Louisiana Administrative Code › Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS › Part XLV - Medical Professions › Subpart 3 - Practice › Chapter 76 - Definition of Enforcement Terms › Subchapter B - Unprofessional Conduct › Section XLV-7603 - Unprofessional Conduct

Current through Register Vol. 50, No. 6, June 20, 2024
A. In the
					 exercise of its duties the board has determined to define the term
unprofessional conduct
, as set forth in
					 R.S.
					 37:1285(A)(13), as conduct
					 that includes but is not limited to the departure from, or the failure to
					 conform to, the standards of acceptable and prevailing medical practice or the
					 ethics of the medical profession including, but not limited to, the principles
					 established by the American Medical Association, the American Osteopathic
					 Association, and relevant medical specialty associations, or the commission of
					 any act contrary to honesty, justice, good morals, patient safety or the best
					 interest of the patient, whether committed in the course of the physician's
					 practice or otherwise, and whether committed within or without of this state.
					 For illustrative purposes only,
unprofessional conduct
includes but is not limited to :
1.
Sexual Misconduct
- any act of sexual intimacy, contact,
					 exposure, gratification, abuse, exploitation or other sexual behavior with or
					 in the presence of a patient or any other individual related to the physician's
					 practice of medicine regardless of consent. Such conduct may be verbal,
					 physical, visual, written or electronic, or it may consist of expressions of
					 thoughts, feelings or gestures that are sexual or reasonably may be construed
					 by a patient or other individual as sexual or which may reasonably be
					 interpreted as intended for the sexual arousal or gratification of the
					 practitioner, the patient or another individual. Sexual misconduct between a
					 physician and a former patient after termination of the physician-patient
					 relationship may also constitute
unprofessional conduct
if the
					 sexual misconduct is a result of the exploitation of trust, knowledge,
					 influence or emotions derived from the professional relationship;
2.
Disruptive Behavior
-a
					 berrant behavior, including but not limited to harassment, sexual or otherwise,
					 manifested through personal interaction with physicians, employees, co-workers,
					 hospital personnel, health care professionals, patients, family members or
					 others, which interferes with patient care or could reasonably be expected to
					 interfere with the process of delivering quality care or jeopardizing patient
					 safety;
3.
Failing to
					 Cooperate with the Board
- physicians shall cooperate with and assist
					 the board to carry out its duties. A physician shall, among other matters:
a. respond or provide information or items
					 requested, respond to a subpoena, or complete an evaluation within the time
					 designated by the board or its staff;
b. not attempt to influence the board, its
					 members, staff or agents by means of intimidation, falsehoods or other means
					 prohibited by law;
c. not contact
					 members of the board directly or through others in an attempt to influence the
					 outcome of an investigation or disciplinary proceeding; and
d. not contact or attempt to contact a
					 complainant or witness regarding a complaint or an investigation by the board
					 for purposes of intimidation or harassment;
4.
Failing to Maintain Independent
					 Medical Judgment
- at all times while engaged in the practice of
					 medicine in this state a physician shall exercise independent medical judgment
					 in the sole interest of the patient. To that end a physician shall not:
a. allow a non-physician to impose or
					 substitute his, her, or its judgment for that of the physician in the exercise
					 of the rights and privileges provided for by medical licensure; or
b. enter into or attempt to enforce an
					 agreement that would have the effect of requiring a physician to abandon a
					 patient, deny a patient continuity of care, or interfere with the patient's
					 freedom of choice in the selection of health care providers or
					 services;
5.
Improperly Delegating or Supervising
- physicians retain responsibility
					 to their patients for the training, delivery and results of medical services
					 rendered to their patients. A physician shall not:
a. delegate professional responsibilities to
					 a person the physician knows or has reason to know is not qualified by
					 training, experience or licensure to perform them; or
b. fail to exercise appropriate supervision
					 over a person who is authorized to practice only under physician
					 supervision;
6.
Exercising Undue Influence
-physicians shall exercise their
					 professional judgment in the best interest of their patients. A physician shall
					 not:
a. place his or her own financial gain
					 over the interest and welfare of a patient in providing, furnishing,
					 prescribing, recommending or referring a patient for therapy, treatment,
					 diagnostic testing or other health care items or services;
b. perform, or refer a patient to another to
					 perform, unnecessary tests, examinations or services which have no legitimate
					 medical purpose; or
c. e xercise
					 influence over a patient in such a manner as to exploit the patient or his or
					 her third party payor for financial gain of the physician or of a third party
					 through the promotion or sale of services, goods, appliances or
					 drugs;
7.
Enabling the Unauthorized Practice of Medicine
- A physician
					 shall insure that he or she is practicing in conformity with the law and in a
					 lawful setting. A physician shall not:
a.
					 enter into any arrangement, as medical director or otherwise, that allows or
					 condones an unlicensed individual to engage in the practice of medicine, as
					 defined by
					 R.S.
					 37:1261(1), in the absence
					 of the physician's direction and immediate personal supervision-i.e., where the
					 physician is physically present on the premises at all times that the
					 unlicensed individual is on duty and retains full responsibility to patients
					 for the training, delivery and results of all services rendered; or
b. practice in a pain management clinic that
					 is not licensed by the Department of Health and Hospitals pursuant to
					 R.S.
					 40:2198.11 et seq., or in any other clinic or
					 medical setting that the physician knows or reasonably should know, is
					 operating in violation of the law or the board's rules;
8.
Practicing or Enabling Practice by
					 Impaired Provider
-a physician shall not:
a. engage in the practice of medicine while
					 under the influence of a mood-altering substance that compromises or has the
					 potential to compromise a physician's medical judgment or practice,
					 irrespective of whether or not prescribed by another physician or authorized
					 practitioner; or
b. prescribe any
					 mood-altering substance to a patient, who is a physician or another licensed
					 health care provider, without instructing the patient to refrain from practice
					 while under the influence of the substance. The physician's record on the
					 patient shall document this instruction;
9.
Failing to Adhere to Accepted
					 Practices; Misleading Practices
-a physician shall:
a. practice within the scope of his or her
					 education, training and experience; and
b. not hold himself or herself out as a
					 specialist in an area of medical practice unless the physician has successfully
					 completed a residency or fellowship training program, which is accredited by
					 the American Council on Graduate Medical Education of the American Medical
					 Association, the American Osteopathic Association, or the Royal College of
					 Physicians and Surgeons of Canada.
10.
Failing to Create or Maintain
					 Medical Records
-a physician shall create and maintain adequate and
					 legible patient records. In addition, a physician shall:
a. not falsely create or alter a medical
					 record or destroy a medical record except as authorized by law;
b. upon receipt of proper authorization, and
					 in conformity with R.S. 40:12999.96, make patient medical records in the
					 physician's possession available within a reasonable period of time to the
					 patient, the patient's representative, or another physician or licensed health
					 care provider;
c . make
					 arrangements for patient access to medical records of the physician after
					 relocating or closing a medical practice, retiring, or being prohibited from
					 practice by consent, decision or other order of the board;
d. make arrangements, or assist another
					 physician practicing in the same group make arrangements, for access by a
					 physician or patients to their medical records after the physician has left a
					 medical practice, relocated a practice to a new location, closed a practice, or
					 retired;
e. insure proper
					 destruction of medical records by methods approved by state or federal
					 authorities; and
f. not abandon or
					 desert medical records.
11.
Self-Treatment; Treatment of
					 Immediate Family Members
-except in cases of emergency, physicians
					 shall not prescribe controlled substances for themselves or their immediate
					 family members. As respects a physician,
immediate family
					 members
include the physician's spouse, children, parents, and
					 siblings.