An employee working in the health services office of a national nursing association receives a call from a member who reveals they may have committed Medicaid fraud with a billing error. The member hangs up and does not reveal their name, but the employee cross references the number and finds the caller’s information in the association’s member database.

The employee happens to be a credentialed member of the association, and their code of conduct or ethics requires them to file a formal complaint to their professional conduct committee when they “have direct knowledge and supporting evidence” of violations to the code.

However, their job at the association requires that the information about the member remains confidential. Is this employee in violation of their association’s code of conduct if they do not file a formal complaint?

As an associate director for an association compliance office, I have been approached with this scenario multiple times. I understand that this can be incredibly confusing for employees who find themselves torn between office protocol and their professional code of conduct.

Handling This Situation

Employees facing this situation should review their employee handbook or speak with the HR department and confirm their responsibility as an association employee. Many associations have internal policies that when a member calls with a professional concern or question, they can do so without fear of retaliation. Associations want members to feel safe should they seek assistance in a confusing or difficult situation.

According to a recent ASAE article by Mark Franco, Esq., “An enforceable code should not … unfairly diminish a professional’s ability to practice or engage in business …”

Conflicts between an association's code of conduct and employment policies can create challenging situations for employees.

In other words, associations with enforceable codes of conduct can’t reasonably require members to not break their employee policy and potentially risk their employment and the confidentiality owed to a fellow member. Additionally, according to this hypothetical situation, the member taking the call has no personal knowledge or evidence that these actions occurred.

It’s unlikely that the employee would get in trouble with their association for not filing a formal complaint in this situation. In fact, filing a formal complaint could cause significant issues within its membership as it would require individuals to submit complaints on baseless or unfounded information.

Situation With Evidence

On the other hand, let’s say the employee attends a healthcare convention and finds a flyer advertising that another employee, who is also a credentialed member of the association, is providing private healthcare services on the weekends.

The second employee’s website states that they are fully qualified to perform these services but does not have the proper credentials or training to provide them. The association’s code of conduct specifically states that members are not to misrepresent their credentials or training. When approached about the issue, the second employee becomes upset and sends threatening emails telling them not to disclose this to anyone.

Under these circumstances, the first employee would be within their right to report this to their association’s appropriate review board. The employee has direct knowledge and evidence that their professional code is being violated.

Accusations can be brought to the board’s attention in several ways, but often they come from association members who witness these events in a professional setting or have some evidence that can establish these accusations occurred. The association has the discretion to determine how it wishes to review and investigate such complaints.

Next Steps

No matter whether you need to file a formal complaint, it’s a good idea to confirm whether your association has an internal office that handles these matters, such as a professional conduct committee or ethics/compliance office. You may still have a responsibility to your employer to notify this office of any potential issues that may come up in the future. In addition, in the case of the first example involving the member, find out if you are required to make a report of this situation in a call-log databank.

It’s sometimes complicated to determine your role when you work for an association and are also one of its members. Conflicts between an association's code of conduct and employment policies can create challenging situations for employees. It is essential to navigate these dilemmas with a clear understanding of internal policies. When in doubt, it never hurts to ask, “What should I do?”