re also pushing for focused education and audit programs to ensure chiropractors are ordering imaging only when absolutely necessary. For instance, instead of creating new Medicare Benefits Schedule (MBS) items for every possible anatomical scenario, the AMA suggests streamlining the system, clarifying claiming processes, and emphasizing compliance. This approach, they argue, would reduce low-value imaging without burdening the system with unnecessary bureaucracy.
Of course, there are exceptions. Patients with complex conditions like progressive scoliosis or fractures with evolving symptoms would still be able to access additional imaging, but these cases would require authorization from a general practitioner (GP). This raises another critical issue: Australia’s GP workforce is already stretched thin. Here’s the dilemma: How do we ensure GP-led care without creating barriers that make healthcare unaffordable or impractical for patients?
The AMA also takes aim at co-claiming practices among medical radiation practitioners, urging reforms to prevent them from splitting services across multiple claims. Additionally, they emphasize that radiologists—not technicians—should be responsible for advising on alternative imaging options and communicating findings to treating doctors. After all, radiologists are the ones making critical clinical decisions, optimizing doses, and assuming legal responsibility for patient care.
But here’s the controversial question: Are chiropractors overstepping their role by ordering so much imaging? Or are they simply filling a gap in a system that lacks clear guidelines? The AMA’s proposal has sparked debate, with some arguing that limits could improve patient safety and reduce costs, while others worry about restricting access to necessary care. What do you think? Is the AMA’s approach fair, or does it go too far? Let’s hear your thoughts in the comments below.
