Part V. Standards of Professional Conduct
18VAC85-110-175. Confidentiality.
A practitioner shall not willfully or negligently breach the confidentiality between a practitioner and a patient. A breach of confidentiality that is required or permitted by applicable law or beyond the control of the practitioner shall not be considered negligent or willful.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005.
18VAC85-110-176. Patient records.
A. Practitioners shall comply with the provisions of § 32.1-127.1:03 of the Code of Virginia related to the confidentiality and disclosure of patient records.
B. Practitioners shall properly manage patient records and shall maintain timely, accurate, legible, and complete patient records.
C. Practitioners shall maintain a patient record in accordance with policies and procedures of the employing entity. In the event the practitioner is a sole proprietor, the practitioner shall develop policies for maintenance of patient records and adhere to those policies.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005; amended, Virginia Register Volume 41, Issue 20, eff. July 3, 2025.
18VAC85-110-177. Practitioner-patient communication; termination of relationship.
A. Communication with patients.
1. Except as provided in § 32.1-127.1:03 F of the Code of Virginia, a practitioner shall accurately inform a patient or the patient's legally authorized representative of the patient's professional assessment and prescribed treatment or plan of care in understandable terms. No practitioner shall deliberately make a false or misleading statement regarding the practitioner's skill or the efficacy or value of a treatment or procedure prescribed or directed by the practitioner in the treatment of any disease or condition.
2. Before any acupuncture treatment or procedure is performed, informed consent shall be obtained from the patient. Practitioners shall inform patients of the risks, benefits, and alternatives of the recommended treatment that a reasonably prudent licensed acupuncturist practicing in Virginia would tell a patient. In the instance of a minor or a patient who is incapable of making an informed decision on the patient's own behalf or is incapable of communicating such a decision due to a physical or mental disorder, the legally authorized person available to give consent shall be informed and the consent documented.
B. Termination of the practitioner-patient relationship.
1. The practitioner or the patient may terminate the relationship. In either case, the practitioner shall make a copy of the patient record available, except in situations where denial of access is allowed by law.
2. No practitioner shall terminate the relationship or make services unavailable without documented notice to the patient that allows for a reasonable time to obtain the services of another practitioner.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005; amended, Virginia Register Volume 41, Issue 20, eff. July 3, 2025.
18VAC85-110-178. Practitioner responsibility.
A. A practitioner shall not:
1. Perform procedures or techniques that are outside the scope of his practice or for which he is not trained and individually competent;
2. Knowingly allow subordinates to jeopardize patient safety or provide patient care outside of the subordinate's scope of practice or area of responsibility. Practitioners shall delegate patient care only to subordinates who are properly trained and supervised;
3. Engage in an egregious pattern of disruptive behavior or interaction in a health care setting that interferes with patient care or could reasonably be expected to adversely impact the quality of care rendered to a patient; or
4. Exploit the practitioner/patient relationship for personal gain.
B. Advocating for patient safety or improvement in patient care within a health care entity shall not constitute disruptive behavior provided the practitioner does not engage in behavior prohibited in subdivision A 2 of this section.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005.
18VAC85-110-179. (Repealed.)
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005; repealed, Virginia Register Volume 41, Issue 20, eff. July 3, 2025.
18VAC85-110-180. Dietary supplements.
A. The recommendation or direction for the use of dietary supplements and the rationale for that recommendation shall be documented by the practitioner. The recommendation or direction shall be based upon a reasonable expectation that such use will result in a favorable patient outcome, including preventive practices, and that a greater benefit will be achieved than that which can be expected without such use.
B. Dietary supplements, used singly or in combination, shall not be sold, dispensed, recommended, prescribed, or suggested in doses that would be contraindicated based on the individual patient's overall medical condition and medications.
C. The practitioner shall conform to the standards of his particular branch of the healing arts in the therapeutic application of dietary supplement therapy.
Statutory Authority
§§ 54.1-2400 and 54.1-2956.9 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005; amended, Virginia Register Volume 35, Issue 22, eff. August 8, 2019.
18VAC85-110-181. (Repealed.)
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005; repealed, Virginia Register Volume 41, Issue 20, eff. July 3, 2025.
18VAC85-110-182. Sexual contact.
A. For purposes of § 54.1-2915 A 12 and A 19 of the Code of Virginia and this section, sexual contact includes, but is not limited to, sexual behavior or verbal or physical behavior that:
1. May reasonably be interpreted as intended for the sexual arousal or gratification of the practitioner, the patient, or both; or
2. May reasonably be interpreted as romantic involvement with a patient regardless of whether such involvement occurs in the professional setting or outside of it.
B. Sexual contact with a patient.
1. The determination of when a person is a patient for purposes of § 54.1-2915 A 19 of the Code of Virginia is made on a case-by-case basis with consideration given to the nature, extent, and context of the professional relationship between the practitioner and the person. The fact that a person is not actively receiving treatment or professional services from a practitioner is not determinative of this issue. A person is presumed to remain a patient until the patient-practitioner relationship is terminated.
2. The consent to, initiation of, or participation in sexual behavior or involvement with a practitioner by a patient does not change the nature of the conduct nor negate the statutory prohibition.
C. Sexual contact between a practitioner and a former patient after termination of the practitioner-patient relationship may still constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge, or influence of emotions derived from the professional relationship.
D. Sexual contact between a practitioner and a key third party shall constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge or influence derived from the professional relationship or if the contact has had or is likely to have an adverse effect on patient care. For purposes of this section, key third party of a patient means spouse or partner, parent or child, guardian, or legal representative of the patient.
E. Sexual contact between a supervisor and a trainee shall constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge or influence derived from the professional relationship or if the contact has had or is likely to have an adverse effect on patient care.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005.
18VAC85-110-183. Refusal to provide information.
A practitioner shall not willfully refuse to provide information or records as requested or required by the board or its representative pursuant to an investigation or to the enforcement of a statute or regulation.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 22, Issue 1, eff. October 19, 2005.