Doctors of chiropractic should recognize their obligation to help others acquire knowledge and skill in the practice of the profession. They should maintain the highest standards of scholarship, education, and training in the accurate and full dissemination of information and ideas. It is unethical for a doctor of chiropractic to receive a fee, rebate, rental payment or any other form of remuneration for the referral of a patient to a clinic, laboratory or other health service entity.
The ACA Code of Ethics mandates, as primary obligation of the doctor of chiropractic, the exercise of clinical judgment and practice "solely for the patient's benefit. The ACA recognizes that there are some forms of rental agreements for space or equipment, which are legitimate arm-length business transactions not conditioned on patient referrals.
However, some forms of rental agreements may be designed to conceal the real nature of the payment, that is, to induce referrals. The ACA also recognizes that the federal government has developed guidelines, which outline those circumstances in which space or equipment rentals would not constitute an illegal or improper form of remuneration in return for Medicare or Medicaid referrals.
The ACA feels these federal guidelines provide an excellent basis by which a doctor of chiropractic can ethically evaluate and engage in space or equipment rental agreements. These guidelines appear in Title 40 of the Code of Federal Regulations, Part and may be summarized and adapted for the purposes of our ethical standards as follows:. A lease agreement for space or equipment in which a doctor of chiropractic refers a patient to an entity which either leases to or from the doctor space or equipment, will not constitute an unethical practice where:.
If the lease is intended to provide the lessee with access to the premises or equipment for periodic intervals of time, rather than on a full-time basis for the term of the lease, the lease specifies exactly the schedule of such intervals, their precise length, their periodicity, and the exact rent for such intervals. The rental charge is consistent with fair market value in arms-length transactions and is not determined in a manner that takes into account the volume or value of any referrals of business between the parties.
Doctors of chiropractic are advised to consult with their local examining board or other regulatory agencies for specific requirements, which may relate to clinic or laboratory referrals. The ACA Ethics Committee "Committee" has received numerous requests for clarification relative to the ethical implications of sexual intimacies between a doctor of chiropractic and a patient he or she is treating. This advisory opinion is intended to resolve any misunderstanding and to state that it is the opinion of the Committee that sexual intimacies with a patient is unprofessional and unethical based on the existing ethical provisions in the ACA Code of Ethics: These guidelines appear in Title 40 of the Code of Federal Regulations, Part and may be summarized and adapted for the purposes of our ethical standards as follows: A lease agreement for space or equipment in which a doctor of chiropractic refers a patient to an entity which either leases to or from the doctor space or equipment, will not constitute an unethical practice where: The lease agreement is in writing and signed by the parties.
The lease specifies the space or equipment covered by the lease. The term of the lease is for not less than one year.
Fortunately this reference also provides a number of answers to the questions that need to be asked in regards to professional boundary violations. The writers do a fine job of logically organizing the materials and presenting a very readable fashion. Ethical Perspectives provides an objective analysis of the literature available sexual boundary issues within the chiropractic profession.
The authors provide insight into possible reasons why the incidence of boundary infractions is higher within our profession. Some of the reasons presented for the increased incidence offered included physical contact with patients, length of time of the office visit and the number of patient encounters or office visits.
The transition zone is the location and timing within the treatment area where most infractions occur. The transition zone timing occurs when the actual care for the office visit is completed and the location is between the treatment table and the door of the treatment room. The ethics of doctors dating or having relationships with current or former patients is a subject that Drs. Stahl and Foreman identify as meriting serious consideration.
Chiropractic Focused • Leader in Malpractice Insurance • Expert Defense. Professional. Boundaries . Sexual and nonsexual relationships with current and former patients Nonsexual .. Date ______. Adapted from The. Jun 14, Others think who they date is a private matter as long as it's between his appearance before the state's Board of Chiropractic Examiners. (Note: Some states never permit a doctor to date a former patient—no matter how.
Most if not all doctors correctly identify sexual relationships with patients as an unethical and unprofessional activity. Regulatory boards have not identified a uniform time when the balance of power is restored and it is acceptable for a doctor and a former patient to date. The discussion of when the imbalance of power between a doctor and a former patient is equalized in relation to dating and sexual contact was an interesting appraisal.