The benefits for many small practices far outweigh the reduction in control. There is no capital outlay or upkeep for equipment, and hospital and radiology groups have the ability to purchase systems that are far more advanced than the busiest chiropractor's office can justify financially.

They are also able to see obese patients, who are a challenge to even the most advanced in-office digital systems. Liability is a non-issue. It is hard for us to argue against using this method if it makes both financial and practical sense to outsource X-rays.

Digital X-Rays

More and more doctors are looking at digital X-rays as a way to move their offices to comply with both the needs of the patient and the push towards EHRs. Like all of the other systems, there is more than one type of digital imaging available.

The primary differences are as complex and as simple as their description: indirect and direct. The two words have implications that bear no resemblance to how the image is taken and the fact that it ends up on a computer screen with no additional processing needed.

Digital imaging is fast, efficient, easy to use and manipulate: no dark rooms or storage areas for film, and a large reduction in retakes due to the ability to enhance the image by adjusting contrast and brightness on the computer screen. I will not go into great detail on this, but a simple search on Google may leave you blinded with plenty of information.

The question regarding how long it takes to convert to digital imaging will depend totally on the type of digital option that the doctor chooses. Most companies require that you purchase a complete system: that means a new generator, bucky system and the digital plate.

If one is buying CR (computed radiography), a processor is also necessary. The time needed to strip out your existing room and set the new system in place will be a function of lead time and the local dealer. After it is installed the new system has to be certified by the state and then you can start to take X-rays.

A sign of a good system in place is the time it takes to implement; you should expect to be digital within 40 minutes of the system arriving at your office.

As far as retrofitting goes, some systems can be used on any X-ray system that has the capacity to output 125KvP and 300ma. The costs of going digital range from the low $20,000 to $100,000, and higher for the newest and latest wireless systems.

Figuring Out If It's Worth the Switch to Digital

We are working on a study that will give us an idea of how many offices currently are using X-ray. For us, the first question to the clinic after establishing that they do indeed take film can be a simple mathematical equation: multiply the numbers of X-rays by the cost of film, plus chemicals and processor cleaning - you then have the basic cost.

If that number exceeds financing costs either through leasing, bank loans or lines of credit then the purchase is simple. Not only will the system save you time, but will also make you real money.

The next group will be those who fall into the smaller practice that still uses film, but when the math is calculated it really is a long-term investment; the question for them is time, space and practice management.

When using digital X-ray, the doctor can have images available to him in as little as 10 seconds, or in a few minutes with CR, both are exponentially quicker than with the traditional X-ray.

Most chiropractors fall into this group. There are also some tremendous tax advantages for purchasing equipment; it makes no sense that a practice would give the tax man a little over $20,000, when he could buy a digital system and never spend a dime on X-ray again.

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Andrew Cheesman is Senior Vice President of Marketing and Sales for RF System Lab North America, based in Lincoln, Nebraska. You may reach him at (800) 905-1554, visit www.rfamerica.com or e-mail .