Complaints, Disciplinary Sanctions, and the Mandatory Duty to Report
This domain tests the Delaware Board's complaint and disciplinary process and the licensee's independent duty to report certain conduct. Questions often ask what a chiropractor must do after learning about a colleague's impairment, fraud, or boundary violation, and what sanctions the Board may impose.
Complaint and hearing process
The Board receives complaints from patients, employers, other licensees, and the public. It may dismiss a complaint, issue a letter of concern, or file a formal complaint. Formal proceedings require notice, an opportunity to respond, and a hearing consistent with due process. The Board may settle through a consent order. Discipline must be supported by the record and proportionate to the conduct.
Grounds and sanctions
Grounds include fraud or deceit, incompetence, unprofessional conduct, substance abuse affecting practice, criminal conviction, discipline in another jurisdiction, and failure to comply with continuing education or record requirements. Sanctions include reprimand, probation with conditions, suspension, revocation, fines, required continuing education, practice restrictions, and assessment of costs. The Board may also seek cease-and-desist relief against unlicensed practice.
Mandatory reporting
Licensees have a duty to report certain conduct to the Board, especially conduct that poses a risk to patients. Good-faith reports are protected; confidentiality promises do not override the duty. Failure to report can itself be unprofessional conduct. The reporter should provide facts, not conclusions, and should not conduct an independent investigation or confront the impaired licensee in a way that risks patient safety. Reporting to an employer or hospital may be necessary but does not automatically satisfy the Board report.
Worked example
A chiropractor learns that a colleague is adjusting patients while visibly impaired and has asked staff to hide it. The colleague says, "I'm handling it privately." Reasoning: patient safety triggers the mandatory report. The chiropractor should report the observable facts to the Board promptly, preserve confidentiality, and avoid promising silence. Waiting for proof beyond a reasonable doubt is wrong; the Board investigates. Retaliation against the colleague or staff who reported is separate misconduct.
Traps that cost marks
Do not treat a patient's request for confidentiality as a bar to reporting serious misconduct. Do not assume a report to an employer is enough. Do not ignore a duty to self-report an arrest or license action if Board rules require it. Do not confuse the Board's burden at a hearing with the lower threshold for making a good-faith report.
Exam focus
Identify the trigger, the reporting channel, and the timing. The safest answer protects patients and uses the Board process rather than private resolution.