Mandatory Reporting and Disciplinary Action
This domain covers the licensee's affirmative duties - reporting abuse, impairment, and misconduct - and the disciplinary process that follows when duties are breached. The exam tests who must report, to whom, with what protection, and how a complaint travels from intake to sanction.
The duty to report
- Abuse and neglect. Delaware health professionals, including dentists and hygienists, are mandatory reporters of suspected child abuse and neglect, reporting to the State's child welfare authority and, where required, law enforcement. Suspected abuse of elders or dependent adults goes to adult protective services. Patient confidentiality and HIPAA do not block these reports; the reporting statute overrides the privilege.
- Impaired or unethical colleagues. A licensee who has reason to believe another licensee is practicing while impaired, practicing beyond scope, or engaged in unprofessional conduct must report to the Board through the Division of Professional Regulation. Good-faith reports carry immunity; failure to report is itself a ground for discipline.
- Unlicensed practice. Suspected practice without a license should be reported to the Division, not handled informally within the office.
- Self-reporting. Arrests or convictions on specified offenses, and certain adverse actions, must be reported by the licensee within the timeframe the law sets.
Disciplinary process
A complaint is screened and investigated through the Division, then presented to the Board with notice to the licensee. The licensee may appear, be represented by counsel, present evidence, and cross-examine. Sanctions escalate from reprimand, fine, and CE orders through probation with monitoring to suspension and revocation; a summary or emergency suspension may be imposed where continued practice poses imminent danger. Grounds include fraud in obtaining a license, incompetence, unprofessional conduct, impairment, conviction of a substantially related crime, and failure to cooperate with an investigation.
Worked example
An associate notices the practice owner diverting opioids and treating patients while visibly impaired. Reasoning: confidentiality protects the patients' information, not the colleague's conduct; the associate reports to the Division of Professional Regulation (and the impaired-professional program) rather than confronting the owner privately. A good-faith report is immune, and staying silent would itself expose the associate to discipline. Answer: report promptly, document contemporaneously, and protect patients in the interim.
Traps
Thinking HIPAA or patient consent bars an abuse report. Waiting for proof beyond suspicion - the standard is reasonable suspicion. Reporting only to the employer or a professional association. Assuming a malpractice suit alone triggers Board action, or that a Board sanction ends the matter without collateral reporting consequences.