Professional Conduct, Ethics, and the Disciplinary Process
This domain tests ethics and the disciplinary machinery. The exam asks how a complaint moves, what counts as a ground for discipline, and what sanction or interim action the Board may take. The key statutes are HRS chapter 436B, HRS chapter 442, and HRS chapter 91.
Grounds and process
- HRS §436B-19 lists grounds for refusal, suspension, or revocation, including fraud, misrepresentation, incompetence, gross negligence, criminal conviction, substance abuse, unprofessional conduct, and violation of the practice act or rules.
- A complaint typically goes to DCCA's Regulated Industries Complaints Office (RICO), which investigates; the Board reviews and may authorize a contested case.
- Contested cases follow HRS chapter 91: notice, hearing, evidence, proposed decision, board decision, and appeal.
- Sanctions include revocation, suspension, fines, probation, required continuing education, and restitution. The Board may take summary action when public health and safety require it.
Ethics
- Put patient welfare first; obtain and document informed consent; maintain boundaries; avoid sexual misconduct.
- Advertising must be truthful and not misleading.
- Confidentiality is a core duty; release records only with authorization or legal compulsion.
- Fee splitting and kickbacks for referrals are improper; disclose financial interests.
Worked example
A chiropractor posts a patient's before-and-after x-rays and a testimonial on a public social media page without written authorization. Analysis: this is a confidentiality breach and unprofessional conduct under HRS §436B-19, independent of whether the care was competent. The Board can discipline; the patient may also have a civil claim. The fix is to remove the post, document the breach response, and obtain proper authorization for any future use.
Traps
- Thinking a malpractice lawsuit and a Board complaint are the same; the Board acts on licensure, not damages.
- Assuming a criminal conviction is required for discipline; unprofessional conduct alone can suffice.
- Ignoring HRS chapter 91 procedure in a hearing question.
- Believing an apology to the patient ends the Board's authority.
- Overlooking that discipline can proceed even when the patient does not complain.