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Legal and Ethical Issues in Medical Practice, Including HIPAA

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1 Legal and Ethical Issues in Medical Practice, Including HIPAA
3 Legal and Ethical Issues in Medical Practice, Including HIPAA

2 Introduction Reasons to study medical law and ethics
Function at the highest professional level Avoid legal problems Learning Outcome: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

3 Medical Law and Ethics Knowledge of medical law and ethics provides insight into The rights, responsibilities, and concerns of health-care consumers The legal and ethical issues facing society, patients, and health-care professionals as the world changes The impact of rising costs on the laws and ethics of health-care delivery Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. Patient legal concerns Who uses information collected about them How information is used Health-care options New medical technologies introduce sensitive issues Reproductive rights Fetal stem cell research Confidentiality Rising costs raise questions about Access to health care Allocation of medical treatment

4 Medical Law and Ethics (cont.)
A law is a rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority. Ethics is a standard of behavior and a concept of right or wrong. Moral values serve as the basis for ethical conduct. Family, culture, and society help form an individual’s moral values. Learning Outcome: 3.1 Define ethics, bioethics, and medical law. Ethics: Concept of right or wrong that goes beyond the legal considerations in any given situation.

5 Medical Law and Ethics (cont.)
Criminal law Crime against the state Criminal acts are Felonies or Misdemeanors Examples include: Murder Arson Sexual assault Burglary Civil law Crimes against the person Includes a general category of laws known as torts Torts are either: Intentional (willful) or Unintentional (accidental) Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. Crime: Any offense committed or omitted in violation of a public law. Felony: A crime punishable by death or by imprisonment in a state or federal prison for more than one year. Misdemeanor: A crime punishable by fines or imprisonment in a facility other than a prison for 1 year or less; less serious than a felony Tort: A civil wrong committed against a person or property that causes physical injury or damage to someone’s property or that deprives someone of his or her personal freedom.

6 Defamation of character
Intentional Torts Open threat of bodily harm An action that causes bodily harm to another, including touching without permission Assault Battery Invasion of privacy Depriving or attempting to deprive a person of his or her rights Fraud Interference with a person’s right to be left alone Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. False imprisonment Defamation of character Damaging a person’s reputation by making false and malicious public statements Intentional, unlawful restraint or confinement of a person

7 Unintentional Torts Acts that are committed with no intent to cause harm but done with a disregard for the consequences The term negligence is used to describe such actions when health-care practitioners fail to exercise ordinary care, resulting in patient injury Malpractice is the negligent delivery of professional services Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

8 Contracts A contract is a voluntary agreement between two parties in which specific promises are made for a consideration. Elements of a Contract Agreement Contractual Capacity Legal Subject Matter Consideration Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law.

9 Types of Contracts Expressed contracts Implied contracts
Clearly stated in written or spoken words An example is a payment contract Implied contracts Actions or conduct of the parties, rather than words, create the contract An example is a patient rolling up his or her sleeve to receive an injection Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. Legal elements of an employment contract Agreement between two or more people to do something legal Names and addresses of people involved Consideration Starting date, ending date, and date contract is signed Signature of employer and employee Elements of a medical assistant employment contract Description of employer duties and employee duties Plans for handling major changes in job responsibilities Compensation Benefits Grievance procedures Conditions under which contract may be terminated Termination procedures Any special provisions, such as job sharing or liability coverage

10 Apply Your Knowledge Good Answer!
What is the difference between law and ethics? ANSWER: A law is a rule of conduct or action and is enacted by governments to maintain order and public safety. Ethics is a standard of behavior based on moral values that are influenced by family, culture, and society. Good Answer!

11 Physician/Patient Contract
Reasonable limitations Both parties have rights and responsibilities related to the contract Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law.

12 Physician Rights Set up a practice within the boundaries of his or her license to practice medicine Select where to set up an office and establish office hours Specialize Decide which services to provide and how those services will be provided Physicians do not have to Treat every patient Return patient to original state of health Make a correct diagnosis in every case Guarantee success of treatment or operation Leaning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

13 Physician Responsibilities
Use due care, skill, judgment, and diligence Keep knowledge up-to-date Perform to the best of his or her ability Furnish complete information and instructions to the patient Leaning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. Medical assistant liability Medical assistants have general liability in duties they perform Held to “reasonable person standard” Must understand standard of care and duty of care to function ethically and legally within job scope

14 Patient Rights/Responsibilities
Patient responsibilities Follow physician’s instructions and cooperate with care Provide relevant information to the physician Follow the physician’s orders for treatment Pay the fees charged for services provided Patients May choose their physician May terminate a physician’s services The Patient Care Partnership A list of standards that patients can expect in health care Formerly the Patient’s Bill of Rights Leaning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

15 Patient-Physician Contract (cont.)
Liability Legal responsibility for actions Understand scope of practice Understand standard of care and duty of care Medical assistants are all held to the “reasonable person standard” Consent Implied – actions imply permission Informed Patient receives all information necessary to make a decision regarding treatment Doctrine of informed consent – legal basis for informed consent Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. Consent: Patient’s expressed or implied permission to the physician to perform an examination, tests, or treatments

16 Special Circumstances – Closing of a Practice
Comply with HIPAA Notify patients in writing Give option of choosing another physician or make referral Secure or dispose of records appropriately Remain up-to-date on HIPAA laws Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. 3.8 Discuss the impact that HIPAA regulations have in the medical office.

17 Apply Your Knowledge Good Job!
Patients have rights and responsibilities relating to health care. The rights are determined by the Patient Care Partnership. What are the patient’s responsibilities? ANSWER: Patient responsibilities are: Follow physician’s instructions and cooperate with plan of care Provide relevant information to the physician Follow the physician’s orders for treatment Pay the fees charged for services provided Good Job!

18 Preventing Lawsuits Lawsuits Prevention Add to cost of health care
Take a psychological toll on all involved Prevention Use of reasonable care to prevent professional liability Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. Health-care practitioners who use reasonable care to prevent professional liability claims are least likely to face malpractice claims.

19 Malpractice Malpractice claims are lawsuits by a patient against a physician for errors in diagnosis or treatment Examples: post-operative complications, Res ipsa loquitur (the thing speaks for itself) Negligence cases are those in which a person believes a medical professional’s actions, or lack thereof, caused harm to the patient Examples: abandonment, delayed treatment Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. Abandonment: Health-care professional stopping care without providing an equally qualified substitute.

20 Malpractice (cont.) Legal terms used to classify negligence
Malfeasance - unlawful act or misconduct Misfeasance - lawful act done incorrectly Nonfeasance - failure to perform an act that is one’s required duty or that is required by law Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law.

21 D The 4 Ds of Negligence uty erelict irect Cause amages
Patients must show that a physician-patient relationship existed. erelict Patients must show that the physician failed to comply with the standards of the profession. irect Cause Patients must show that any damages were a direct cause of a physician’s breach of duty. Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. amages Patients must prove that they suffered injury. Patients must be able to prove all 4 Ds in order to move forward with a malpractice suit.

22 Malpractice (cont.) Civil law Settling malpractice suits
Concerned with an individual’s private rights Torts Negligence Breach of contract Failure to adhere to a contract’s terms Settling malpractice suits Arbitration People with special knowledge in the field listen to the case and decide the dispute Court Written court orders (subpoena) are delivered to involved parties. Subpoena duces tecum is a court order to produce documents such as patient records Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law.

23 Malpractice (cont.) Law of Agency
Employees are considered to be agents of the physician while performing professional tasks Physicians are responsible or liable for the negligence of employees Respondeat superior is a Latin term meaning “Let the master answer” Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. Employee negligence Even though the physician is liable for employee negligence, negligent employees can be sued directly by the patient, the employer, or the employer’s insurance company. Some medical assistants choose to obtain malpractice insurance. AAMA offers malpractice insurance from various insurance companies at reduced rates. Employees are also legally responsible for their own actions, and they can be sued directly.

24 Courtroom Conduct Attend court proceedings as required and do not be late for scheduled hearings Bring required documents to court and present them when requested to Refresh your memory before testifying Speak slowly, clearly, and professionally Answer all questions in a straightforward manner Answer only the question asked Appear well groomed, and dress in clean, conservative clothing Learning Outcome: 3.3 Discuss medical documentation and how it applies to medical law. Failure to appear in court could result in Charges of contempt of court Forfeiting the case Answer professionally Do not lose your temper Do not try to be humorous

25 Malpractice (cont.) Reasons patients sue
Unrealistic expectations Poor rapport and poor communication Greed and our litigious society Poor quality of care Professional Liability Coverage – protects the physician and staff against financial losses from lawsuits filed against them Learning Outcome: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. Poor rapport/communication Not returning phone calls Seeming inaccessible to patient or family Poor quality of care Can be either real or perceived Lawsuit can result from either one

26 Malpractice (cont.) Statute of limitations
Laws that set the deadline or maximum period of time within which a lawsuit or claim may be filed Deadlines vary Type of case State vs. federal court Learning Outcome: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

27 The 4 Cs of Malpractice Prevention
aring Sincere caring decreases the likelihood that a patient will sue if outcomes are unsatisfactory or adverse events occur. C ommunication Develop trust and respect with patients by communicating professionally and confirming that you have been understood. ompetence Maintain competence and update knowledge and skills frequently. Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. Medical assistants can help ensure effective communication by: Developing good listening and nonverbal communication skills Setting aside a certain time each day to return patient phone calls Avoiding statements that could be construed as admitting fault Using tact, good judgment, and professional ability Reaching an understanding about fees before treatment harting Documentation is proof of competence. Chart every conversation and interaction you have with a patient.

28 Terminating Care of a Patient
Reasons for terminating care of a patient Refusal to follow physician instructions Patient family member complaints Personality conflicts Failure to pay for services rendered Repeated failure to keep appointments When withdrawing from care, a physician must Provide written notification Reasons for withdrawing Recommend that the patient find another physician Send by certified mail with return receipt requested Document in the patient record reasons for terminating care and actions taken to inform the patient Learning Outcome: 3.3 Discuss medical documentation and how it applies to medical law. Be sure to place a copy of the certified termination letter and the return receipt in the patient’s file.

29 Standard of Care Apply legal concepts to practice by
Maintaining confidentiality Practicing within the scope of training and capabilities Preparing and maintaining medical records Documenting accurately Using proper guidelines when releasing information Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality.

30 Standard of Care (cont.)
Apply legal concepts to practice by Following legal guidelines and maintaining awareness of health-care legislation and regulations Maintaining and disposing of regulated substances appropriately Following risk-management and safety procedures Recognizing professional credentialing criteria Learning Outcomes: 3.4 Discuss the various types of health-care legislation. 3.5 Describe OSHA requirements for a medical office. 3.6 Describe procedures for handling an incident of exposure to hazardous materials.

31 Administrative Duties and the Law
Duties related to legal requirements Insurance billing Patient consent forms Documentation in the medical record Making appointments Appointment books are a legal document State reporting requirements Births Abuse Certain diseases Injuries from violent acts Deaths Phone calls Maintain privacy Learning Outcomes: 3.3 Discuss medical documentation and how it applies to medical law. 3.4 Discuss the various types of health-care legislation.

32 Documentation Clear and complete Medical records Referrals
Missed appointments Dismissals Patient contact Medical record correction Medical records Property of facility or physician Doctrine of Professional Discretion Retention and storage Based on state law Learning Outcomes: 3.3 Discuss medical documentation and how it applies to medical law. 3.4 Discuss the various types of health-care legislation. Complete documentation “If it is not written down, then it was not done.” Pay attention to detail Use medical dictionary if necessary Missed appointments Document both in patient charts and in appointment book/computer Treating physician should review records and note whether follow-up is indicated

33 Controlled Substances and the Law
Be familiar with correct dosages, potential complications, and refill rules. Medical assistants must follow the correct procedure for keeping and disposing of controlled substances. Learning Outcomes: 3.3 Discuss medical documentation and how it applies to medical law. 3.4 Discuss the various types of health-care legislation. For questions about disposal of controlled substances, call the U.S. Department of Drug Enforcement or go to their website.

34 Legal Documents and the Patient
States the types of treatment the patient does and does not want in an event of terminal illness, unconsciousness, or comatose state. Patients with living wills are asked to name someone that will make decisions on their behalf (durable power of attorney) if they are unable to do so. Living Will (Advance Directive) Learning Outcomes: 3.3 Discuss medical documentation and how it applies to medical law. 3.4 Discuss the various types of health-care legislation. Two components of living wills Advance directive—states what type of treatment the patient wishes or does not wish to receive if terminally ill, unconscious, or permanently comatose Durable power of attorney—someone named to make medical care decisions on the patient’s behalf if the patient is unable to do so Contact your state’s Public Health Department website for additional information about living wills and the uniform donor card. Uniform Donor Card A legal document that states a person’s wish to donate one or more organs or whole body.

35 Confidentiality Issues
Legal obligation to maintain confidentiality of patient information Discuss with patient privately Share patient information only when appropriate Do not discuss the case with anyone outside the medical office Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality. Confidential

36 Federal Legislation Affecting Health Care
Health Care Quality Improvement Act (1986) Purpose: Improve the quality of medical care nationwide National Practitioner Data Bank Federal False Claims Act Qui tam To bring action for the king and one’s self Control three types of illegal conduct False billing claims Kickbacks Self-referrals Learning Outcome: 3.4 Discuss the various types of health-care legislation. Health Care Quality Improvement Act (HCQIA) Requires professional peer review in certain cases Limits damages to professional reviewers Protects those who provide information to professional review bodies from liability Federal False Claims Act False billing claims—billing for services not performed Kickbacks—financial incentives for referring patients or recommending services or products Self-referrals—referring patients to any service or facility in which the health-care provider has financial interests

37 OSHA Regulations The Occupational Safety and Health Administration (OSHA) is a division of the U.S. Department of Labor Regulations describe precautions that must be taken to protect workers from exposure to health hazards on the job, including exposure to infectious diseases such as Human immunodeficiency virus (HIV) AIDS Hepatitis B virus (HBV) Learning Outcomes: 3.5 Describe OSHA requirements for a medical office. 3.6 Describe procedures for handling an incident of exposure to hazardous materials. OSHA Blood-borne Pathogens Protection Standard of 1991—regulations for controlling workers’ exposure to infectious disease Standard Precautions—developed by the CDC to prevent medical professionals from exposing themselves and others to blood-borne pathogens

38 Exposure Plan Personal protective equipment or gear
Immunizations against hepatitis B virus (HBV) Information on what to do in case of exposure Information on decontamination of waste products Information on how to dispose of sharp equipment (needles, etc.) Information on post-exposure evaluation and follow-up Learning Outcomes: 3.5 Describe OSHA requirements for a medical office. 3.6 Describe procedures for handling an incident of exposure to hazardous materials.

39 Exposure Plan (cont.) Information on how to keep an inventory of hazardous materials Labeling for bio-hazardous wastes Training, annual updates regarding hazardous materials and infectious substances Recordkeeping and documentation to protect the legal rights and safety of employees Learning Outcomes: 3.3 Discuss medical documentation and how it applies to medical law. 3.5 Describe OSHA requirements for a medical office. 3.6 Describe procedures for handling an incident of exposure to hazardous materials.

40 HIPAA Health Insurance Portability and Accountability Act (1996)
Improve efficiency and effectiveness of health-care delivery Protect and enhance the rights of patients Access to health-care information Control inappropriate use or disclosure Improve the quality of health care by restoring trust in the health-care system Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality.

41 Title I: Health Care Portability
Increases workers’ ability to get health-care coverage when starting a new job Reduces workers’ probability of losing existing health-care coverage Helps workers maintain continuous health-care coverage when changing jobs Helps workers purchase health insurance on their own if they lose coverage under an employer’s group plan and have no other health-care coverage available Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality. Specific protections included in Title I: Limits the use of exclusions for preexisting conditions. Prohibits group plans from discriminating by denying coverage or charging extra for coverage based on an individual’s or a family member’s past or present poor health. Guarantees certain small employers, as well as certain individuals who lose job-related coverage, the right to purchase health insurance. Guarantees, in most cases, that employers or individuals who purchase health insurance can renew the coverage regardless of any health conditions of individuals covered under the insurance policy.

42 Title II: Prevention of Health Care Fraud and Abuse, Administrative Simplification and Medical Liability Reform HIPAA privacy rules Give patients more control over their health information Set boundaries on the use and release of health-care records Establish appropriate safeguards to protect the privacy of health information Hold violators accountable if they violate patients’ privacy rights Strike a balance when public responsibility supports disclosure of some forms of data Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality.

43 HIPAA (cont.) Privacy Rule – protected health information (PHI)
Use – movement within an organization Disclosure – transmitted between or among organizations Managing and storing Sharing Notice of Privacy Practices (NPP) Protection – security measures HIPAA Security Rule Computer networks The Internet Disks, other storage media, and extranets Chart Reception area and clinical stations Fax, copier, and printer Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality. Use—sharing, employing, applying, utilizing, examining, analyzing Disclosure—releasing, transferring, providing access to, divulging in any manner Sharing patient information Allowed under HIPAA for treatment, payment, and operations (TPO) Most other uses require authorization Patient notification Communication of patient rights (through NPP) Explanation of medical facility’s policy on obtaining authorization for use and disclosure of patient information for uses other than TPO

44 HIPAA (cont.) Violations and penalties Administrative simplification
Civil Criminal – for the knowing, wrongful misuse of health information Administrative simplification Standardizing patient information Standardized codes and formats – electronic transaction records Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality. Civil penalties Up to $100 for each offense Cap of $25,000 for repeated violations of the same requirement Criminal penalties Up to $50,000 and/or 1 year in prison for knowing, wrongful use of individually identifiable health information Up to $100,000 and/or 5 years in prison for misuse under false pretenses Up to $250,000 and/or 10 years in prison for offenses to sell for profit or malicious harm

45 Confidentiality Issues and Mandatory Disclosure
Principles for preventing improper release of information When in doubt, do not release information It is the patient’s right to keep patient information confidential or disclose it All patients should be treated with the same degree of confidentiality Be aware of all applicable laws and of the regulations Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality.

46 Confidentiality Issues and Mandatory Disclosure (cont.)
Principles for preventing improper release of information When necessary to break confidentiality and when there is a conflict between ethics and confidentiality: Discuss it with the patient If the law does not dictate what to do in the situation, the attending physician should make the judgment based on the urgency of the situation and any danger that might be posed to the patient or others Get written approval from the patient before releasing information Learning Outcomes: 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality.

47 Code of Ethics Principles of right and wrong
Laws are often based on ethical considerations Medical professionals are expected to act ethically Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

48 Code of Ethics (cont.) Bioethics
Pertains to issues that arise due to medical advances Principles of medical ethics have developed over time dating back to Hippocrates AMA: defines ethical behavior for physicians Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities Replaced the Patient’s Bill of Rights Learning Outcomes: 3.1 Define ethics, bioethics, and medical law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims.

49 Legal Contract Elements
An agreement between two or more competent people to do something legal Names and addresses of the people involved Consideration (whatever is given in exchange, such as money, work, or property) Starting and ending dates, as well as date(s) the contract was signed Signature of the employer and employee Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Discuss medical documentation and how it applies to medical law. A contract must have all of these elements to be binding.

50 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!

51 Labor and Employment Laws
Title VII of the Civil Rights Act of 1964 Law prevents employers from discriminating in hiring or firing on the basis of race, color, religion, sex, or national origin Age Discrimination in Employment Act (ADEA) of 1967 Prohibits discrimination in hiring or firing based on age for persons aged 40 or older Sexual harassment The victim has the responsibility to let the harasser know that the conduct is offensive The victim should also report any instance of sexual harassment to a supervisor or the personnel department Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.4 Discuss the various types of health-care legislation.

52 Labor and Employment Laws (cont.)
1976 Pregnancy Discrimination Act Makes it illegal to fire an employee based on pregnancy, childbirth, or related medical conditions Civil Rights Act of 1991 Provides monetary damages in cases of intentional employment discrimination Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.4 Discuss the various types of health-care legislation.

53 Labor and Employment Laws (cont.)
Titles I and V of the Americans with Disabilities Act of 1990 Ban discrimination against disabled persons in the workplace Mandate equal access for the disabled to certain public facilities Require all commercial firms to make existing facilities and grounds more accessible to the disabled Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.4 Discuss the various types of health-care legislation.

54 Labor and Employment Laws (cont.)
1938 Fair Labor Standards Act Prohibits child labor and firing employees for exercising their rights under the act’s wage and hour standards Provides for overtime pay and a minimum wage Equal Pay Act of 1963 Requires equal pay for men and women doing equal work Family Leave Act of 1991 Allows employees to take unpaid leave time for maternity, for adoption, or for caring for ill family members Learning Outcomes: 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.4 Discuss the various types of health-care legislation.

55 Apply Your Knowledge Good Job!
What are your responsibilities if you feel you have been a victim of sexual harassment? ANSWER: The victim has the responsibility to let the harasser know that the conduct is offensive and should also report any instance of sexual harassment to a supervisor or the personnel department. Good Job!

56 Legal Medical Practice Models
Be aware of laws governing the practice model of your place of employment Five types of practice models Sole proprietorship Single physician Partnership Two or more physicians practice together Contract specifies rights, obligations, and responsibilities Learning Outcomes: 3.4 Discuss the various types of health-care legislation. 3.10 Describe the different practice management models.

57 Legal Medical Practice Models (cont.)
Group practice Three or more licensed physicians Physicians share the collective income, expenses, facilities, equipment, records, and personnel for the practice Professional corporation Corporation is a body formed and authorized by law to act as a single entity Physicians who form corporations are shareholders and employees of the organization Incorporators and owners have limited liability in case lawsuits are filed Learning Outcome: 3.10 Describe the different practice management models.

58 Legal Medical Practice Models (cont.)
Clinics Broad in their range of specialties and sub-specialties Locations In hospital Freestanding – urgent care In-store Learning Outcome: 3.10 Describe the different practice management models.

59 Apply Your Knowledge Right!
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. Right!

60 End of Chapter 3 Let no one come to you without leaving better and happier. —Mother Theresa


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