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Imaging CDM - Coggle Diagram
Imaging CDM
Its out of my hands
Some cultures are more resistant to clinician direction
Some patients are too irrational / anxious / argumentative / suffering too much
Biopsychosocial complexity of LBP
face yellow flags
Providing imaging is easier than managing BPS complexity
Imaging can "prove" nothing is wrong to difficult clients
I face patient pressure... Sometimes I have to give in
I tried my best, they still want it
I face time constraints / imaging is a pragmatic tool to manage time
I have to maintain relationships... imaging is a pragmatic tool to manage relationships
I have to consider interprofessional relationships
Breaking therapeutic relationships
My decisions influence others decisions
Imaging is expected / required for specialist referral
Patients expect imaging / think it shows what's wrong
Private practice means patients get to choose / i have to defer to patients
Colleague behavior influences patients, influencing me
Valuation of imaging
Imaging does not benefit patients
Imaging can lead to unnecessary care
Imaging can cause nocebo
Imaging findings are usually uninformative
Radiation exposure
Imaging is costly to patients / systems
Imaging can benefit patients
Imaging findings can improve (chiropractic) treatment specificity and outcomes
Imaging generates buy in
Imaging findings are associated with symptoms / spine health
Imaging provides reassurance
Subsidized imaging justifies its use
Avoids missing a diagnosis / better safe than sorry
Imaging needs to alter management
UNSURE
Experience is my guideline
Learned behavior from peer interactions
Aware but unfamiliar with guidelines
Guidelines are for the inexperienced
You don't need an xray with experience / expertise (past clients, assessment skills)
Appropriate imaging accelerates access to appropriate care
Delaying appropriate imaging delays appropriate care
Its in my hands
Its my duty to be judicious
"anti-imaging" stance
Professional identity - moral clinician
Avoiding repeat referrals
I face patient pressure... Can I provide alternatives?
Education
Reassurance
Interdisciplinary care referral
Medications
Thorough assessment
My duty is to the patient
The importance of shared decision making
Agreeing to imaging improves experience / satisfaction