Professional Conduct and Standards of Care
Standard of care
Professional conduct is measured by what a reasonably prudent optometrist with similar training would do in similar circumstances. The standard is not what most practitioners happen to do, and it is not a guarantee of outcome. Informed consent, confidentiality, appropriate referral, and accurate records are core duties.
Concepts
Know the elements of informed consent: diagnosis, nature of treatment, risks and benefits, alternatives, and consequences of refusal, documented in the record. Understand confidentiality and its exceptions, conflicts of interest, fee splitting, advertising limits, impairment, patient abandonment, and delegation to assistants. Know the duty to report certain conduct and the obligation not to practice while impaired.
Traps
A signed consent form is not automatically informed consent; the discussion must occur and be documented. Abandonment requires more than a missed appointment; it usually involves unilateral termination without notice or access to records. Another trap is assuming a referral discharges all duty; co-management requires communication.
Worked example
A patient refuses a recommended referral for a suspicious lesion. The optometrist should explain the risk, offer alternatives, document the refusal, and continue appropriate follow-up. The record should show what was said, not merely "patient refused."
Rule of thumb: if it is important enough to discuss, it is important enough to document.