Standards of Professional Conduct and Ethics
This domain tests the conduct standards the Board enforces: informed consent, professional boundaries, honesty in billing and advertising, recordkeeping, and confidentiality.
Core duties
- Informed consent: explain diagnosis, proposed care, material risks, alternatives, and costs before treatment, and document the discussion.
- Boundaries: sexual contact with a current patient is prohibited and treated as serious misconduct. If a personal relationship develops, terminate the clinical relationship, offer records and a referral, and document.
- Honesty: bills and claims must reflect services actually rendered; advertising must not be false, misleading, or guarantee outcomes.
- Records: contemporaneous, legible, retained as the rule requires, and released on proper authorization.
- Confidentiality: Oregon law and HIPAA both apply; HIPAA sets a floor, not a ceiling.
Worked example. A long-term patient gives a chiropractor an expensive watch "for fixing my back." Accepting a modest thank-you gift is generally not a violation, but a valuable gift creates an appearance of exploitation, especially where the patient is vulnerable or care is ongoing. Correct approach: decline or accept only a token, explain why, and document the exchange. The wrong answer treats any gift as automatic grounds for discipline.
Traps
- Believing HIPAA preempts stricter Oregon confidentiality rules.
- Assuming a relationship is acceptable because the patient "consented."
- Altering a record after a records request, which is itself a separate violation.