Standards of Conduct, Ethics, and Patient Rights
This domain examines the professional duties owed to patients and the public: consent, confidentiality, boundaries, honest billing, and access to records. Items frequently present a plausible-sounding shortcut and ask whether it is permissible.
Duties owed to every patient
- Informed consent - the nature of care, material risks, alternatives, and the right to refuse, documented in the record.
- Confidentiality - HIPAA sets a floor; DC law adds protections, notably for HIV-related information, which requires specific authorization before release.
- Non-discrimination and culturally appropriate care.
- Professional boundaries - sexual contact with a current patient is prohibited.
- Non-abandonment - ending the relationship requires notice and a transition plan.
- Billing integrity - bill only for services actually delivered by qualified personnel; no upcoding.
- Truthful advertising - no implying a certification or specialty you do not hold.
- Conflict-of-interest limits - no payment for referrals, no gifts that buy influence.
Patient rights
Patients may access their record, choose their provider, be told the charges, receive privacy during care, and complain to the Board without retaliation.
Records requests
Respond to a written request from the patient or an authorized representative. A reasonable copying fee is permitted. Withholding records solely to force payment of a bill is not an acceptable basis for refusal.
Worked example
After a billing dispute, a patient requests his record. The front desk says the clinic will release it "once the balance is paid." That is a patient-rights violation. Provide the copies with the permitted fee and pursue the balance through billing channels. Similarly, posting a treatment video on the clinic's social media account with the patient's face visible requires written authorization; a verbal "sure" in the gym, undocumented, is not enough.
Traps
Discussing patients in elevators or on social media; assuming HIPAA preempts stricter DC confidentiality rules; accepting gifts that create obligations; treating friends or family informally without documentation; retaliating against a patient who complains.