Research
What unprofessional conduct actually covers
The phrase sounds like bedside manner. In the three state codes read here it is a long enumerated list that reaches record-keeping, advertising, supervision, cooperation with the regulator and the promotion of unnecessary treatment.
It is a defined term, not a description
In each of the three states read here, unprofessional conduct is a statutory category with enumerated contents rather than a general standard a board fills in case by case.
Washington states the frame plainly. Except as provided in one cross-referenced section, the following conduct, acts, or conditions constitute unprofessional conduct for any licence holder under the jurisdiction of the chapter, and then lists them. The list in the version read runs to a thirtieth numbered item.
California is explicit that its enumeration is not exhaustive. The board shall take action against any licensee who is charged with unprofessional conduct, and in addition to other provisions of the article, unprofessional conduct includes, but is not limited to, the items listed.
Virginia frames the same idea as a menu of sanctions attached to a list of acts. Its Board of Medicine may refuse to issue a certificate or licence, reprimand, place on probation, impose a monetary penalty or terms, suspend for a stated period or indefinitely, or revoke any licence, for any of the enumerated acts of unprofessional conduct.
The practical consequence is that the phrase does very little work on its own. What a state means by it is whatever its list says, and the lists are not identical.
Clinical failure is only part of it
The clinical entries are there, and they are narrower than they sound. Washington names incompetence, negligence, or malpractice which results in injury to a patient or which creates an unreasonable risk that a patient may be harmed.
The same Washington item then adds a limiting sentence that is easy to miss. The use of a nontraditional treatment by itself shall not constitute unprofessional conduct, provided that it does not result in injury to a patient or create an unreasonable risk that a patient may be harmed.
California lists gross negligence, incompetence and repeated negligent acts, and then defines the last one with unusual care. To be repeated there must be two or more negligent acts or omissions; an initial negligent act or omission followed by a separate and distinct departure from the applicable standard of care constitutes repeated negligent acts.
California goes further and explains when two events are one event. An initial negligent diagnosis followed by an act or omission medically appropriate for that negligent diagnosis constitutes a single negligent act, while a departure from the standard of care at a point where the standard requires a change in diagnosis or treatment is a separate and distinct breach.
Virginia's clinical entry is phrased around risk rather than outcome: intentional or negligent conduct in the practice of any branch of the healing arts that causes or is likely to cause injury to a patient or patients, alongside a separate item for conducting a practice in such a manner as to be a danger to the health and welfare of patients or the public.
Business conduct sits in the same list
The entries that surprise readers are the commercial ones, and they sit in the same enumerations as the clinical failures.
Washington lists all advertising which is false, fraudulent, or misleading, and separately lists misrepresentation or fraud in any aspect of the conduct of the business or profession.
One Washington item speaks directly to selling. Promotion for personal gain of any unnecessary or inefficacious drug, device, treatment, procedure, or service is enumerated unprofessional conduct.
Another addresses what a licensee may accept. Acceptance of more than a nominal gratuity, hospitality, or subsidy offered by a representative or vendor of medical or health-related products or services intended for patients, in contemplation of a sale or for use in research publishable in professional journals, where a conflict of interest is presented as defined by the disciplining authority's rules, is on the list.
Virginia carries a parallel advertising entry, naming publishing in any manner an advertisement relating to professional practice that contains a claim of superiority or violates board regulations governing advertising, and separately names performing any act likely to deceive, defraud, or harm the public.
Conduct toward the regulator itself
A distinct cluster of items has nothing to do with patients and everything to do with the investigation.
Washington enumerates failure to cooperate with the disciplining authority, and then spells out four ways that failure can occur: not furnishing papers, documents, records or other items; not furnishing in writing a full and complete explanation covering the matter in the complaint; not responding to subpoenas, whether or not the recipient is the accused; and not providing reasonable and timely access for authorised representatives seeking to perform practice reviews at facilities the licence holder uses.
Washington defines practice review separately as an investigative audit of records related to the complaint without prior identification of specific patient or consumer names, or an assessment of the conditions, circumstances and methods of the professional's practice related to the complaint.
California's version is pointed at attendance and at pressure on witnesses. Failure by a certificate holder, in the absence of good cause, to attend and participate in an interview by the board no later than thirty calendar days after being notified is enumerated, as is dissuading, intimidating, or tampering with a patient, witness, or any person in an attempt to prevent them from reporting or testifying about a licensee.
California also names any action of the licensee, or another person acting on the licensee's behalf, intended to cause a patient or their authorised representative to rescind consent to release medical records to the board or the department's investigation unit. Washington reaches the same ground through an interference item covering wilful misrepresentation of facts, threats or harassment against a patient or witness, and financial inducements to prevent evidence being given.
What the lists tell a reader to check
Read together, the three enumerations point at a small number of facts that are visible from outside a clinical encounter.
Scope is one. Washington lists practice beyond the scope of practice as defined by law or rule, and separately lists aiding or abetting an unlicensed person to practise when a licence is required. Virginia names aiding or abetting, having professional connection with, or lending one's name to any person known to be practising illegally.
Supervision is another. Washington enumerates failure to adequately supervise auxiliary staff to the extent that the consumer's health or safety is at risk, which is a duty that attaches to whoever holds the licence, not to the staff member.
Reciprocity is a third. Washington lists suspension, revocation, or restriction of the individual's licence to practise any health care profession by competent authority in any state, federal, or foreign jurisdiction, with a certified copy of the order conclusive evidence of it. Virginia lists restriction of a licence in another state, the District of Columbia, a United States possession or territory, or a foreign jurisdiction, or for an entity of the federal government, and states that its board shall refuse to issue a certificate or licence to an applicant whose licence elsewhere has been revoked or suspended and not reinstated.
One caution belongs with all of this. Several numbered items in the Washington list are cross-references to other sections rather than descriptions of behaviour, so counting the items is not counting the grounds, and none of these lists is a substitute for the board regulations that sit underneath them.
Key takeaways
- Unprofessional conduct is an enumerated statutory category in Washington, California and Virginia alike.
- California states that its list includes, but is not limited to, the items enumerated.
- Washington says a nontraditional treatment is not by itself unprofessional conduct absent injury or unreasonable risk.
- California defines repeated negligent acts as two or more, and explains when two events count as one.
- Promotion for personal gain of an unnecessary or inefficacious treatment is an enumerated Washington ground.
- Failure to cooperate with the regulator is itself a ground, described in Washington in four specific forms.
Frequently asked questions
Is unprofessional conduct about bedside manner?
Not principally. In the three codes read here it is an enumerated statutory category. Washington's list includes advertising that is false, fraudulent or misleading, misrepresentation or fraud in any aspect of the conduct of the business, failure to cooperate with the disciplining authority, practice beyond scope, and failure to adequately supervise auxiliary staff, alongside the clinical entries. California and Virginia carry comparable business and cooperation entries in their own lists.
Does a single mistake count?
California draws the line explicitly for one of its grounds. To constitute repeated negligent acts there must be two or more negligent acts or omissions, and an initial negligent act followed by a separate and distinct departure from the standard of care constitutes repeated negligent acts. The same section states that an initial negligent diagnosis followed by an act medically appropriate for that negligent diagnosis is a single negligent act. Gross negligence and incompetence are listed separately.
Is using an unconventional treatment unprofessional conduct in Washington?
The statute addresses that directly and says not by itself. Its negligence item states that the use of a nontraditional treatment by itself shall not constitute unprofessional conduct, provided that it does not result in injury to a patient or create an unreasonable risk that a patient may be harmed. The qualifier is the operative part, and the item it sits in is about injury and risk rather than about convention.
Can promoting a product be unprofessional conduct?
Washington enumerates promotion for personal gain of any unnecessary or inefficacious drug, device, treatment, procedure, or service. It separately enumerates acceptance of more than a nominal gratuity, hospitality, or subsidy from a representative or vendor of medical or health-related products intended for patients, in contemplation of a sale or for research publishable in professional journals, where a conflict of interest is presented as defined by the disciplining authority's rules.
What happens if a licensee does not respond to the board?
It is itself a listed ground. Washington enumerates failure to cooperate with the disciplining authority and describes four forms of it, including not furnishing documents, not furnishing a full written explanation of the matter in the complaint, not responding to subpoenas whether or not the recipient is the accused, and not providing timely access for practice reviews. California enumerates failure, absent good cause, to attend a board interview within thirty calendar days of being notified.
Does discipline in one state matter in another?
Both Washington and Virginia list it. Washington enumerates suspension, revocation or restriction of a licence to practise any health care profession by competent authority in any state, federal or foreign jurisdiction, with a certified copy of the order conclusive evidence. Virginia lists restriction of a licence in another state, the District of Columbia, a possession or territory, a foreign jurisdiction, or for a federal entity, and directs its board to refuse a licence where an out-of-state licence was revoked or suspended and not reinstated.
Sources
Each document below is named as it names itself, with the date printed on that document rather than the day it was read.
- Revised Code of Washington 18.130.180, Unprofessional conduct, the enumerated grounds under the Uniform Disciplinary Act — Washington State Legislature, 2025
- Revised Code of Washington 18.130.020, definitions including standards of practice, practice review and unlicensed practice — Washington State Legislature, 2025
- California Business and Professions Code section 2234, unprofessional conduct, including the definition of repeated negligent acts — California Legislative Information, California Legislature, January 2024
- Code of Virginia section 54.1-2915, Refusal, revocation or suspension for enumerated acts of unprofessional conduct — Virginia Law, Virginia General Assembly, 2020
- Code of Virginia section 54.1-3316, Board of Pharmacy grounds for refusal, revocation, suspension and denial — Virginia Law, Virginia General Assembly, 2007