Presentation is loading. Please wait.

Presentation is loading. Please wait.


Similar presentations

Presentation on theme: "MEDICAL ETHICS, LAW, AND COMPLIANCE"— Presentation transcript:


2 Medical Ethics, Law, and Compliance
Learning Objectives Define medical ethics, bioethics, and etiquette. State three functions of medical practice acts. Discuss the legal responsibilities of physicians. Describe the ways to ensure the proper transfer of information. State the purpose of a medical compliance plan and three ways the assistant can help the practice be compliant. List the safeguards against litigation. Chapter 2

3 Key Terms Abandonment Arbitration Assault Authorization Battery
Bioethics Compliance Contributory negligence Defensive medicine Deposition Ethics Etiquette Express consent Fraud Good Samaritan act Health Insurance Portability and Accountability Act (HIPAA) Implied consent Chapter 2

4 Key Terms (cont’d) Informed consent Liability Licensure Litigation
Malpractice Medical practice acts Registration Release of information Settlement Statute of limitations Subpoena Summons Chapter 2

5 Medical Ethics Ethics are the standards of conduct that grow out of one’s understanding of right and wrong Each profession usually has written policies or codes These statements of right or wrong hold members of the profession to a high degree of competency Chapter 2

6 Medical Ethics (cont’d)
Hippocratic Oath First statement governing the conduct of physicians AMA Code of Ethics requires physicians to Practice high standards of patient care Respect patients’ rights Treat patients with compassion Safeguard patient confidences Chapter 2

7 Medical Assistant’s Ethical Responsibility
AAMA Code of Ethics and Creed Based on AMA code Medical assistant acts as agent of physician Chapter 2

8 Bioethics Ethics of treatment, medical technology, and procedures
Spurred by advances in science, rapid development in technology, and new treatments Issues Abortion, moment of death, patients’ rights, genetic engineering Living will Chapter 2

9 Moral Values Concepts of what is good
Terms such as “compassion,” “honesty,” and “responsibility” Physician must put benefit of patient first Moral values are often contained within state laws Violence to children must be reported in many states Chapter 2

10 Etiquette Behavior and customs that are standards for what is considered good manners or mark the courteous treatment of others Dressing appropriately Using proper forms of address Greeting visitors cheerfully Using good telephone techniques Observing the use of polite phrases Basis for good communication Chapter 2

11 The Right to Practice States govern the practice of medicine with medical practice acts These acts Define “medical practice” Explain who must be licensed Set rules for obtaining a license State the duties imposed by the license State grounds for revocation List statutory reports to be sent to government These acts also protect users of health care services Chapter 2

12 Medical Law Licensure granted by each state Educational requirements
Examinations Reciprocity Endorsement through National Board of Medical Examiners Relicensure (annually or every other year) Continuing education requirements Chapter 2

13 Medical Law (cont’d) Certified Specialization
American Board of Specialties “Board Certified” Additional academic in-hospital training as a resident Comprehensive certification examination Chapter 2

14 Medical Law (cont’d) Narcotics Registration DEA permit
Enables physicians to write drug prescriptions DEA permit Renewed annually Chapter 2

15 The Physician’s Practice
Contractual relationship Implied or express contract Physician is legally required to Possess the skill/learning held by a reputable physician Act for the benefit of the patient Preserve confidentiality Act in good faith Perform to the best of his/her ability Advise against unwise or unnecessary treatment Advise when condition is beyond scope of his/her competency Chapter 2

16 The Physician’s Practice (cont’d)
Physician is not legally required to Accept all who seek his/her services Restore patients to condition prior to illness Obtain recovery for all patients Guarantee successful results Know all possible reactions of patients to various medicines Be free from errors in complex cases Possess the maximum amount of education Continue care after patient discharges him/herself Chapter 2

17 Patient’s Responsibilities
Give necessary information to allow for correct diagnosis Follow the physician’s instructions and treatment Generally cooperate with physician Pay for all services rendered Chapter 2

18 Consent Implied consent Express consent Not stated outright
Routine treatment only Express consent Oral or written Persons incapable of giving consent may be treated in an emergency Chapter 2

19 Consent (cont’d) Informed consent
Illness or problem has been explained in understandable language Options for treatment, along with their benefits and risks, have been explained Physician’s prognosis is clearly stated Chapter 2

20 Consent (cont’d) Competent to give consent Legal age and of sound mind
Parents give consent for children Some minors (for example, in military service or if married or divorced) may give consent in certain cases Pregnancy tests and prenatal care Diagnosis and treatment of sexually transmitted diseases Diagnosis and treatment of alcohol or drug abuse Chapter 2

21 Medical Liability Legal responsibility for actions or nonactions and their consequences Responsible for patients Responsible for Safety of employees Safety of premises Defensive medicine Chapter 2

22 Malpractice Improper care or treatment of a patient
Despite vigilance on part of physician Accidents can happen during treatment Patients can become dissatisfied with care Patient may file lawsuit to prove injury Chapter 2

23 Termination by Physician
End of the physician/patient relationship Usually due to patient’s stated intention to go to another physician, OR Patient does not follow treatment instructions Patient fails to pay for services rendered Physician must notify patient in writing Allow enough time for patient to obtain a new provider Chapter 2

24 Abandonment Opposite of termination
Physician does not continue to treat or follow up with patient Good documentation Essential to prove that the physician did not abandon the patient Chapter 2

25 Assault and Battery Assault is the clear threat of injury
Battery is bodily contact without permission Procedures done without consent Procedures beyond the scope of consent Physician acting in a grave emergency Chapter 2

26 Fraud Intentionally dishonest practice that deprives others of their rights Falsifying qualifications or licensure False statement about the benefits of a drug or treatment Filing false insurance claims Penalties vary by state License can be revoked Chapter 2

27 Litigation Bringing of lawsuits against the physician
Steps in litigation Summons is sent to person being sued (defendant) Subpoena orders all documentation relevant to case be delivered to the courts Deposition (sworn statement) is made outside of court Chapter 2

28 Response to Litigation
Accurate documentation is critical Contributory negligence by patient Documentation to show that patient refused tests, did not follow treatment, etc. Alternatives to trial Settlement between plaintiff (patient) and physician’s insurance company Arbitration by a neutral third party Statute of limitations Sets time limit for initiating a lawsuit Varies by state Chapter 2

29 Good Samaritan Act Protects physician from liability for civil damages resulting from providing emergency care Minor variations by state Chapter 2

30 Medical Communications
Final privacy rule Federal law that requires patients to give consent to share information needed to carry out treatment or to submit insurance claims Patients must also provide authorization for specific items not covered by general consent Chapter 2

31 Medical Communications (cont’d)
Release of Information Form Written form Must contain Name of facility releasing information Name of facility requesting information Patient’s name, address, and date of birth Specific dates of treatment Description of information to be released Signature of patient (or parent/guardian) Date signed Chapter 2

32 Confidentiality To help ensure confidentiality
Avoid speaking about patients’ treatments, records, finances, etc. Never leave messages, other than requests for call backs, on answering machines Keep documents from view; shred documents Keep computerized documents secure Chapter 2

33 Confidentiality (cont’d)
Exceptions Physicians must file statutory reports for Births Deaths Abuse Wounds resulting from violence Occupational illnesses Communicable diseases Food poisoning Chapter 2

34 Electronic Transmission of Information
Fax Confirm receipt of fax Do not use for confidential information Health Insurance Portability and Accountability Act (HIPAA) Regulates how electronic patient information is stored and shared Chapter 2

35 Medical Compliance Plans
Voluntary plan to reduce risk of accusations of fraud/abuse in submitting insurance claims OIG/HHS Compliance Program Guidance for Individual and Small Group Physician Practices Risk areas Coding and billing Reasonable and necessary services Documentation Improper inducements, kickbacks, self-referrals Chapter 2

36 Medical Compliance Plans (cont’d)
Aim to prevent submission of erroneous claims or unlawful conduct involving federal health care programs Seven basic elements Written policies and procedures Designation of a chief compliance officer Training and education programs Effective line of communication Auditing and monitoring Well-publicized disciplinary directives Prompt corrective action Chapter 2

37 Medical Assistant’s Role in Compliance
Central role in ensuring compliance Accurate data entry Increased accuracy of documentation Timely filing and storing of records Prompt reporting of errors or instances of fraudulent conduct Chapter 2

38 Safeguards Against Litigation
Maintain confidentiality Promote effective communication between medical assistant and physician, patient, employees Keep complete and accurate records Be safety conscious Chapter 2

39 Quiz Matching Implied consent Fraud
Malpractice Assault Bioethics Improper care or treatment of a patient. Ethics of treatment, technology, and procedures. Intentional commission of dishonest act. Permission that is not stated outright. Clear threat of injury. Chapter 2

40 Critical Thinking Explain the items covered by medical practice acts.
Each state’s medical practice acts define “medical practice,” explain who must be licensed, set rules for obtaining a license, state the duties imposed by the license, state the grounds for revocation, and list statutory reports that must be sent to governmental agencies. Chapter 2


Similar presentations

Ads by Google