1. Legal and Ethical Issues in Medical Practice, Including HIPAA3
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