Professional Conduct, Mandatory Reporting, and Disciplinary Actions
Domain 4 tests ethical duties, legally required reports, and the disciplinary process. The key distinction is between confidentiality and mandatory disclosure.
Professional conduct
Nebraska's Uniform Credentialing Act prohibits unprofessional conduct, including fraud, incompetence, gross negligence, sexual misconduct, practicing beyond scope, and violating statutes or rules. Confidentiality is broad but not absolute: it yields to mandatory reports and authorized disclosures.
Mandatory reporting
Chiropractors are mandatory reporters of child abuse or neglect under Neb. Rev. Stat. §28-711 when they have reasonable cause to believe abuse or neglect occurred. Nebraska also requires reports of abuse, neglect, or exploitation of vulnerable adults under the Adult Protective Services Act. The report goes to law enforcement or the Department, not to the alleged abuser. Document the disclosure and the report; the chiropractor need not investigate.
Disciplinary process
Complaints are investigated by the Department; the Board reviews; contested cases proceed to hearing. Sanctions include reprimand, probation, suspension, revocation, and civil penalties. Licensees must cooperate with investigations.
Worked example
A patient discloses that her child has a suspicious burn and asks the chiropractor not to tell anyone. The chiropractor reports to law enforcement and DHHS, documents the statement, and continues treating the patient's back pain. The report is not a breach of confidentiality; it is a statutory duty. Waiting for proof or confronting the family risks delay and liability.
Traps
Traps: promising absolute confidentiality; reporting only after certainty; failing to report a colleague's impairment or boundary violation; and treating a subpoena as automatic authorization for all records.