Quality assurance: standards of care and ethical practice

Abstract

In the past, standards of care in chiropractic were based upon the bias, empiricism and little if any scientific work by the author. This was due, in part, to history which fostered the belief that all that was needed was anecdotal testimony and in part to the isolation of chiropractic colleges from main stream science. Today, standards are being based upon the scientific evaluation of the clinical procedures used and formulated by consensus of experts within the profession. The chiropractic profession has the duty to create standards of practice that will advance its clinical practice, protect the patient, ensure its contribution to health care and promote research into the assessment of outcomes and effectiveness. Although such steps are being actively pursued, significant discrepancies exist between the 60 statutes regulating chiropractic practice. Absence of consensus not only in the scope of practice but also in lexicon, adds confusion within and outside the profession. In addition, the profession is facing the same difficult task as the other health care professions, the need to develop quality assurance parameters for standards of care, quality of care and outcome of care measurements. Each of the parameters must be rational, defensible and modifiable as advances in science and technology become available. It is the responsibility of each chiropractor to maintain the appropriate level of professional skills to ensure that the patient receives the best care possible.

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