Expired License, Boundary Violation, and Board Complaint
At a small New Hampshire clinic, a PT arrives early and finds that a colleague, Dan, has been treating patients for six weeks after his license expired on March 31. The front desk accepted his renewal payment, but the Board's website lists his status as 'expired.' Dan asks the PT not to say anything because he is 'almost reinstated' and has a full schedule. The PT also learns that Dan has been dating a current patient, a 29-year-old woman he treated for chronic neck pain, and that Dan signed a continuing education attestation claiming 30 hours when he completed only 18. The clinic owner says, 'Let's keep this internal; the Board doesn't need another paperwork case.' The PT has documented the expired license status and the dating relationship in a personal notebook. A patient's family later calls the Board to complain about Dan's care.
1. What are the PT's mandatory reporting obligations?
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The PT has a professional duty to report. Practicing on an expired license is unlicensed practice; a romantic relationship with a current patient is a boundary violation; falsifying a continuing education attestation is unprofessional conduct. The PT should report to the New Hampshire Board of Physical Therapy promptly and in good faith, providing factual information. Internal reporting is not enough. The PT should not investigate or confront Dan alone. Many states provide immunity for good-faith reports. The PT should also protect current patients by ensuring coverage and preventing further unlicensed treatment.
2. How should the PT respond to the owner's instruction to keep the matter internal?
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The owner's instruction cannot override the legal duty. The PT should explain the reporting obligation, put concerns in writing to the owner, and avoid altering or destroying records. If Dan continues to treat, the PT may need to escalate. The PT should not participate in concealment. Document observations objectively, not opinions. Report to the Board even if the clinic handles it internally. The PT should also avoid retaliating against Dan or discussing the matter with patients in a way that violates confidentiality.
3. What happens in the Board complaint process, and what should the PT do when contacted?
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The Board may open a complaint, notify Dan, investigate, and take interim action if patients are at risk. The PT should cooperate, provide records as requested, and not alter records. The PT may consult an attorney. The PT should be truthful and not retaliate. The Board can discipline Dan and may also review the clinic's supervision and continuing education practices. Continuing education fraud is a separate violation. The PT should keep the personal notebook factual and preserve any relevant clinic records.