Purpose

This Code of Conduct outlines the professional standards and expectations for all specialists in the RubiconMD specialist network. By setting forth clear guidelines for communication, quality of care, and platform use, we aim to ensure a consistent, high-quality experience for our providers and patients. Adherence to this code is essential for maintaining the integrity of our platform, fostering trust among our healthcare partners, and ultimately improving patient outcomes.

Mission and Values Statement

RubiconMD's mission is to democratize medical expertise through our virtual-first specialty care solutions. Our specialists are at the heart of this mission, using their knowledge and insights to enhance patient care and outcomes. In pursuit of our mission, we believe the following value statements are essential:

• We collaborate through open communication and mutual respect, fostering a supportive environment where specialists and primary care providers can drive better patient care.
• We embrace empathy and respect for our clients and each other, ensuring specialists can authentically engage in their vital work.
• We empower our specialists with the flexibility and resources to adapt to challenges and deliver the best possible care.
• We passionately pursue our mission by supporting specialists in providing an invaluable service to underserved communities and enhancing health equity.

These values guide our actions and decisions, shaping the way we interact with each other, our providers, and the patients we ultimately serve. By upholding these principles, we create a culture of excellence, innovation, and compassion that drives us toward our goal of transforming healthcare delivery. Your commitment to this Code of Conduct not only ensures the highest standards of professional practice but also contributes to the broader vision of accessible, high-quality specialty care for all.

Communication

Importance of professionalism

As a specialist in the RubiconMD network, you play a crucial role in supporting our mission and upholding our values. Your expertise, communication, and conduct directly impact the quality of care provided to patients and the satisfaction of our providers. Maintaining the highest standards of professionalism is essential to the success of our platform and the health outcomes we strive to improve.

Being respectful, clear, and concise

Always communicate with providers in a respectful, clear, and concise manner. Use language that is easy to understand, avoiding excessive jargon or abbreviations. Remember that primary care providers using RubiconMD come from various clinical backgrounds and practice settings. Wherever possible, please tailor your communication to their level of expertise and specific patient case to provide the most relevant and helpful guidance.

Inappropriate language, tone, opinions

Refrain from using any inappropriate language, sarcastic or dismissive tone, or personal opinions not grounded in clinical evidence. Maintain a neutral, professional tone focused on providing helpful guidance. Refrain from using any language that is racist, homophobic, misogynistic, or otherwise discriminatory or offensive, both within eConsults and in communication with RubiconMD staff.

Consideration

Be mindful of RubiconMD's staff working hours and avoid contacting them outside of designated support times unless in case of a critical emergency.

Clinical value focus

Prioritize providing clinical value in your responses, directly addressing the specific questions and concerns raised by the requesting provider. If additional information is needed to provide a thorough response, please request clarification and/or provide the clinical rationale for that information.

Examples of expected conduct

• Provide thoughtful, complete responses to eConsults; avoid claiming eConsults without providing a substantive response.
• Keep responses focused on the PCP and patient; avoid personal comments about RubiconMD (e.g., "RubiconMD doesn't pay me enough for this").
• Direct feedback about the product, workflow, or platform to RubiconMD through appropriate channels, not within consult responses.
• Maintain zero tolerance for discriminatory language.
• Use snippets to improve efficiency, but ensure responses are patient-specific and appropriately edited (e.g., remove unnecessary information).
  

Quality of Care

Evidence-Based and Up-to-Date Practice

Base all clinical guidance and recommendations on the latest evidence-based practices and guidelines in your specialty. Stay current with new research and developments to ensure the accuracy and relevance of your advice. When providing recommendations that deviate from established clinical guidelines, offer clear clinical rationale to support your suggestions.

Thorough Review and Analysis

Before responding to an eConsult, meticulously review all provided patient details, history, and attachments. If essential information appears to be missing, request clarification from the requesting provider rather than making assumptions. Your responses should be comprehensive, addressing all significant aspects of the case, and should offer clear, evidence-based recommendations.

Actionable and Patient-Centered Recommendations

Provide clear, actionable recommendations to assist the primary care provider in the next steps of diagnosis, treatment, or management. Where appropriate, include specific suggestions regarding medications (including dosages and potential side effects), necessary monitoring, lifestyle modifications, or indications for referral to other specialists. Ensure that your advice is patient-centered, considering the patient's unique circumstances, preferences, and values.

Ethical and Legal Responsibility

Adhere to the highest ethical standards in all communications and recommendations. Respect patient confidentiality and autonomy, ensuring that your guidance complies with all applicable laws and regulations, including HIPAA. Be mindful of the scope of your practice and provide guidance that supports the primary care provider without overstepping legal or regulatory boundaries.

Cultural Competence and Sensitivity

Be attentive to cultural, linguistic, and socioeconomic factors that may influence patient care. Tailor your recommendations to be culturally sensitive and appropriate, acknowledging any barriers the patient or provider might face in implementing your advice. Promote health equity by considering the diverse backgrounds of patients and striving to eliminate disparities in care.

Examples of Quality Care Practices

• Disclosure: If you reference any resources or materials that you have authored, or if you have potential conflicts of interest related to your recommendations, disclose this information to maintain transparency.
• Relevance of Resources: Ensure that all resources and references provided are directly pertinent to the specific patient case or question posed by the primary care provider.
• Contextual Explanation: Offer context and detailed explanations for your recommendations, especially if they differ from standard practices or guidelines, to enhance understanding and facilitate informed decision-making.
• Follow-Up Recommendations: Include appropriate follow-up suggestions or monitoring guidelines, and indicate when it might be necessary for the primary care provider to reassess the patient or consider additional interventions.
• Clear Communication: Use clear, concise, and jargon-free language to improve comprehension and avoid misinterpretation that could adversely affect patient care.
• Consideration of Accessibility: Be proactive in considering the cost-effectiveness and accessibility of treatments or interventions, acknowledging potential financial constraints or resource limitations faced by patients.
• Support Shared Decision-Making: Encourage shared decision-making by providing options when appropriate, empowering the primary care provider to engage the patient in discussions about their care preferences and choices.
  
  

Timeliness and Availability

Response Expectations

When an eConsult is assigned to you, our expectation is that you either accept or decline the consult in a timely manner. We strive to minimize consults timing out to ensure prompt care for our patients. If you are consistently unable to accept or decline consults, please reach out to our support team to discuss pausing your assignments.

Delays and Time Off

Proactively communicate any expected delays that would require us to pause you on the platform, such as vacations or other obligations. If you feel you cannot answer consults for a certain period of time, please reach out to support to pause assignments.

Reassignment Process

If you are unable to provide a timely response to an eConsult you've already claimed, please contact our support team immediately to arrange for reassignment. Do not let the eConsult remain unanswered.

Examples of expected conduct

• Do not claim a consult by responding with a short phrase, a single character (e.g., "."), or a non-relevant question. This behavior is considered gaming the system and is not acceptable.
• Only claim an eConsult if you intend to complete it within the same day of acceptance, adhering to our standard timeframes (8 hours to accept, 3 hours to respond once accepted).
• If you realize you cannot complete a claimed consult within the expected timeframe, promptly notify our support team for reassignment.
• Maintain open communication with our team about your availability to ensure efficient assignment of consults and timely patient care.
  
  

Platform Use and Security

Proper Use

Use all RubiconMD platform features and tools only for their intended purposes, as described in your onboarding training and ongoing guidance. Do not attempt to circumvent any security measures or access information not directly related to your claimed eConsults.

• All specialists must reside and work in the United States. Accessing the RubiconMD platform from outside the United States is strictly prohibited.
• Specialists agree not to use the platform for any purpose that is unlawful or in any manner that could damage, disable, overburden, or impair the platform.

Confidentiality

Maintain strict confidentiality of all patient and provider information accessed through the platform, in compliance with HIPAA regulations and RubiconMD's privacy policies.

• Safeguard and keep confidential any login credentials provided by RubiconMD to access the platform. Do not share this access with any other persons.
• Do not take screenshots or save any patient data locally on your devices. All case information must remain securely within the RubiconMD platform.

HIPAA Compliance

As a RubiconMD specialist, you agree to uphold the following HIPAA principles (see https://www.hhs.gov/sites/default/files/privacysummary.pdf for more details):

• Safeguard protected health information (PHI)
• Follow best practices for secure data storage and transmission
• Maintain the confidentiality of all patient information shared on the platform
• Report any potential data breaches or unauthorized access immediately

Technical Issues

Promptly report any technical issues, security concerns, or potential breaches to support@rubiconmd.com.

Additional Security Measures

• Use a secure, private internet connection when accessing the RubiconMD platform. Avoid using public Wi-Fi networks for platform access.
• Ensure your device has up-to-date antivirus software and security patches.
• Log out of the RubiconMD platform when you are not actively using it, especially on shared or public devices.
• Be vigilant about phishing attempts. RubiconMD will never ask for your password via email or other unsecured channels.

Remember, maintaining the security and integrity of the RubiconMD platform is crucial for protecting patient privacy and ensuring the continued trust of our healthcare partners. Any violation of these security protocols may result in immediate action, up to and including termination of your relationship with RubiconMD.

Conflicts of Interest

Disclosure

Disclose any potential conflicts of interest, such as financial relationships with pharmaceutical companies and other ineligible companies to RubiconMD during the onboarding process and whenever new potential conflicts arise. Identifying relevant financial relationships between individuals in control of educational clinical content is integral to avoid the introduction of commercial bias into the response.

Personal Gain

Do not use the RubiconMD platform for personal gain, such as promoting your own practice or soliciting patients for in-person care. Maintain focus solely on providing unbiased, evidence-based guidance to support the requesting provider's care plan.

Objectivity

Provide clinical advice based on the best available evidence and your professional expertise, without regard to any personal interests or biases. If you feel you cannot provide objective guidance on a particular case, notify the RubiconMD Network team to discuss reassignment.

Examples of Conflicts to Avoid

• Self-promotion of products, services, articles, studies, or blogs (including those you have authored) when there are alternative options or when it is not in the best interest of the patient.
• Suggesting specific branded medications or devices without clear clinical justification, especially if you have a financial relationship with the manufacturer.
• Using the platform to recruit patients for clinical trials or research studies in which you have a personal or financial interest.
• Allowing personal relationships or affiliations to influence your clinical recommendations.
• Billing any payor, including federal or state healthcare programs, for the services provided through the platform. 
• Referring a patient to your own practice if you become aware of the patient's identity.

Ongoing Responsibility

• Regularly review and update your conflict of interest disclosures with RubiconMD.
• If you are unsure whether a potential conflict should be disclosed, err on the side of transparency and discuss it with the RubiconMD team.
• Be prepared to recuse yourself from cases where your objectivity might be reasonably questioned due to a conflict of interest.

Remember, maintaining transparency and objectivity is crucial for preserving the integrity of the RubiconMD platform and ensuring the best possible care for patients. When in doubt, always prioritize patient interests and platform integrity over personal or financial considerations.

 Social Media Policy 

As a specialist in the RubiconMD network, your conduct on social media reflects both your professional reputation and that of RubiconMD. It is important to maintain a standard of professionalism and confidentiality across all online interactions to uphold our shared values and commitment to quality care.

Always conduct yourself professionally on social media, just as you would in any other public or professional setting. Avoid sharing content that could be considered unprofessional, defamatory, harassing, or discriminatory. Be particularly mindful of patient confidentiality; never share any patient information or details obtained from the RubiconMD platform on social media—even in de-identified form. This also applies to proprietary or confidential information about RubiconMD’s operations, technology, and business strategies.

When expressing personal opinions on social media, it is important to clarify that these views are your own and do not represent RubiconMD. Avoid using RubiconMD logos, trademarks, or other branding elements on your social media profiles or posts unless you have explicit permission. Refrain from making endorsements, testimonials, or promotional content on behalf of RubiconMD without authorization.

Interactions on social media should always be respectful and culturally sensitive. Engage courteously with others and steer clear of arguments or negative exchanges that could reflect poorly on you or RubiconMD. Avoid using social media to solicit business, recruit patients, or promote personal financial interests that might conflict with your responsibilities as a RubiconMD specialist.

Compliance with all legal and ethical standards is mandatory. This includes adhering to HIPAA regulations and patient confidentiality laws—never share protected health information (PHI) on social media. Also, respect intellectual property rights and refrain from posting copyrighted materials without permission.

If you have concerns or grievances related to RubiconMD, please use internal communication channels rather than addressing them publicly on social media.

Consequences of Non-Compliance

RubiconMD takes adherence to this Code of Conduct seriously to maintain the integrity of our platform and ensure the highest quality of care for patients. Violations of this Code of Conduct may result in corrective action.

Reporting and Investigation

Any suspected violations of our Code of Conduct should be reported to the RubiconMD Network team. All reports will be promptly investigated and kept as confidential as possible while still allowing for a thorough review.

Range of Consequences

Depending on the nature and severity of the violation, consequences may include, but are not limited to:

• Informal warning
• Formal written warning
• Mandatory retraining
• Temporary suspension from the platform
• Permanent removal from the RubiconMD network

Determination of Consequences

The appropriate consequence will be determined by RubiconMD leadership, taking into account factors such as:

• Intent (accidental vs. deliberate)
• Impact on patient care or platform integrity
• Pattern of behavior (isolated incident vs. repeated violations)
• Response and willingness to correct behavior

RubiconMD reserves the right to take any action deemed necessary to address violations of this Code of Conduct, up to and including termination of the specialist's relationship with RubiconMD.

Acknowledgment and Agreement

By participating on the RubiconMD platform, you acknowledge that you have read, understand, and agree to abide by this Code of Conduct. You commit to upholding the highest standards of professionalism, quality, and integrity in your participation on the RubiconMD platform.

RubiconMD reserves the right to modify this Code of Conduct at any time. Specialists will be notified of any changes and are responsible for reviewing and adhering to the most current version of the Code of Conduct.