About PBI Education
Click here to view our full course policies.
Most PBI Education courses are already approved, but we recommend you send our course agenda to your regulator (licensing board or regulatory college) for pre-approval before you register, to confirm that the course meets requirements.
To seek course approval you can download an agenda by pressing the “course agenda” button at the top of the course information page and email it to your regulator for approval.
Course fees can be paid by credit or debit card, or with financing through PayPal Credit. PayPal Credit allows participants to confirm their enrollment in a course interest- free with a $99.00 down payment if the course is paid in full within six months. Just select PayPal Credit as your payment option during registration and follow the prompts to verify your credit. To make use of the financing, you will need to create a PayPal account if you do not already have one.
Yes! PBI courses are considered equivalent to many courses from other providers and are competitively priced. Courses are generally approved by submitting an agenda to your regulator (licensing board or regulatory college). We are always happy to assist with this process, so if you need help, call or email us.
Our courses compare to similar courses from providers like: Vanderbilt, Sante, Center for Personalized Education for Professionals (CPEP), Physician Assessment and Clinical Education (PACE), Case Western, Western Institute of Legal Medicine (WILM), Institute for Medical Quality (IMQ), KSTAR Physician Resources, Florida Medical Association (FMA), and others.
Yes! We welcome and encourage participants to proactively educate themselves by taking our courses, even if they have no disciplinary issues to address.
No, full participation is required throughout the entire course in order to receive a certificate of completion.
Remediation and remedial education
Remediation is a process intended as a remedy or corrective intervention for a lapse in professional behavior. It assumes that the person who erred is of inherent value to their profession and has the characterologic potential to learn from past mistakes, hold themselves accountable, and adhere to future safeguards. Remediation can be accomplished through a formal program or curriculum that provides opportunities for reflection and analysis of the professional’s particular situation. It is most successful when delivered in a live setting (virtual-live, which is synchronous, works well), either in a small group or one-on-one. In fact, coupled with the development of a plan to safeguard future behavior, it is the only intervention that has demonstrated success in helping professionals avoid recidivism.
Anyone in a fiduciary relationship is at risk of a lapse in professionalism, boundaries, or ethics, especially those in the professions of medicine, psychotherapy, law, education, and ministries.
Implementation of the risk management strategies that are taught in PBI courses fosters healthy and safe professional decision making. This improves interpersonal skills, which in turn, reduce the risk for professionalism transgressions. Patients, clients, professionals, clinics, hospitals, institutions and corporations are safeguarded.
The legal environment demands, and the public expects, strict adherence to professional boundaries. No conscientious professional sets out to violate standards of appropriate professional relationships with clients or patients, yet violations continue to occur. This can happen to those who are dedicated, moral and highly professional in the overall conduct of their practice. Boundaries training is essential for professional protection.
Reporting violations and resources for the public and victims
It is our moral and ethical responsibility to safeguard the public and to help one another when in trouble. If you feel unable to talk to the offending professional, contact a representative from their licensing board, regulatory college, or an advocacy program, such as their state or provincial Physician or Professional Health Program. Contact PBI if you need further assistance. It may be your legal duty to report the knowledge of a boundary violation. Failure to do so may allow patient harm to go unchecked and may expose your license to disciplinary proceedings and potential criminal charges.
D ocInfo, a search tool launched by the Federation of State Medical Boards, is an excellent resource where you can verify a US doctor’s license and professional background information.
Otherwise, the clinician’s regulatory website is a great resource. To locate it, first navigate to your search engine and type in the US state or Canadian province/territory where the clinician practices, then their profession, then either the word “board” or “college” (board if they live in the U.S., college if they live in Canada). For example, a nurse from Florida would type “Florida Nursing Board.” A physician from Alberta would type “Alberta Physician College.”
Professional boundaries define effective and appropriate interactions between professionals and the public they serve. Boundaries exist to protect both the professional and the patient/client.
Any behavior or interaction which damages the patient, the professional, and/or the therapy is a violation. It is the victimization and exploitation of a patient by the professional. It is a betrayal of the sacred covenant of trust. This includes sexual and non-sexual misconduct.
Boundaries protect the very core of the professional-patient association. The breach of a boundary, whether intentional or not, can lead to serious harm to all parties. The etiology of a boundary violation is complex. On rare occasion, the professional may be a sociopath, absent of conscience, who knowingly exploits their patients. In the majority of cases, the offending professional may suffer from a mental illness or experience crises which impair professional judgment. The professional may not be fully cognizant of the violation and may remain unaware of the damage that has occurred. In either case, the result is exploitation and harm.
Boundary violations harm the patient and the professional. The ramifications are widespread. Damage usually extends to marriages, families, other patients, communities, clinics, institutions, and the profession in general.
Generally, no, because the fiduciary relationship between professionals and those they serve remains of paramount importance. However, certain social, cultural, and political forces in the US and other countries have both shaped and been shaped by the expectations of professional behavior among the public. Examples include the ethical principle of respect for patient autonomy that underlies the informed consent process, the widespread accessibility of institutional ethics committees, and laws and documents that set forth patients’ rights. Whereas certain boundary crossings, such as inappropriate language in the operating room or unchaperoned exams, had been tolerated in the past, that is much less true nowadays.
- Commonplace actions go awry or get misinterpreted. For example: A well-meaning professional may want to be a “nice guy” and may not know how to say no to requests to write prescriptions or treat someone without the usual thoroughness they would employ with a bona fide patient.
- Professionals are prized for their self-reliance and competence. But some carry that too far. They may avoid asking important questions about policies, procedures, or standards for fear of appearing incompetent or weak to co-workers or supervisors.
- Clinicians may neglect to familiarize themselves with applicable laws, such as those regarding prescribing, supervision, and ordering.
- Professionals may not recognize that interacting with patients, families, or co-workers in a casual way may come across as inappropriate.
If you suspect that a colleague is in danger of perpetrating a boundary violation or has done so, do not assume that they recognize the situation. In the majority of cases, the professional’s denial and rationalization of their misbehavior is entrenched. When confronted, these professionals tend to distort and minimize the violation. It has been said that these violations occur within a “circumscribed detachment of reality.” This means that a professional may function competently and ethically in all aspects of their practice except in regard to their interaction with the specific patient/victim.
The worst thing you can do is to ignore the problem. Remember that the perception of misconduct can be as damaging as the actual event. This is a professional colleague who is in need of your help. In many aspects, it is not unlike an impaired professional who is suffering from a chemical dependence. An intervention is necessary to safeguard the professional and to protect the public. Your help may prevent further harm and, in the long run, preserve the professional’s career.
In short, no. The chief concern about dating a current or former patient has to do with the power gradient in the relationship. The sharing of intimacies can create ambiguities regarding exploitation and self-serving motives. Different professions and different jurisdictions have their own regulations regarding decisions to date a former patient. Your professional society is a good place to learn what the standards are in your profession and in your locale. As one example, however, the American Medical Association’s position is that sexual contact with a current patient constitutes sexual misconduct. Further, the field of psychiatry holds to the “once a patient, always a patient” dictum, meaning that it is never ethically permissible to date a current or former patient.
Ethics and professionalism
Individuals with knowledge of a specialized area or skill that requires advanced training and serves others in a fiduciary capacity are known as professionals. Most areas of specialization typically have a Code of Ethics. Professionals are held to a higher standard of conduct by the society they serve. Demonstration of that standard of conduct is called professionalism.
Ethics is a field of study that helps us answer “should” questions, such as “What should I do in this situation?” or “How should I behave?” The field of ethics provides several different methods of answering questions where there are multiple stakeholders and factors to consider. Those methods include consideration of virtues, ideals, and aspirations, and reasoning that considers consequences, moral principles, context, and norms. Professionalism is related to ethics in that those who demonstrate professionalism conduct themselves according to the ethical principles, expectations, and norms of their profession.
Professionals in the fields of medicine, psychotherapy, law, education, and religion are fiduciaries. By definition, they are agents that demonstrate trustworthiness, inspire confidence and function responsibly. With this duty comes an obligation to serve others morally, ethically and competently. To successfully uphold this fiduciary duty, professionals must possess an increased awareness of personal and professional influences that can place them at risk for a violation.
Well-conceived codes of ethics generally stand the test of time, although novel situations could not necessarily be anticipated when codes were originally developed. Generally, professions update their codes of ethics as needed to assist their members to handle situations that arise over time, such as with the modernization of health care (e.g., use of electronic communication, electronic health records, etc.).
- Be familiar with your professional code of ethics and institutional code of conduct.
- Behave as if you are on camera.
- Make sure you are meeting your personal needs appropriately. Don’t look to your profession or practice.
- Avoid personal and professional isolation.
- Stay up-to-date with standards of practice through your professional press.
- If applicable, institute checks and balances to make sure your billing and documentation systems are accurate and complete.
- Do not cut corners.
- Create personal policies. They help minimize room for error and create a standard way for you to handle every situation of that type. For example, create a uniform policy about handling requests to treat or write prescriptions for friends or family members.
- Look at your state’s professional practice act (e.g., state Medical Practice Act, provincial Veterinary Practice Act, territorial Dental Practice Act, etc.) for guidance. It should give define scope of authority, supervision, prescribing, and other professional expectations and parameters.
- When in doubt, seek the advice of your licensing board, regulatory college, professional society, or a trusted colleague. Don’t seek advice from someone who will tell you what you want to hear, but someone who will offer an honest and informed opinion.
These terms are general labels for objectionable and actionable conduct, arising from statutes that delineate the expectations of ethical conduct for licensed professionals. Admittedly, these are general terms that can apply to a wide range of infractions. The process of remediation can assist the accused to understand with greater specificity and nuance the lapse in professionalism they need to work on, including how they went off track and how they can get back on track and stay there.
Many professionals are in a position to supervise trainees, other professionals, and office staff. Some supervisory relationships, such as that between a physician assistant and a physician, have clear and formal requirements and expectations that must be followed. Other supervisory relationships, such as a student rotating through a faculty member’s clinic, are less formal. The primary ethical issue is one of accountability. As “captain of the ship,” the licensed professional is ultimately responsible for all the activity in their domain and has a duty to ensure the integrity of those activities.