4809 STANDARDS OF CONDUCT

4809.1 A licensee shall not engage in sexual conduct with a patient with whom he or she has a patient-chiropractor relationship.

4809.2 A patient-chiropractor relationship exists unless:

1. (a) Professional services are terminated and the patient receives written notice of the termination, whether the termination was initiated by the patient or licensee;
2. (b) The patient has been appropriately referred to another health professional in writing;
3. (c) The patient has accepted treatment by another health professional and the licensee documents the patient's chart prior to closing the file; or
4. (d) The patient has not received professional services for six (6) consecutive months and has not contacted the chiropractor for treatment.

4809.3 Sexual conduct includes the following:

1. (a) Any behavior, gestures, or verbal or nonverbal expressions, which may reasonably be interpreted as seductive or sexual in nature; and
2. (b) Sexual comments or discussion about a patient or a former patient that are not related to chiropractic care or treatment.

4809.4 A patient shall be provided with a private treatment room, as well as examination conditions, which prevent the exposure of the unclothed body of the patient unless it is necessary for the chiropractic exam or treatment.

4809.5 A licensee shall not engage in sexually harassing behavior in the practice of chiropractic of a single extreme act or multiple acts toward a patient, coworker, employee, student or supervisee whether or not such individual is in a subordinate position to the licensee or not.

4809.6 A licensee may have a chiropractor-patient relationship with a spouse, family member or an individual with whom he or she has a mutually committed relationship and perform chiropractic treatment, provided the treatment is within accepted standards of chiropractic care and the performance of the services are not utilized to exploit the patient for sexual arousal or sexual gratification.

4809.7 A licensee shall not seek or solicit sexual contact with a patient with whom he or she has a patient-chiropractic relationship or in exchange for professional services.

4809.8 A licensee may not raise the following defenses to any action under this section:

1. (a) The licensee was in love with or had affection for the patient; and
2. (b) The patient solicited or consented to the sexual contact with the licensee.

4809.9 A licensee shall exercise independent professional judgment in the treatment or evaluation of the patient regardless of whether the patient was referred by another healthcare provider.

4809.10 Repealed

4809.11 A licensee shall prepare a written or verbal report for consultative purposes for another

chiropractor, another healthcare provider, hospital or agency that currently provides or has provided service to the patient upon request.

4809.12 A licensee shall terminate a professional relationship with a patient shall in an appropriate and timely manner so as not to adversely impact the health of the patient.

4809.13 A licensee shall continue a professional relationship for emergency treatment with a current patient for a reasonable period of time to allow the patient time to obtain another healthcare provider.

4809.14 A licensee shall arrange for adequate coverage of his or her patients during absences when the chiropractor is unavailable to the patients.

4809.15 A licensee shall not:

(a) Accept a patient for treatment or continue with treatment when the treatment is unnecessary and the patient cannot be reasonably expected to benefit from treatment within normal standards of chiropractic care and consistent with the treatment philosophy of the treating chiropractor.

(b) Attempt to treat or make misrepresentations about his or her ability to treat patients beyond his or her scope of expertise and/or area of specialty certification.

(c) Refer a patient to a diagnostic or treatment facility or prescribe goods and services to be purchased from another facility, in which the chiropractor has a pecuniary interest, without first disclosing that interest in writing to the patient or third party payor.

SOURCE: Final Rulemaking published at 53 DCR 87 (January 6, 2006); as amended by Final Rulemaking published at 55 DCR 7938 (July 25, 2008); as amended by Final Rulemaking published at 55 DCR 10139 (October 3, 2008).