• Foster BJ

• Chiropractors / United States
• Drug Prescriptions
• Open Access Document
• Scope of Practice / United States

The health care delivery system in the United States is changing. Evolving approaches to health professional regulation and administration have increasingly focused on improving efficiency and effectiveness and lowering costs through a more patient-centered culture. This trend emphasizes value to the patient.1 No longer do medical doctors (MD) and doctors of osteopathy (DO) have absolute authority over patient care. Instead, the future of patient-centered care is integrated and best developed using evidence-based tools and practicality to achieve high-value care. Expansion of scope of practice in health professions is part of a current trend to improve patient access to high-value care. Each state determines the scope of practice and rules of licensure for non-MD/DO providers. There are fundamentally two ways to broaden practice- scope laws. The first is by expanding the basic licensure of a profession to include additional modalities. The second is by adopting specialized training and certifications. This second method, used by the nursing profession and others, is commonly called tiering. This article advocates for high-value, patient-centered care through expanding the scope of practice for qualified Doctors of Chiropractic (DC) to include limited pharmacological privileges through tiering.

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