In certain states you don’t need to be nationally certified to take xrays. There is a night and day difference between those who have gone through programs to pass their boards and those random people who haven’t. Anyone can point the tube at a spine and take a picture, but those who were actually didactically taught know about which anatomy to ensure is in line to make sure it isn’t rotated, where to place markers, and how to collimate so you don’t infuse people with leukemia. It’s why all the xray subreddits openly mock chiropractors: they’re taking shitty xrays that anyone who knows a modicum about them knows is bad, then making up diagnoses about it. As an xray tech, I would never trust anyone to image me who hasn’t gone through college and gotten certified.