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In this chapter, you will be able to understand: Explain the difference between laws and ethics; identify the responsibilities of the patient and physician in a physicianpatient contract, including the components for informed consent that must be understood by the patient; Ddescribe the four Ds of negligence required to prove malpractice and explain the four Cs of malpractice prevention;...
CHAPTER Legal and Ethical Issues 5-2 Learning Outcomes 5.1 Explain the difference between laws and ethics 5.2 Identify the responsibilities of the patient and physician in a physician-patient contract, including the components for informed consent that must be understood by the patient 5.3 Describe the four Ds of negligence required to prove malpractice and explain the four Cs of malpractice prevention 5-3 Learning Outcomes 5.5 Briefly summarize the purpose of the following federal healthcare regulations: HCQIA, Federal False Claims Act, OSHA and HIPAA 5.6 Identify the six principles for preventing improper release of information from the medical office 5.7 Explain the importance of ethics in the medical office 5.8 Explain the differences among the practice management models 5-4 Introduction • Medical law is important quality of patient care • You must understand – Medical law – Ethics – Health Insurance Portability and Accountability Act (HIPAA) 5-5 Introduction (cont.) • Basic knowledge of medical law and ethics – Rights, responsibilities, and concerns – Legal and ethical issues – Impact of rising costs • Protected information 5-6 Laws and Ethics • Law – Rule of conduct or action – Formally recognized as binding – Enforced by a controlling authority • Ethics – Standard of behavior • Classification of Law – Criminal law – Civil law 5-7 Laws and Ethics (cont.) Intentional Torts • Assault • Battery • Defamation • False imprisonment • Fraud • Invasion of privacy Unintentional Torts • Negligence • Malpractice 5-8 Contracts Elements of a Contract Contractual Capacity 5-9 Contracts (cont.) • Types of contracts – Expressed contracts – clearly stated – Implied contracts – conduct of the parties indicated acceptance – Legal elements 5-10 Contracts (cont.) • Employment Contract – Description of duties – Plans for handling change in job – Compensation – Benefits – Grievance procedures – Reasons for termination – Termination procedures – Special provisions 5-51 HIPAA (cont.) • HIPAA Security Rule – A security officer – Security awareness training – Audit controls – Limit physical access – Conduct risk analyses – Establish policies and procedures 5-52 HIPAA (cont.) • HIPAA Security Rule – Chart security – Reception area security – Patient care area security – Fax security – Copier and printer security 5-53 HIPAA (cont.) • HIPAA Security Rule – Violations and penalties – Administrative simplification • Standardizing patient information • Standardized codes and formats – electronic transaction records 5-54 Apply Your Knowledge What OSHA regulations describe? ANSWER: OSHA regulations describe precautions that must be taken to protect workers from exposure to health hazards on the job While you are documenting on the computer, you are called to a patient room for an emergency What should you before leaving the computer? ANSWER: You should close the patient record and log off the computer to protect the confidentiality of patient information Confidentiality Issues and Mandatory Disclosure When in doubt, not release information It is the patient’s right to keep patient information confidential Use the same degree of confidentiality for all patients 5-55 Confidentiality Issues and Mandatory Disclosure (cont.) Be aware of all applicable laws and of the regulations If it is necessary to break confidentiality discuss situation with the patient Obtain written approval from the patient before releasing information 5-56 5-57 Apply Your Knowledge A police officer enters the physician’s office where you work and requests information about a patient May you release this information? What should you do? ANSWER: No, you should not be the person to release this information You should refer the officer to the patient’s physician, who will make the judgment based on the urgency of the situation and any danger that might be posed to the patient or others 5-58 Ethics • Principles of right and wrong vs requirements of law • Bioethics: social issues – Issues that arise due to medical advances – Hippocratic Oath – AMA: Code of Medical Ethics: Current Opinions with Annotations 5-59 Apply Your Knowledge Mr Jones would like to try a new treatment for his Parkinsonism, but his physician refuses to discuss a new treatment with Mr Jones because he morally disagrees with this type of treatment This is an example of what type of issue, and what should the physician do? ANSWER: This is an example of a bioethical issue The physician should refer the patient to another physician who specializes in this treatment Good Answer! 5-60 Legal Medical Practice Models • Five types of practice models – Sole proprietorship – Partnership – Group practice – Professional Corporation – Clinics 5-61 Apply Your Knowledge What is the difference between a group practice and a professional corporation? ANSWER: A group practice is three or more physicians who share the practice income, expenses, and facilities In a professional corporation the physicians are shareholders and employees of the corporation 5-62 In Summary 5.1 A law is a rule of conduct or action Ethics are standards of behavior or concepts of right or wrong 5.2 Physician and patient rights and responsibilities 5.3 The four Ds of malpractice and the four Cs of malpractice prevention 5-63 In Summary (cont.) 5.4 Credentialing is the approval process a healthcare provider must go through to be allowed to bill Medicare and other insurance carriers for providing medical services to patients under their insurance plans 5.5 Federal healthcare regulations: HCQIA, Federal False Claims Act, OSHA, and HIPAA 5-64 In Summary (cont.) 5.6 The six rules for preventing improper release 5.7 Ethics reflect the general principles of right and wrong A professional, particularly a medical professional, is expected to follow especially high ethical standards 5.8 There are five basic types of practice management models 5-65 End of Chapter Let no one come to you without leaving better and happier —Mother Theresa ... • Basic knowledge of medical law and ethics – Rights, responsibilities, and concerns – Legal and ethical issues – Impact of rising costs • Protected information 5- 6 Laws and Ethics • Law – Rule... patients 5- 15 Physician Rights and Responsibilities (cont.) • Medical Assistants and Liability – Know scope of practice – Understand • Standard of care • Duty of care 5- 16 Patient Rights and Responsibilities... models 5- 4 Introduction • Medical law is important quality of patient care • You must understand – Medical law – Ethics – Health Insurance Portability and Accountability Act (HIPAA) 5- 5 Introduction