legal issues facing healthcare employees · physician is the plaintiff, the person who seeks...
TRANSCRIPT
Legal Issues facing
Healthcare Employees
Medical Therapeutics
Gibson County High School
Learning Objectives for Standard 2
Compare and contrast the specific laws and ethical issues that impact relationships among patients and the healthcare professional
Explain characteristics of advanced directives, living wills, durable power of attorney, and other legal directives governing medical treatment. Explain, using domain-specific language and accurate definitions of legal concepts, how the content of these legal documents impacts patients’ rights for all aspects of care.
At the conclusion of class today I CAN:
Identify malpractice issues in healthcare and how they affect the every day operations of healthcare
Define key terms that are used within medical law
compare and contrast advanced directives, living wills, durable power of attorney and give examples of how they are used in healthcare
Medical Malpractice Act
Statute or law regulating the practice of medicine
Safeguards patient’s safety and privacy
Responsibility of all personnel in health care
Licensure
Regulation to ensure competence
May vary from state to state
Renew and pay every 2 years
Continued education
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
Respondent Superior
“Let the master answer”
Physicians are legally responsible for their employees
Hospitals carry malpractice insurance for it’s employees
Employees should have their own malpractice insurance
Certification ensures competence
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!
Standard of Care
The minimum safe professional conduct under specific
conditions as determined by professional peer
organizations
Failure to perform is negligence
Omission: failure to use good judgment that results in
harm to the patient
Commission: performance of improper act that results in
harm to patient
Unintentional tort: negligence resulting in harm to a patient
Consent
Implied consent— patient
consents to treatment
through actions What would be an example of
implied consent?
Informed consent—
written form, signed by
patient explaining
procedure or treatment,
who will perform, risks,
and expected results When would informed consent
be necessary?
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
When might the Good Samaritan law be used?
Barriers to Informed Consent
Malpractice
Medical form of negligence proven by four criteria, the 4 “D’s”
Duty: must prove relationship existed (how?)
Dereliction of duty: Must prove standard of care was not met (Use of expert witness)
Direct cause: Damages suffered were a direct result of action in question
Damage: must prove injury occured
This patient received an overdose of an antibiotic, which
was ultimately the fault of the pharmacy – the pharmacist
and the pharmacy tech. She developed Stevens Johnson
syndrome, which, to describe it in layman’s terms, burns you
from the inside out.
This is the patient now…
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
A patient who brings a lawsuit against the
physician is the plaintiff, the person who seeks
monetary damages for the tort allegedly
committed against him or her . The plaintiff will
hire a lawyer to represent him or her in court.
The accused physician is the defendant, the
person who must defend or explain his or her
actions before the court.
Employees need to have their own insurance
and not just “be covered” under the facility’s
plan.
Intentional Torts: gross negligence, a form of negligence that involved an intentional act or failure to act that causes harm;
MALPRACTICE INSURANCE DOES NOT COVER 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
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
Civil Law
Private law
Protects the rights of individuals
Most commonly exercised type of law in ambulatory care
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
Patients who fail to comply with treatment
recommendations cannot expect the treating physician to
be responsible for the outcome of their care
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
Patient Noncompliance
Statute of Limitations
Determined by each state
Determines length of time during
which a lawsuit may be filed
Medical records
Accurate documentation
Risk Management
Medical staff and physician can best defend against
medical malpractice lawsuits by preventing lawsuits
from occurring
Accurate, complete documentation provides the
best back up
Proper documentation, presenting reasonable
expectations, and being kind and empathetic
toward patients all decrease the risk of a
malpractice lawsuit.
Confidentiality
Patient’s medical and personal
information used for treatment,
payment, and administrative operations
“Need to know”
Authorized release of information
HIPAA – confidentiality and access
Exceptions to Disclosure Rules
Court order such as
workers’ compensation
Impact on public safety
such as reporting
communicable diseases
and abuse
Harm to patient or
another individual may
result
Organ donor
Vital statistics such as
births and deaths
Reporting Abuse
Healthcare professionals are required by law
to report all suspected abuse
Procedures and forms vary from state to state
Follow office policy and procedure manual
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
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
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
What happens when someone has not appointed
a durable power of attorney?
Living Will
Document outlining type of care a patient requests in the event of severe injury
Life support, feeding tubes, medications, kidney dialysis, ventilators, organ donation, etc.
https://www.youtube.com/watch?v=1rmlGJxdpMk
Can you…?
Explain Medical Malpractice 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
What type of court are most medical malpractice lawsuits tried in?
Why?
What are the the 4 D’s? Why are they important?