TBCE ethics Questions and Answers correct

TBCE ethics Questions and Answers correct What is not in the scope of Texas Chiro laws 1) incisive or surgical procedures; (2) the prescription of controlled substances, dangerous drugs, or any other drug that requires a prescription; or (3) the use of x-ray therapy or therapy that exposes the body to radioactive materials. If youre questioning the scope of practice, what should you do? write to the board explaining: (1) a detailed description of the service or procedure that will provide the Board with sufficient background information and detail to make an informed decision; (2) information on the use of the service or procedure by chiropractors in Texas or in other jurisdictions; and (3) an explanation of how the service or procedure is consistent with either: (A) using subjective or objective means to analyze, examine, or evaluate the biomechanical condition of the spine and musculoskeletal system of the human body; or (B) performing nonsurgical, nonincisive procedures, including adjustment and manipulation, to improve the subluxation complex or the biomechanics of the musculoskeletal system. T/F After your hearing the board can cease and desist order in the name of the board prohibiting the person from engaging in that activity true What are the requirements of an out of facility screening? the booth, site or location must prominently display the name of the sponsoring facility; (2) the sponsoring facility must have business cards with contact information readily available to the public; (3) the licensee must possess on their person the wallet size proof of licensure; (4) a licensee and/or clinic sponsoring a spinal screening is responsible for ensuring compliance with §77.2 of this title (relating to Publicity); and (5) a licensee may allow or direct any staff or employee to conduct a spinal screening upon ensuring compliance with §77.5 of this title (relating to Delegation of Authority), and maintaining proof of adequate training. If youre doing a spinal screening, what must you wear? wear on their person a readily visible identification tag that provides the name of the person and whether the person is licensed as a chiropractor under Chapter 201, Occupations Code. When can you call yourself a chiropractor? once licensed in the state What is considered a chiropractor in Texas? person performs non-surgical, non-incisive procedures that are intended to improve the subluxation complex or the biomechanics of the musculoskeletal system. DC's must be able to document that all tests and treatments performed on patients are directly related to the evaluation and treatment of the spine or the musculoskeletal system and/or related subluxations. Can a DC work on animals? nope- must have a vet present and their consent Can a DX prescribe or administer anything? no When can a DC use a needle draw blood acupuncture **needle EMG outlawed Can DCs give nutritional supplement Can not prescribe any controlled substance or drug that requires a prescription or carries a legend. The term "controlled drug" also includes medical equipment that requires a prescription. DCs are allowed to recommend and sell over-the-counter non-prescription supplements and homeopathic remedies. What can a DC do in an exam or evaluation 1) In the practice of Chiropractic, licensees of this board provide necessary examination and evaluation services to: (A) Determine the bio-mechanical condition of the spine and musculoskeletal system of the human body including, but not limited to, the following: (i) the health and integrity of the structures of the system; (ii) the coordination, balance, efficiency, strength, conditioning and functional health and integrity of the system; (iii) the existence of the structural pathology, functional pathology or other abnormality of the system; (iv) the nature, severity, complicating factors and effects of said structural pathology, functional pathology or other abnormality of the system; (v) the etiology of said structural pathology, functional pathology or other abnormality of the system; and (vi) the effect of said structural pathology, functional pathology or other abnormality of the system on the health of an individual patient or population of patients; (B) Determine the existence of subluxation complexes of the spine and musculoskeletal system of the human body and to evaluate their condition including, but not limited to: (i) The nature, severity, complicating factors and effects of said subluxation complexes; (ii) the etiology of said subluxation complexes; and (iii) The effect of said subluxation complexes on the health of an individual patient or population of patients; (C) Determine the treatment procedures that are indicated in the therapeutic care of a patient or condition; (D) Determine the treatment procedures that are contra-indicated in the therapeutic care of a patient or condition; and (E) Differentiate a patient or condition for which chiropractic treatment is appropriate from a patient or condition that is in need of care from a medical or other class of provider. What can a DC do to examine a person (A) physical examinations; (B) diagnostic imaging; (C) laboratory examination; (D) electro-diagnostic testing, other than an incisive procedure; (E) sonography; and (F) other forms of testing and measurement. What services need additional training (A) Performance of radiologic procedures, which are authorized under the Texas Chiropractic Act, Texas Occupations Code, Chapter 201, may be delegated to an assistant who meets the training requirements set forth under §78.1 of this title (relating to Registration of Chiropractic Radiologic Technologists B Technological Instrumented Vestibular-Ocular-Nystagmus Testing may be performed by a licensee with a diplomate in chiropractic neurology xamination and evaluation services, and the equipment used for such services, which are outside the scope of chiropractic practice include: (A) incisive or surgical procedures; (B) the prescription of controlled substances, dangerous drugs, or any other drug that requires a prescription; (C) the use of x-ray therapy or therapy that exposes the body to radioactive materials; or (D) other examination and evaluation services that are inconsistent with the practice of chiropractic and with the examination and evaluation services described under this subsection. licensees may render an analysis, diagnosis, or other opinion regarding the findings of examinations and evaluation through (A) An analysis, diagnosis or other opinion regarding the biomechanical condition of the spine or musculoskeletal system including, but not limited to, the following: (i) the health and integrity of the structures of the system; (ii) the coordination, balance, efficiency, strength, conditioning and functional health and integrity of the system; (iii) the existence of structural pathology, functional pathology or other abnormality of the system; (iv) the nature, severity, complicating factors and effects of said structural pathology, functional pathology, or other abnormality of the system; (v) the etiology of said structural pathology, functional pathology or other abnormality of the system; and (vi) the effect of said structural pathology, functional pathology or other abnormality of the system on the health of an individual patient or population of patients; (B) An analysis, diagnosis or other opinion regarding a subluxation complex of the spine or musculoskeletal system including, but not limited to, the following: (i) the nature, severity, complicating factors and effects of said subluxation complex; (ii) the etiology of said subluxation complex; and (iii) the effect of said subluxation complex on the health of an individual patient or population of patients; (C) An opinion regarding the treatment procedures that are indicated in the therapeutic care of a patient or condition; (D) An opinion regarding the likelihood of recovery of a patient or condition under an indicated course of treatment; (E) An opinion regarding the risks associated with the treatment procedures that are indicated in the therapeutic care of a patient or condition; (F) An opinion regarding the risks associated with not receiving the treatment procedures that are indicated in the therapeutic care of a patient or condition; (G) An opinion regardi the chiropractor should make a treatment plan to A) Improve, correct, or optimize the biomechanical condition of the spine or musculoskeletal system of the human body including, but not limited to, the following: (i) the health and integrity of the structures of the musculoskeletal system; and (ii) the coordination, balance, efficiency, strength, conditioning, and functional health and integrity of the musculoskeletal system; (B) Promote the healing of, recovery from, or prevent the development or deterioration of abnormalities of the biomechanical condition of the spine or musculoskeletal system of the human body including, but not limited to, the following: (i) the structural pathology, functional pathology, or other abnormality of the musculoskeletal system; (ii) the effects and complicating factors of any structural pathology, functional pathology, or other abnormality of the musculoskeletal system; (iii) the etiology of any structural pathology, functional pathology, or other abnormality of the musculoskeletal system; and (iv) the effect of any structural pathology, functional pathology, or other abnormality of the musculoskeletal system on the health of an individual patient or population of patients; and (C) Promote the healing of, recovery from, or prevent the development or deterioration of a subluxation complex of the spine or musculoskeletal system, including, but not limited to, the following: (i) the structural pathology, functional pathology, or other abnormality of a subluxation complex; (ii) the effects and complicating factors of any structural pathology, functional pathology, or other abnormality of a subluxation complex; (iii) the etiology of any structural pathology, functional pathology, or other abnormality of a subluxation complex; and (iv) the effect of any structural pathology, functional pathology, or other abnormality of a subluxation compl What can the DC do tp treat the patient (A) Osseous and soft tissue adjustment and manipulative techniques; (B) Physical and rehabilitative procedures and modalities; (C) Acupuncture and other reflex techniques; (D) Exercise therapy; (E) Patient education; (F) Advice and counsel; (G) Diet and weight control; (H) Immobilization; (I) Splinting; (J) Bracing; (K) Therapeutic lasers (non-invasive, nonincisive), with adequate training and the use of appropriate safety devices and procedures for the patient, the licensee and all other persons present during the use of the laser; (L) Durable medical goods and devices; (M) Homeopathic and botanical medicines, including vitamins, minerals, phytonutrients, antioxidants, enzymes, neutraceuticals, and glandular extracts; (N) Non-prescription drugs; (O) Referral of patients to other doctors and health care providers; and(P) Other treatment procedures and services consistent with the practice of chiropractic what must you do to practice acupuncture? 1. Passing the NBCE acupuncture exam, or 2. Passing the National Certification Commission for Acupuncture and Oriental Medicine exam, or 3. By successfully completing a course in acupuncture of at least 100 hours in a course provided by a CCE approved chiropractic college, or 4. By successfully completing a course in acupuncture of at least 100 hours in a course approved by the TBCE, or 5. By demonstrating to the TBCE that the doctor has been practicing acupuncture for at least ten years. The board can make rules to... (A) perform the board's duties; and (B) regulate the practice of chiropractic; and In order to make a rule, the board must establish methods under which the board, to the extent appropriate, will seek input early in the rule development process from the public and from persons who will be most affected by a proposed rule. Methods must include identifying persons who will be most affected and soliciting, at a minimum, the advice and opinions of those persons. Methods may include negotiated rulemaking, informal conferences, advisory committees, and any other appropriate method. Can the board take away/suspend your license if you commit a felony? yup Can the board take away/suspend your license if you engage in grossly unprofessional conduct or dishonorable conduct of a character likely to deceive or defraud the public; yup Can the board take away/suspend your license if you have a drug addiction yup Can the board take away/suspend your license if you are using an advertising statement that is false or that tends to mislead or deceive the public yup Can the board take away/suspend your license if you directly or indirectly employing or associating with a person who, in the course of the person's employment, commits an act constituting the practice of chiropractic when the person is not licensed to practice chiropractic; yup Can the board take away/suspend your license if you are advertising professional superiority, or advertising the performance of professional services in a superior manner, if that advertising is not readily subject to verification yes Can the board take away/suspend your license if you are proven insane yes Can the board take away/suspend your license if you are failing to use proper diligence in the practice of chiropractic or using gross inefficiency in the practice of chiropractic yes can a dc call themselves a physician or chiropractic physician nope Can you associate for someone who lost or is loosing their license? nope What is considered defrauding the public 1. commits an act that violates any state or federal law if the act is connected with the chiropractor's practice of chiropractic; (2) prescribes or administers a treatment that is nontherapeutic in nature or nontherapeutic in the manner the treatment is prescribed or administered; (3) violates Section 311.0025, Health and Safety Code; (4) fails to supervise adequately the activities of those acting under the supervision of the chiropractor; or (5) delegates professional chiropractic responsibility or acts to a person if the delegating chiropractor knows or has reason to know that the person is not qualified by training, experience, or licensure to perform the responsibility or acts. If you are accused of defrauding the public do you have to be conviceted in a court of law for the board to take action? no - Proof of the commission of the act while in the practice of chiropractic or under the guise of the practice of chiropractic is sufficient for the board's action. Does the board see impairment as public deception not exactly- but it a huge concern What is considered impairment mpairment may be due to reasons of age, illness or mental condition in addition to abuse of alcohol, narcotics or prescription drug abuse. If the board has probable cause that youre impaired what must you do? submit to a mental and/or physical examination by the appropriate health care provider designated by the board if the board has probable cause to believe that the licensee or applicant is impaired What is considered probable cause (1) sworn statements from two people, willing to testify before the board, that a certain licensee or applicant is impaired; (2) evidence that a licensee or applicant left a treatment program for alcohol or chemical dependency before completion of that program; (3) evidence that a licensee or applicant is guilty of intemperate use of drugs or alcohol; (4) evidence of repeated arrests of a licensee or applicant for intoxication or offenses in which intoxication is a factor; (5) evidence of recurring temporary commitments to a mental institution of a licensee or applicant; (6) chiropractic records and/or medical records showing that a licensee or applicant has an illness or condition which results in the inability to function properly in his or her practice; or (7) medical records evidencing a mental or physical condition of the licensee or applicant. In order to adjust outside their office, what must a DC do? 1. A licensee must be the registered owner of or be employed at a registered chiropractic facility in order to provide out-of-facility services. 2. The rule does not apply to a licensee who treats a patient at the patient's home due to a physical inability to travel to the registered chiropractic facility 3. A licensee performing services attendant to a designated doctor under the Texas Labor Code is exempted from compliance with the rule for those services provided as a designated doctor. To adjust in an out-of-facility services what must the DC provide to the board? (1) its name; (2) its address and telephone number; (3) the name of the owner or manager; and (4) the planned or actual number of visits per week. When must you file an out- of-service form with the board within 10 days after the services were first performed What is considered healthcare fraud wantonly misleading or misrepresenting patient treatment circumstances or any other dynamic of the healthcare industry, resulting in any type of financial gain for the doctor, patient, or any other third party or entity. What does the board consider fraud (1) there must be a cause of deception; (2) the act or acts must show an intentional misrepresentation of fact; and (3) the provider must stand to gain financially from the deception and misrepresentation. What does the board consider unprofessional conduct. (1) maintaining unsanitary or unsafe equipment; (2) failing to use the word "chiropractic", "chiropractor," "Doctor, D.C.," or "Doctor of Chiropractic, D.C." in all advertising medium, including signs and letterheads; (3) engaging in sexual misconduct with a patient within the chiropractic/patient relationship; (4) exploiting patients through the fraudulent use of chiropractic services which result or are intended to result in financial gain for a licensee or a third party. The rendering of chiropractic services becomes fraudulent when the services rendered or goods or appliances sold by a chiropractor to a patient are clearly excessive to the justified needs of the patient as determined by accepted standards of the chiropractic profession; (5) submitting a claim for chiropractic services, goods or appliances to a patient or a third-party payer which contains charges for services not actually rendered or goods or appliances not actually sold; (6) failing to disclose, upon request by a patient or his or her duly authorized representative, the full amount charged for any service rendered or goods supplied. if a patient consents to sex, is that a good enough reason nope Can you ever have sex with a patient, anywhere? nope how long has to go by before you can date a previous patient 6 months without being their doctor How long do you have to inform the board of a felony? 30 days after judgement Serious crimes by the boards rules (1) practicing chiropractic without a license and other violations of the Chiropractic Act; (2) deceptive business practices; (3) medicare or medicaid fraud; (4) a misdemeanor or felony offense involving: (A) murder; (B) assault; (C) burglary; (D) robbery; (E) theft; (F) sexual assault; (G) injury to a child; (H) injury to an elderly person; (I) child abuse or neglect; (J) tampering with a governmental record; (K) forgery; (L) perjury; (M) failure to report abuse; (N) bribery; (O) harassment; (P) insurance claim fraud, including under the Penal Code §32.55; (Q) solicitation under the Penal Code §38.12(d) or Occupations Code, Chapter 102; or (R) mail fraud; (5) delivery, possession, manufacture, or use of or the dispensing or prescribing a controlled substance, dangerous drug, or narcotic; or (6) other misdemeanors or felonies, including violations of the Penal Code, Titles 4, 5, 7, 9, and 10, which indicate an inability or tendency for the person to be unable to perform as a licensee or registrant or to be unfit for licensure or registration if action by the board will promote the intent of the Chiropractic Act, board rules including this chapter, and Occupations Code, Chapter 53. t/f Doctors of Chiropractic may use the term "Chiropractic Physician" when filing a claim for services if the billing has universally applied predetermined coding or description requirements that are a prerequisite to appropriate reimbursement. true non licencees can NOT (included CA's) (1) rendering a diagnosis and prescribing a treatment plan; or (2) performing a chiropractic adjustment or manipulation. When can a Chiro student adjust? Does the DC need to be present? qualified for admission to the outpatient clinic at the aforementioned college licensee who need not be physically present in the treating room at the time of the adjustment or manipulation, but must be on-site at the time of the adjustment or manipulation. Can a recent grad adjust? Yes- within past 12 months Overseeing doctor must notify board of hire within 10 days and must send in copy of diploma Who determines if assistant is quilified DC decides (1) Requisite education may be determined by a license, degree, coursework, on-the-job training, or relevant general knowledge. (2) Requisite training may be determined by instruction in a specific task or procedure, relevant experience, or on-the-job training. (3) Requisite skill may be determined by a person's talent, ability, and fitness to perform a specific task or procedure. (4) A licensee may delegate a specific task or procedure to an unlicensed person if the specific task or procedure is within the scope of chiropractic and if the delegation complies with the other requirements of this section, the Chiropractic Act, and the board's rules. What can an assistant do? 1) taking the patient's medical history; (2) taking or recording vital signs; (3) performing radiologic procedures; (4) taking or recording range of motion measurements; 5) performing other prescribed clinical tests and measurements; (6) performing prescribed physical therapy modalities, therapeutic procedures, physical medicine and rehabilitation, or other treatments as described in the American Medical Association's Current Procedural Terminology Codebook, the Centers for Medicare and Medicaid Services' Health Care Common Procedure Coding System, or other national coding system; (7) demonstrating prescribed exercises or stretches for a patient; or (8) demonstrating proper uses of dispensed supports and devices. What can an unlicensed DC or CA NOT do? (1) to perform activities that are outside the licensee's scope of practice; (2) to perform activities that exceed the education, training, and skill of the person or for which a person is not otherwise qualified and properly trained; or (3) to exercise independent clinical judgment unless the person holds a valid Texas license or certification that would allow or authorize the person to exercise independent clinical judgment. if you have assistants working for you, do you hav to be there? No- can be on call (15 minutes away) for consultation Do you need to specify if the DC or assistant did the service yes can the board regulate advertising? no except to prohibit false, misleading, or deceptive practices by that person. when advertising what can you NOT do? Do not claim to provide services that are superior to other DCs or to other health care providers. Do not make claims that cannot be substantiated. Do not guarantee results. if doing telemarketing, what must the doctor do? at the start of each call, to inform the person called who they are (caller's name) and who they represent (clinic/doctor). hall keep a copy of each script used for calling and a log of all calls made that shall include the date, telephone number, and the name of each person called. Such scripts and logs shall be maintained for a minimum of two years. if you advertise and use study, what must you do? cite it and make copies of article upon request can you advertise as free No unless... 1) all the component services which will or might be performed at the time of, or as part of, the service; (2) as to each such component service, whether that service will be free or, if not, the exact amount which will be charged for it; and (3) if a component service is an evaluation, whether the report of findings will be free or, if not, the exact amount which will be charged for the report of findings. when providing service what must the DC provide to the patient on the date of providing goods or services to a patient, disclose to the patient in writing the full amount of the licensee's charges. Compliance with this rule may be in any written form reasonably calculated to notify the patient of the actual charges for the goods or services provided. can you say chiropractic cures anything nope What must be specified in a prepaid plan? disclose a limited, defined number of visits and should include all aspects of the treatment being provided. Can the patient cancel a prepaid plan The plan must be cancellable by either party at any time for any reason without penalty of any kind to the patient. 2) Upon cancellation of the plan the patient shall receive a complete refund of all fees paid on a pro rata basis of the number of treatments provided compared to total treatments contracted. in order to use a prepaid plan, the DC must have in the file... file must contain the proposed treatment plan, including enumeration of all aspects of evaluation, management, and treatment planned to therapeutically benefit the patient relative to the condition determined to be present and necessitating treatment. If using braces or nutrition, the DC must denote if its included or not