Subchapter D. MINIMUM STANDARDS OF PRACTICE
Sec.
25.211. [Reserved].
25.212. Professional advertising.
25.213. Medical records.
25.214. Corporate practice and fictitious names.
25.215. Definitions.
25.216. Sexual misconduct.
25.217. Delegation.
25.218. Conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy.§ 25.211. [Reserved].
Source The provisions of this § 25.211 adopted January 16, 1987, effective July 17, 1987, 17 Pa.B. 255; amended October 9, 1987, effective October 1, 1987, 17 Pa.B. 4040; amended October 20, 1989, effective October 21, 1989, 19 Pa.B. 4511; reserved July 10, 1998, effective July 11, 1998, 28 Pa.B. 3282. Immediately preceding text appears at serial pages (210048) to (210050).
Notes of Decisions Validity
Regulations which required a medical doctor or an osteopathic physician to obtain a written waiver from the State Board of Medicine or the State Board of Osteopathic Medicine for treatment of patients with drugs known as ‘‘sympathomimetic amines’’, beyond the 45-day period, was an unreasonable exercise of bureaucratic authority and the regulations were void and unenforceable. Pennsylvania Medical Society v. State Board of Medicine, 546 A.2d 720 (Pa. Cmwlth. 1988).
§ 25.212. Professional advertising.
(a) Advertising in any medium is permitted if it is not misleading, deceptive, untrue or fraudulent on its face or by its effect in actual practice.
(b) Advertising, letterhead, publications or transmissions shall designate or indicate the licensee’s school of medical practice by the term ‘‘D.O.,’’ ‘‘doctor of osteopathy,’’ ‘‘osteopathic physician’’ or ‘‘osteopathic physician and surgeon.’’
Authority The provisions of this § 25.212 issued under section 16 of the Osteopathic Medical Practice Act (63 P.S. § 271.16); and section 902(b) of the Health Care Services Malpractice Act (40 P. S. § 1301.902(b)).
Source The provisions of this § 25.212 adopted January 10, 1992, effective January 11, 1992, 22 Pa.B. 209.
§ 25.213. Medical records.
(a) A medical record shall be maintained for each patient, identifying the patient, the person making the entry, the date of each contact, pertinent clinical information, diagnoses, findings, laboratory results and other diagnostic, corrective or therapeutic procedures, including prescription drug orders, arising out of the licensee’s care of the patient.
(b) A patient’s medical record shall be retained for at least 7 years from the last entry. In addition, for minors, the medical record shall be retained until 2 years after the patient’s 18th birthday or 7 years from the last entry, whichever is later. Storage may be off-premises.
(c) Medical records shall be kept confidential, unless disclosure is required for bona fide treatment, with the patient’s written consent, except as follows:
(1) Upon receipt of a court order for the production of documents.
(2) Upon lawful demand by auditors for public or private third-party payers which have contracted to reimburse the licensee for services provided to the patient.
(3) To defend against allegations of civil or criminal medical malpractice, if the licensee’s treatment of the patient has been placed at issue by the complaining party, and only to the extent necessary to controvert factual allegations in the complaint.
(4) To comply with other relevant State or Federal health care laws.
(d) The licensee shall provide a patient with a complete copy of the patient’s medical record, within a reasonable time of the request of the patient or an authorized representative. Reasonable charges for copying may be made.
Authority The provisions of this § 25.213 issued under section 16 of the Osteopathic Medical Practice Act (63 P. S. § 271.16); and section 902(b) of the Health Care Services Malpractice Act (40 P. S. § 1301.902(b)).
Source The provisions of this § 25.213 adopted January 10, 1992, effective January 11, 1992, 22 Pa.B. 209.
Cross References This section cited in 34 Pa. Code § 501.5 (relating to exemptions); and 49 Pa. Code § 25.415 (relating to confidentiality—waived).
§ 25.214. Corporate practice and fictitious names.
(a) A licensee may hold ownership interests in businesses formed to provide goods or services related to the practice of medicine, if not otherwise prohibited by law, and if the licensee complies with the disclosure requirements of sections 1—3 of the act of May 26, 1988 (P. L. 403, No. 66) (35 P. S. § § 449.21—449.23).
(b) A licensee may form partnerships or professional corporations, for the practice of medicine, with other licensed physicians, allopathic or osteopathic, optometrists, dentists, psychologists, podiatrists and chiropractors if the incorporation is also authorized by Chapter 5, 16, 23, 29, 33 or 41.
(c) A licensee may practice under a fictitious name which is not misleading, deceptive, untrue or fraudulent, if not otherwise prohibited by law.
(d) Before filing with the Corporation Bureau of the Department of State, a licensee of the Board shall first file corporate documents with the Board for review and approval under this section.
Authority The provisions of this § 25.214 issued under section 16 of the Osteopathic Medical Practice Act (63 P. S. § 271.16); and section 902(b) of the Health Care Services Malpractice Act (40 P. S. § 1301.902(b)); amended under 15 Pa.C.S. § 2903(d)(ii).
Source The provisions of this § 25.214 adopted January 10, 1992, effective January 11, 1992, 22 Pa.B. 209; amended December 23, 1994, effective December 24, 1994, 24 Pa.B. 6420. Immediately preceding text appears at serial page (165205).
§ 25.215. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Board-regulated practitioner—An osteopathic physician, perfusionist, physician assistant, genetic counselor, respiratory therapist, licensed athletic trainer, acupuncturist or an applicant for a license or certificate issued by the Board.
Immediate family member—A parent or guardian, child, sibling, spouse or other family member, whether related by blood or marriage, with whom a patient resides.
Sexual behavior—Any sexual conduct which is nondiagnostic and nontherapeutic; it may be verbal or physical and may include expressions of thoughts and feelings or gestures that are sexual in nature or that reasonably may be construed by a patient as sexual in nature.
Sexual exploitation—Any sexual behavior that uses trust, knowledge, emotions or influence derived from the professional relationship.
Authority The provisions of this § 25.215 issued under sections 10.1(c), 15(a)(8) and (b)(9) and 16 of the Osteopathic Medical Practice Act (63 P.S. § § 271.10a(c), 271.15(a)(8) and (b)(9) and 271.16); amended under sections 10(f) and (h), 10.1(c), 10.2(f), 10.3, 13.3 and 16 of the Osteopathic Medical Practice Act (63 P.S. § § 271.10(f) and (h), 271.10a(c), 271.10b(f), 271.10c, 271.13c and 271.16).
Source The provisions of this 25.215 adopted January 2, 2004, effective January 3, 2004, 34 Pa.B. 47; amended August 2, 2013, effective August 3, 2013, 43 Pa.B. 4336; amended January 31, 2014, effective February 1, 2014, 44 Pa.B. 589; amended March 11, 2016, effective March 12, 2016, 46 Pa.B. 1316. Immediately preceding text appears at serial page (370253).
§ 25.216. Sexual misconduct.
(a) Sexual exploitation by a Board-regulated practitioner of a current or former patient, or of an immediate family member of a patient, constitutes unprofessional conduct, is prohibited, and subjects the practitioner to disciplinary action under section 15(a)(8) and (b)(9) of the act (63 P.S. § 271.15(a)(8) and (b)(9)).
(b) Sexual behavior that occurs with a current patient other than the Board-regulated practitioner’s spouse, constitutes unprofessional conduct, is prohibited, and subjects the practitioner to disciplinary action under section 15(a)(8) and (b)(9) of the act.
(c) When a Board-regulated practitioner has been involved with the management or treatment of a patient other than the practitioner’s spouse for a mental health disorder, sexual behavior with that former patient which occurs prior to the 2-year anniversary of the termination of the professional relationship constitutes unprofessional conduct, is prohibited, and subjects the practitioner to disciplinary action under section 15(a)(8) and (b)(9) of the act.
(d) A practitioner who engages in conduct prohibited by this section will not be eligible for placement into an impaired professional program in lieu of disciplinary or corrective actions.
(e) Consent is not a defense to conduct prohibited by this section.
Authority The provisions of this § 25.216 issued under sections 10.1(c), 15(a)(8) and (b)(9) and 16 of the Osteopathic Medical Practice Act (63 P.S. § § 271.10a(c), 271.15(a)(8) and (b)(9) and 271.16).
Source The provisions of this 25.216 adopted January 2, 2004, effective January 3, 2004, 34 Pa.B. 47.
Cross References This section cited in 49 Pa. Code § 25.809 (relating to disciplinary action for licensed perfusionist); and 49 Pa. Code § 25.908 (relating to disciplinary action for applicants and genetic counselors).
§ 25.217. Delegation.
(a) An osteopathic physician may delegate to a health care practitioner or technician the performance of a medical service if the following conditions are met:
(1) The delegation is consistent with the standards of acceptable medical practice embraced by the osteopathic physician community in this Commonwealth. Standards of acceptable medical practice may be discerned from current peer reviewed medical literature and texts, teaching facility practices and instruction, the practice of expert practitioners in the field and the commonly accepted practice of practitioners in the field.
(2) The delegation is not prohibited by the statutes or regulations relating to the other health care practitioner.
(3) The osteopathic physician has knowledge that the delegatee has education, training, experience and continued competency to safely perform the medical service being delegated.
(4) The osteopathic physician has determined that the delegation to a health care practitioner or technician does not create an undue risk to the particular patient being treated.
(5) The nature of the service and the delegation of the service has been explained to the patient and the patient does not object to the performance by the health care practitioner or technician. Unless otherwise required by law the explanation may be oral and may be given by the osteopathic physician or the osteopathic physician’s designee.
(6) The osteopathic physician assumes the responsibility for the delegated medical service, including the performance of the service, and is available to the delegatee as appropriate to the difficulty of the procedure, the skill of the delegatee and risk to the particular patient.
(b) An osteopathic physician may not delegate the performance of a medical service if performance of the medical service or if recognition of the complications or risks associated with the delegated medical service requires knowledge and skill not ordinarily possessed by nonphysicians.
(c) An osteopathic physician may not delegate a medical service which the osteopathic physician is not trained, qualified and competent to perform.
(d) An osteopathic physician shall be responsible for the medical services delegated to the health care practitioner or technician.
(e) An osteopathic physician may approve a standing protocol delegating medical acts to another health care practitioner who encounters a medical emergency that requires medical services for stabilization until the osteopathic physician or emergency medical services personnel are available to attend to the patient.
(f) This section does not prohibit a health care practitioner who is licensed or certified by a Commonwealth agency from practicing within the scope of that license or certificate or as otherwise authorized by law. For example, this section is not intended to restrict the practice of certified registered nurse anesthetists, nurse midwives, certified registered nurse practitioners, physician assistants, or other individuals practicing under the authority of specific statutes or regulations.
Authority The provisions of this § 25.217 issued under sections 3 and 16 of the Osteopathic Medical Practice Act (63 P.S. § § 271.3 and 271.16).
Source The provisions of this § 25.217 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6414.
§ 25.218. Conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy.
(a) Background. Conversion therapy, also known as sexual orientation change efforts or reparative therapy, poses critical health risks to lesbian, gay, bisexual, transgender, queer/questioning, intersex and asexual individuals, including suicidality, substance abuse, confusion, depression, guilt, helplessness, hopelessness, shame, social withdrawal, stress, disappointment, self-blame, decreased self-esteem and authenticity to others, increased self-hatred, hostility and blame toward parents, feelings of anger and betrayal, loss of friends and potential romantic partners, problems with sexual and emotional intimacy, sexual dysfunction, high-risk sexual behaviors, a feeling of being dehumanized and untrue to self, a loss of faith and a sense of having wasted time and resources. The American Medical Association opposes the use of conversion therapy for sexual orientation or gender identity. Due to the lack of scientific evidence supporting conversion therapy and the risk of harm to minors, the practice of conversion therapy is strongly opposed by the American Academy of Child Adolescent Psychiatry, American Academy of Pediatrics, American Association for Marriage and Family Therapy, American College of Physicians, American Medical Association, American Psychiatric Association, American Psychoanalytic Association, American Psychological Association, National Association of Social Workers, Pan American Health Organization and the World Psychiatric Association.
(b) Board authority. The Board has statutory authority to license, regulate and discipline Board-regulated practitioners in this Commonwealth. Under section 15 of the act (63 P.S. § 271.15), the Board is authorized to refuse, revoke or suspend the license of a Board-regulated practitioner who is guilty of immoral or unprofessional conduct.
(c) Guidelines. The following conversion therapy guidelines should be considered by Board-regulated practitioners to ensure compliance with the act and the Board’s regulations.
(1) Being lesbian, gay, bisexual, transgender, queer/questioning, intersex or asexual is not a disease, disorder, illness, deficiency or shortcoming.
(2) Conversion therapy includes the following conduct:
(i) A practice or treatment that seeks to change an individual’s sexual orientation or gender identity.
(ii) An effort to change the behavioral expression of an individual’s sexual orientation, change gender expression, or eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.
(3) Conversion therapy does not include a practice or treatment that provides counseling for an individual undergoing gender transition, counseling that provides acceptance, support and understanding, or the facilitation of coping, social support and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices. Conversion therapy does not include a practice that does not seek to change sexual orientation or gender identity.
(4) In a disciplinary action brought against a Board-regulated practitioner, the Board may find the use of conversion therapy on an individual under 18 years of age to be immoral or unprofessional conduct. A Board-regulated practitioner who uses conversion therapy on an individual under 18 years of age may be subject to discipline by the Board.
Authority The provisions of this § 25.218 added under section 15(a)(8) and (b)(9) of the Osteopathic Medical Practice Act (63 P.S. § 271.15(a)(8) and (b)(9)); and section 3(g) of the Acupuncture Licensure Act (63 P.S. § 1803(g)).
Source The provisions of this § 25.218 added June 7, 2024, effective June 8, 2024, 54 Pa.B. 3165.
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