Professional Conduct, Ethics, and Boundary Issues
What the exam tests
This domain tests ethical decision-making, informed consent, confidentiality, boundaries, and professional integrity. Scenarios often involve social media, gifts, dual relationships, or billing pressure.
Core rules
- Put the patient’s interests first. Obtain informed consent before evaluation and treatment, and explain alternatives, risks, and the right to refuse.
- Maintain confidentiality in conversations, records, and online posts. Do not post identifiable patient information or discuss patients in public areas.
- Avoid dual relationships that could impair judgment or exploit the patient. Sexual relationships with current patients are prohibited; personal or business relationships require careful boundary management or referral.
- Boundary crossings (small talk, a modest gift) are not automatically violations, but boundary violations exploit the patient or harm trust.
- Bill only for services actually provided and documented. Do not alter records or diagnoses to obtain payment.
- Report impaired or unethical practice as required by law and Board rules; seek help for your own impairment.
Worked example
A patient offers a $200 gift card after discharge. The PT should decline or follow an employer policy that avoids exploitation. A small token after discharge may be acceptable in some settings, but a large gift from a current patient creates a boundary concern. The PT should document the offer and decision if policy requires.
Traps
Treating a friend or family member without considering objectivity; posting a “success story” with a photo; accepting a gift that creates obligation; ignoring a colleague’s impairment; falsifying a note under productivity pressure.