Are chiropractors requesting an overwhelming amount of diagnostic imaging, and what does this mean for patient care and costs?
It might surprise you to learn that chiropractors are responsible for a staggering 90% of all diagnostic imaging requests made by allied health professionals. This statistic, highlighted in a recent submission by the Australian Medical Association (AMA), is raising eyebrows and prompting calls for significant changes to how imaging is accessed.
But here's where it gets controversial... the AMA is proposing strict limits on these requests. They suggest capping chiropractors at a maximum of three spinal imaging requests per patient annually. This isn't just about numbers; the AMA emphasizes that such a policy aims to reduce unnecessary radiation exposure for patients and curb the rising costs associated with diagnostic imaging.
Data revealed in a departmental letter from November 15, 2025, indicated that in 2024, chiropractors accounted for an astonishing 89% of all diagnostic imaging requests from allied health workers. This figure dwarfs the usage by other allied health professionals like physiotherapists and osteopaths. The AMA's analysis shows a significant increase in these requests, climbing from 473,922 in 2020 to 624,613 in 2024.
When asked about creating specific billing codes (MBS items) for chiropractor-requested imaging, the AMA firmly recommended against it. Instead, they advocate for a more streamlined approach. Their submission states, "We agree action is warranted given the high level of chiropractor utilisation. However, we urge a policy response that focuses on streamlining the schedule, strengthening claiming clarity, and targeting education and compliance, rather than proliferating new items."
And this is the part most people miss... The AMA's core proposal involves implementing frequency controls. The goal is to discourage repetitive, low-value imaging and, crucially, to minimize patient exposure to radiation. This means limiting chiropractor-requested spinal imaging to just three per patient within a 12-month period.
However, the AMA is not advocating for a completely inflexible system. They acknowledge that certain complex cases, such as progressing scoliosis under specialist care or fractures with evolving symptoms, may require more frequent imaging. In these instances, they suggest that a patient's regular General Practitioner (GP) could authorize additional imaging.
Here's a thought-provoking question: The AMA also recognizes the existing shortage of GPs in Australia. They stress that any reforms should avoid creating situations where patients are forced to see their GP for duplicate appointments simply to access rebates, which could lead to delays and increased costs. The proposed policy aims to support GP-led care without imposing rigid requirements that might make accessing necessary treatment unaffordable or impractical.
The AMA also called for crucial reforms regarding the roles of medical radiation practitioners and radiologists. They want to prevent medical radiation practitioners from splitting services across multiple claims. Furthermore, they aim to clarify that radiologists are ultimately responsible for advising on alternative imaging options and communicating findings directly with the patient's treating doctor. The AMA emphasizes, "Radiologists lead the [diagnostic imaging] team, supervise services, make clinical decisions, and assume medical and legal responsibility." They are the ones who decide on the imaging method, radiation dose, contrast agents, and the interpretation and communication of results. Medical radiation practitioners, on the other hand, provide essential technical expertise in acquiring the images and supporting the patient. The AMA is clear that they should not independently assess requests, suggest alternative imaging, interpret findings, or act as gatekeepers for imaging deemed "low-value." Their role is to escalate urgent or unexpected findings to the on-duty radiologist first, and only contact the referrer if the radiologist is unavailable.
What are your thoughts on these proposed changes? Do you believe limiting imaging requests from chiropractors is a necessary step for patient safety and cost-effectiveness, or could it hinder access to appropriate care? Share your opinions in the comments below!
