Legal Considerations in Healthcare: Licensure, Certification, and Liability

1. Chapter 6 Legal Considerations

3. Learning Objectives Define licensure and certification as well as their purposes Define the Scope of Practice and its importance Discuss the Standard of Care for health-care professionals Describe negligence and the 4 “D’s” of malpractice

4. Learning Objectives Compare and contrast the three main business structure forms for medical offices Discuss implied consent and informed consent and when they are appropriate Compare and contrast intentional and unintentional torts Compare and contrast civil and criminal law as it applies to health care

5. Learning Objectives Explain how the Good Samaritan law protects individuals in cases where consent cannot be obtained Describe procedures used to release a noncompliant patient and how such a release can help prevent a charge of abandonment Describe the purpose of a durable power of attorney and a living will

6. Learning Objectives Describe a patient release of information and how it is obtained List the circumstances in which patient authorization to release information is not necessary Describe reporting requirements for child and elder abuse

7. Medical Malpractice Act Statute or law regulating the practice of medicine Safeguards patient’s safety and privacy Responsibility of all personnel in health care

8. Licensure Regulation to ensure competence May vary from state to state Renew and pay every 2 years Continued education

9. Revoking a License Conviction of crime such as a felony or fraud Unprofessional conduct, such as, addiction, breach of confidentiality, false advertising, unethical behavior, inability to perform duties, or fee splitting

10. Respondeat Superior “Let the master answer” Physicians are legally responsible for their employees Liability for medical assistant’s actions is the physician’s Certification for medical assistants ensures competence

11. Scope of Practice The range of services a professional can offer based on education, training, ability, and licensure For example, medical assistants are trained to assist with minor surgery…medical assistants cannot perform surgery!

12. Standard of Care The minimum safe professional conduct under specific conditions as determined by professional peer organizations Failure to perform is negligence Omission Commission Unintentional tort

13. Consent Implied consent— patient consents to treatment through actions Informed consent— written form, signed by patient explaining procedure or treatment, who will perform, risks, and expected results

14. Barriers to Informed Consent • Interpreters may be necessary if a patient is hearing impaired or speaks a different language • Good Samaritan law protects emergency personnel when a patient may not be able to speak or give consent

15. Malpractice Medical form of negligence proven by four criteria, the 4 “D’s” Duty Dereliction of duty Direct cause Damage

16. The Lawsuit Process Subpoena—legal document requiring appearance in court or for a deposition Deposition—formal gathering of information Trial—information is gathered, date is set by court, expert witnesses, jury, verdict, and settlement Malpractice insurance—mandatory in most states

17. Intentional Torts Assault—threat or perceived threat of bodily harm to another person Battery—touching inappropriately without permission Defamation—slander False imprisonment—holding a patient against his or her will Fraud—intentional misrepresentation of facts for financial gain Invasion of privacy—release of private information

18. Criminal Law Protects the safety and welfare of the public Determines what is legal and illegal The crime is considered to be against society or the state

19. Civil Law Private law Protects the rights of individuals Most commonly exercised type of law in ambulatory care

20. Patient Noncompliance Physician and patient enter into contract Physician responsible for diagnosing and treating patient, being available for patient care and communication, and arranging for different physician if absent Patient responsible for truthfully relating medical history, following treatment recommendations, and keeping appointments

21. Patient Noncompliance • Either party may end the physician–patient contract • Physician must send certified letter to patient • If physician does not follow proper procedure, abandonment may be charged

22. Statute of Limitations Determined by each state Determines length of time during which a lawsuit may be filed Medical records Accurate documentation

23. Risk Management Medical staff and physician can best defend against medical malpractice lawsuits by preventing lawsuits from occurring Accurate, complete documentation

24. Confidentiality Patient’s medical and personal information used for treatment, payment, and administrative operations “Need to know” Authorized release of information HIPAA

25. Exceptions to Disclosure Rules Court order such as workers’ compensation Impact on public safety such as reporting communicable diseases and abuse Organ donor Vital statistics such as births and deaths

26. Durable Power of Attorney Legal document that is effective when a patient is unable to speak for himself or herself or make medical decisions Patient names another to make decisions States have standard forms

27. Living Will Document outlining type of care a patient requests in the event of severe injury Life support, feeding tubes, and ventilators

28. Reporting Abuse Medical assistants are required by law to report all suspected abuse Procedures and forms vary from state to state Follow office policy and procedure manual

29. Child Abuse Neglect—child unattended, needs are not being met Emotional abuse—caregiver yells at child, fails to provide affection and attention Physical abuse—bruises, cigarette burns, and bites Sexual abuse—painful urination and unusual sexual knowledge for child’s age

30. Elder Abuse Neglect—unclean or unsafe living conditions, poor hygiene, and weight loss Physical abuse—frequent injuries, bruises, and patient’s fear of the caregiver

31. Discussion Explain Medical Practice Act and discuss what this means for physicians Identify who should have durable power of attorney and living wills in place Discuss what you would do if you suspect abuse when you are interviewing a patient

32. Credits