Subchapter D. MINIMUM STANDARDS OF PRACTICE

§ 25.211. [Reserved].

   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).

   Validity

 (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.’’

   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)).

 (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.

   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)).

   The provisions of this §  25.213 adopted January 10, 1992, effective January 11, 1992, 22 Pa.B. 209.

 (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.

   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).

 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, physician assistant, respiratory care practitioner, 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.

   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).

 (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.

   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).

 (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.

   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).

   The provisions of this §  25.217 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6414.