Standards of Ethical Conduct, Professional Responsibility, and Patient Rights
Domain 3 tests conduct and patient rights - duties that exist independently of clinical skill. Items often present a plausible business or personal decision and ask whether it crosses a line.
Core duties
- Patient welfare outranks schedule, convenience, or revenue. Practice within your competence and refer when a problem exceeds it.
- Protect confidentiality in every medium: social media, hallway conversation, scheduling screens, and billing records.
- Do not abandon a patient. Ending the relationship requires notice, an opportunity to arrange other care, and documentation.
- Sexual contact or sexual misconduct with a patient is prohibited and is among the most serious violations the Board handles.
- Bill only for services actually provided and documented; upcoding and phantom visits are fraud, not billing mistakes.
Patient rights
- Patients have the right to information about their care, to consent or refuse, to privacy, to access their records, and to be treated without discrimination. Rights are bounded by law and by the provider's duty to protect safety.
Worked example
A clinic owner offers therapists a bonus tied to visits per patient, and a therapist notices discharge decisions shifting. Reasoning: the arrangement is not automatically unlawful, but the therapist's duty is to discharge on clinical criteria and document the basis. If pressure to retain patients alters care, that is a conflict of interest to refuse or report.
Traps
- Assuming confidentiality ends when a patient posts publicly about their own care.
- Treating a former patient as automatically fair game for a sexual relationship.
- Letting marketing testimonials override privacy.
- Confusing rudeness with unethical conduct - the exam tests duties, not manners.