SECTION 435:55-7-3. Standards of ethics and professional conduct

(a)   Purpose. The rules in this section on the profession of Orthotics and Prosthetics shall be to establish the standards of professional conduct and code of ethics required of a licensee.

(b)   In the conduct of their professional activities the Orthotist and/or Prosthetist shall be bound by the following ethical and professional principles in conjunction with the canons of ethical conduct as published by the American Board for Certification and the Board for Orthotist Prosthetist Certification.

(1)   Responsibilities to the patient.

(A)   Services. The Orthotist and/or Prosthetist shall provide orthotic and/or prosthetic devices in an effective, dignified and efficient manner in accordance with the direction of patient's physician.

(B)   Recognition of possible pathologies requiring orthotic and/or prosthetic intervention. The Orthotist and/or Prosthetist shall assist lay people to recognize problems and the need for appropriate medical care only out of a desire to protect one who would not otherwise seek or obtain proper medical attention. Such assistance should recommend that the patient have a physician diagnose any orthopedic/vascular pathology.

(C)   Confidential information.

(i)   The Orthotist and/or Prosthetist shall keep all information relating to a patient's background, condition, treatment, management plan or other areas relating to the orthotist and/or prosthetist-patient relationship confidential unless prior written consent of the patient or the patient's legal guardian is received.

(ii)   The Orthotist and/or Prosthetist shall keep patient information that may be derived as a result of any Orthotist and/or Prosthetist's peer review process confidential by all participants unless written permission to release the information is obtain from the patient or the patient's legal guardian.

(iii)   The Orthotist and/or Prosthetist shall keep all patient information that is derived in a workplace from a working relationship among orthotists and/or prosthetists relating to any patient confidential.

(iv)   The Orthotist and/or Prosthetist shall strictly adhere to the confidentiality requirements set forth in the subsection unless the release is ordered by a court of law or release is necessary to protect the welfare of the patient and/or the community in accordance with applicable legal requirements.

(D)   Competency.

(i)   The Orthotist and/or Prosthetist shall provide services that reflect the best practices in the profession and use best efforts to meet the patient's orthotic and/or prosthetic requirements.

(ii)   Upon accepting an individual for orthotic and/or prosthetic services, the orthotist and/or prosthetist shall assume the responsibility for evaluating that individual; planning, implementing and supervising the patient's care; reevaluating and changing the orthotic and/or prosthetic program; and maintaining adequate records of the case, including progress reports.

(iii)   The orthotist and/or prosthetist shall not fill a prescription that is beyond his/her degree of expertise.

(E)   Research. The Orthotist and/or Prosthetist shall ensure that all research projects or studies are done in accordance with standards accepted by the Board.

(F)   Trust and honesty. The orthotist and/or prosthetist shall always be truthful and honest in orthotic and/or prosthetic matters to the patient, physician, Board and the public in general.

(G)   Fees and compensation.

(i)   The orthotist and/or prosthetist shall not provide services solely for personal financial gain.

(ii)   The orthotist and/or prosthetist shall not engage in false, misleading or deceptive representations in relation to the cost of the services undertaken or furnished.

(iii)   The orthotist and/or prosthetist shall not recommend or provide continued orthotic and/or prosthetic services to a patient when the orthotist and/or prosthetist is aware that the services are being recommended or provided more frequently than necessary, or that orthotic and/or prosthetic service has already progressed beyond the point at which further benefit to the patient is possible.

(iv)   The orthotist and/or prosthetist shall not submit false or misleading information in requesting reimbursement from third-party payers, including Medicare and private insurers.

(H)   Practice arrangements.

(i)   Except for fees earned for services performed for the patient, the orthotist and/or prosthetist shall not give or receive valuable consideration solely because of referrals.

(ii)   Participation in the business, partnership, corporation or other entity does not exempt the orthotist and/or prosthetist, whether employer, partner or stockholder, either individually or collectively, from the obligation of complying with this Code of Ethics and the rules of the Board.

(iii)   The orthotist and/or prosthetist shall advise the Board and/or the advisory council of any employer or employee practice that is in contradiction with this Code of Ethics.

(I)   Delay in services. The orthotist and/or prosthetist shall not accept any prescription when the orthotist and/or prosthetist knows or believes the orthotic and/or prosthetic device cannot be furnished with in a reasonable period of time unless the orthotist and/or prosthetist has advised the patient in advance the approximate length of time it will take to fill the prescription. In such instances, the orthotist and/or prosthetist must discuss the situation with the patient and prescribing health care practitioner.

(J)   Compliance with laws and regulations. The orthotist and/or prosthetist shall provide consultation, evaluation, treatment, business practices, and preventive care, in accordance with the laws and regulations of the State of Oklahoma.

(K)   Consumer protection. The orthotist and/or prosthetist shall report to the Board any conduct that appears to be unethical, incompetent or illegal. Failure to report any such behavior that is known to the orthotist and/or prosthetist shall be unethical.

(L)   Maintenance of patient records. The orthotist and/or prosthetist shall initiate and maintain appropriate records about his/her service with each patient. The orthotist and/or prosthetist has the duty to maintain patient files in a safe manner and ensure the confidentiality of the patient's records.

(M)   Delegation of responsibility. The orthotist and/or prosthetist shall exercise adequate supervision over persons to whom the orthotist and/or prosthetist has delegated certain responsibilities requiring unique skills, knowledge or judgment. The orthotist and/or prosthetist is responsible for orthotic and/or prosthetic care performed by support personnel under his/her supervision. The orthotist and/or prosthetist is responsible for assuring that adequate supervision of support personnel (assistants, fitters, technicians) occurs to ensure the patient receives the necessary and appropriate care. Additionally, the orthotist and/or prosthetist is responsible in ensuring that said personnel receive annual continuing education in order to perform their responsibilities at the highest level of public protection.

(N)   Quality Assurance. The Orthotist and/or Prosthetist will conduct and maintain a quality assurance program involving all treated patients.

(O)   Illegal discrimination. The orthotist and/or prosthetist shall not decline to accept a patient on the basis of race, gender, color, religion or national origin or on any basis that would constitute illegal discrimination.

(P)   Discontinuing service. The orthotist and/or prosthetist has a duty to inform the physician if the patient fails to follow the physician's plan for orthotic and/or prosthetic treatment or discontinues the physician's plan for orthotic and/or prosthetic treatment prematurely.

(2)   Practitioner responsibilities to the physician.

(A)   Diagnosis and prescription. The orthotist and/or prosthetist must receive a prescription from a physician before providing any orthotic and/or prosthetic device to a patient.

(B)   Orthotic and/or prosthetic evaluation and recommendation.

(i)   The orthotist and/or prosthetist shall recognize that each individual patient is different and deserves specific and responsible guidance from the orthotist and/or prosthetist.

(ii)   The orthotist and/or prosthetist, after evaluating a patient, may recommend to the physician specific orthotic and/or prosthetic device designs along with the reasoning for such recommendation.

(iii)   The orthotist and/or prosthetist has the responsibility for the final design for the orthotic and/or prosthetic device.

(iv)   The orthotist and/or prosthetist should only dispense orthotic and/or prosthetic devices that are in accordance with the prescription and that meet the needs of the patient.

(v)   The orthotist and/or prosthetist shall be guided at all times by concern for the physical, emotional, social and economic welfare of the patient.

(C)   Changes in patient's condition.

(i)   When requested by the patient and/or the patient's physician, the orthotist and/or prosthetist shall monitor and observe the patient's physical condition in connection with the orthotic and/or prosthetic care and the prescribed device.

(ii)   The orthotist and/or prosthetist must notify the referring physician and the patient as soon as possible of any change in the patient's condition related to the orthotic and/or prosthetic management plan.

(D)   Altering orthotic and/or prosthetic devices. The orthotist and/or prosthetist may repair or adjust an orthotic and/or prosthetic device without notifying the prescribing physician. However, such repairs or adjustments must conform to the original prescription. Any repairs, adjustments, modifications and/or replacements that alter the original prescription must be authorized by the physician.

(3)   Responsibilities to colleagues and the profession.

(A)   Dignity and stature.

(i)   The orthotist and/or prosthetist has the personal responsibility to conduct himself or herself in a manner that will assure the dignity and stature of the profession of orthotics and/or prosthetics.

(ii)   The orthotist and/or prosthetist should discharge his/her responsibilities with honor and integrity, making the greatest possible effort to satisfy the patient's orthotic and/or prosthetic requirements.

(iii)   Examples of unacceptable behavior include, but are not limited to, the misuse of the license and misrepresentation of capacity as a provider of services.

(B)   Commercialization. The orthotist and/or prosthetist's primary professional function is to develop the orthotic and/or prosthetic device as part of a medical treatment team. However, the orthotist and/or prosthetist is not prohibited from providing non-custom, prefabricated orthosis' and prosthesis' as long as each patient and the public in general are made aware of the differences between the "off the shelf" and custom fitted and fabricated orthosis and prosthesis.

(C)   Solicitation.

(i)   It is unethical for an orthotist and/or prosthetist to either directly or indirectly solicit the patronage of individual patients by way of intimidation, threats, harassing conduct, undue influence, coercion, duress, or solicitation of a patient who is apparently in a mental condition that impairs his/her personal judgment to make decisions concerning the products or services being offered.

(ii)   The orthotist and/or prosthetist shall abide by current Medicare or comparable government regulations regarding patient solicitations.

(D)   Board review. The Advisory Committee on Orthotics and Prosthetics will determine whether the orthotist and/or prosthetist is practicing in accordance with the laws and rules of the Board. In the event that the Committee determines that there are violations of these laws or rules, the Committee will refer the matter to the Board who shall handle the matter as a complaint and proceed in accordance with the Oklahoma Administrative Procedures Act.

(E)   Education.

(i)   The orthotist and/or prosthetist is encouraged to support quality educational programs.

(ii)   It is unethical for the orthotist and/or prosthetist to participate in any programs, educational or otherwise, that falsely or deceptively represent the rights and privileges of the profession.

(iii)   It is unethical for the orthotist and/or prosthetist to falsify his/her continuing education units and may lead to permanent license revocation.

(iv)   An orthotist and/or prosthetist shall teach only in areas of service within his/her credential and scope of practice.

(F)   Standards of practice. The orthotist and/or prosthetist should adhere to a standard of practice as outlined in the Act and rules and as recommended by the American Board for Certification and/or the Board for Orthotic Prosthetic Certification. The orthotist and/or prosthetist can engage in practice beyond the standards of practice if the orthotist and/or prosthetist's scope of practice includes such (i.e.: pedorthics, etc.) or if the Orthotist and/or Prosthetist holds credentials in that profession.

(4)   Patient care by other professionals.

(A)   The orthotist and/or prosthetist should conduct himself/herself in a professional manner.

(B)   Concerns regarding patient care provided by physicians or other medical professionals should be addressed directly to the professional rather than to the patient. In the event that such concerns rise to the level of criminal violation, incompetency, malpractice or a violation of the Oklahoma law or the rules of the Board, then the orthotist and/or prosthetist must immediately notify the Board or other appropriate regulatory agency.

(5)   Licensure. The orthotist and/or prosthetist shall use the fact that they are licensed only as evidence of meeting the requisite standard of knowledge and competency in the profession as defined by the Board. It is unethical for a non-licensed orthotist and/or prosthetist to represent, directly or indirectly, that he or she is licensed or equally qualified.

[Source: Added at 19 Ok Reg 549, eff 12-28-01 (emergency); Added at 19 Ok Reg 2323, eff 6-28-02]