Standards of Acceptable and Prevailing Practice and Unprofessional Conduct
The governing standard
The Board may discipline an optometrist for immoral or unprofessional conduct and for failing to meet standards of acceptable and prevailing practice. The standard of care is the degree of care, skill, and judgment ordinarily exercised by reputable optometrists in similar circumstances. It is not a guarantee of a good outcome and not the single best possible treatment.
What the standard covers
- Adequate history and examination, diagnosis, treatment plan, informed consent, follow-up, and referral.
- Referral when a condition exceeds the optometrist's legal scope or personal competence, especially emergent retinal, neurologic, or surgical problems.
- Accurate, timely records that document findings, advice, referrals, and patient responses.
Unprofessional conduct categories
- Fraud, false billing, falsified or altered records.
- Practicing beyond scope, including therapeutic treatment without TPA certification or performing surgery.
- Gross negligence or incompetence, patient abandonment, and failure to maintain required records.
- Delegating licensed functions to unlicensed personnel or aiding unlicensed practice.
- Sexual misconduct, substance impairment, breach of patient confidentiality, fee splitting, misleading advertising, and failure to cooperate with a Board investigation.
Worked example
A patient reports sudden painless loss of vision in one eye. The optometrist records dryness, prescribes artificial tears, and schedules a routine visit in four weeks without urgent referral. The omission is not proved by the poor outcome alone; it is proved by showing that reputable optometrists would have obtained urgent evaluation for a retinal or vascular cause. The failure to refer supports a standard-of-care violation and may also be unprofessional conduct.
Traps that cost marks
- Assuming unprofessional conduct means only egregious behavior; documentation, advertising, and delegation can qualify.
- Confusing the standard of care with personal preference or one expert's ideal practice.
- Thinking patient consent excuses incompetence or an unlawful scope decision.
- Altering records after a complaint, which creates a separate credibility and conduct problem.
Key takeaways
Document the reasoning for referrals and follow-up. Scope limits are conduct limits. The Board evaluates both clinical customary practice and professional behavior.