That's an artifact of the health system (as an economic/insurance system), not of medicine itself. Chiropractors are different, the problem with them isn't the bureaucracy of insurance.
Conflating medicine with how health systems work in some countries is a serious error.
* first see a GP, no real diagnosis.
* get an ultrasound - everyone already knows it won’t show anything of use but insurance companies require this escalation path
* get an xray - same as above
* maybe if you insist get an MRI.
* regardless the treatment is the same: go to a PT’s office.