A physician has the right, after forming a contract or agreeing to accept a patient under his or her care, to make reasonable limitation on the contractual relationship. The physician is under no legal obligation to treat patients who may wish to exceed those limitations. Under the patient-physician contract, both parties have certain rights and responsibilities. 2. Patient right and responsibilities Patients have the right to choose a physician; although some managed care plans may limit choices. Patients also have the right to terminate a physician’s services if they wish.
3. Patient responsibilities Patients are also part of the medical team involved in their treatment. Patients have the responsibility under an implied contract to: Follow any instructions given by the physician and cooperate as much as possible. Give all relevant information to the physician in order to reach a correct diagnosis. If a patient fails to inform a physician of any medical conditions he or she may have and an incorrect diagnosis is made, the physician is not liable. Follow the physician’s order for treatment. Pay the fees charged for services provided.
4. Informed consent Informed consent involves the patient’s right to receive all information relative to his or her condition and to make a decision regarding treatment based upon that knowledge. II. Doctrine of informed consent The doctrine of informed consent is the legal basis for informed consent and is usually outlined in a state’s medical practice acts. 5. What are the special circumstances for physician practices 6. Define malpractice claims Malpractice claims are lawsuits by a patient against a physician for errors in diagnosis or treatment.
7. Give examples of negligence Not taking care of someone or something, the result of which is harm to that person or thing. Neglect those results in abuse. Examples: – Not giving someone their medication, so they end up having a seizure – Giving someone the wrong dose of medication because of carelessness and having them accidentally overdose – Taking someone’s respirator out and forgetting to put it back – Not writing something down on a chart that a doctor needs to know when treating a patient 8. Explain the four D’s of negligence I.
Duty- Patients must show that a physician-patient relationship existed in which the physician owned the patient a duty. II. Derelict- Patients must show that the physician failed to comply with the standards of the profession. (For example, a gynecologist has routinely take Pap smears of a patient and then, for whatever reason, does not do so. If the patient then shows evidence of cervical cancer, the physician could be said to have been derelict. ) III. Direct cause- Patients must show that any damages were s direct cause of a physician’s breach of duty.
(For example, if a patient fell on the sidewalk and damaged her cast, she could not prove that the cast was damaged because it was incorrectly or poorly applied by her physician. It would be clear that the damage to the cast resulted from the fall. If, however, the patient’s leg healed incorrectly because of the way the cast had been applied, she might have a case. IV. Damages- Patients must prove that they suffered injury. 9. Differentiate subpoena from subpoena duces tecum A subpoena is a written court order addressed to a specific person, requiring that person’s presence in court on a specific date at a specific time.
Subpoena duces tecum is a court order to produce specific, requested documents required at a certain place and time to enter into court records. 10. Explain the law of agency of respondeat superior According to the law of agency, an employee is considered to be acting as a doctor’s agent (on the doctor’s behalf) while performing professional tasks. The Latin term respondeat superior, or “let the master answer,” is sometimes used to refer to this relationship. For example, the employee’s word is as binding as if it were the doctor’s (so you should never, for example, promise a patient a cure).
11. When did HIPAA became a law? What are the goals of HIPAA? On August 21, 1996, the U. S. Congress passed the Health Insurance Portability and Accountability Act (HIPAA). The primary goal of the act are to improve the portability and continuity of health-care coverage in group and individual markets; to combat waste, fraud, and abuse in health-care insurance and health-care delivery; to promote the use of medical savings account; to improve access to long-term care services and coverage; and to simplify the administration of health insurance.
12. State three purpose of HIPAA -Improve the efficiency and effectiveness of health-care delivery by creating a national framework for health privacy protection that builds on efforts by states, health systems, and individual organizations and individuals. -Protect and enhance the rights of patients by providing them access to their health information and controlling the inappropriate use or disclosure of that information.
-Improve the quality of health care by restoring trust in the health-care system among consumers, health-care professionals, and the multitude of organizations and individuals committed to the delivery of care. 13. What is HIPAA privacy rule? The HIPAA Standards for Privacy of Individually Identifiable Health Information provide the comprehensive federal protection for the privacy of health information. The privacy rule is designed to provide strong privacy protections that do not interfere with patient access to health care of the quality of health-care delivery.
14. What is the core of the HIPAA privacy rule? The core of the HIPAA Privacy Rule is the protection use, and disclosure of protected health information (PHI). Protected health information means individually identifiable health information that is transmitted or maintained by electronic or other media, such as computer storage devices. 15. What is disclosure? Disclosure occurs when the entity holding the information performs any of the following actions so that the information is outside the entity: -Releasing -Transferring -Providing access to-Divulging in any manner 16.
When using or disclosing PHI, a provider must make reasonable efforts to limit the use or disclosure to the minimum amount of PHI necessary to accomplish the intended purpose. Providing only the minimum necessary information means taking reasonable safeguard to protect an individual’s health information from incidental disclosure. State laws may impose more stringent requirements regarding the protection of patient information. 17. 18. What are the rules to keep the patients charts confidential?
* A security officer must be assigned the responsibility for the medical facility’s security * All staff, including management, receives security awareness training * Medical facilities must implement audit controls to record and examine staff who have logged into information systems that contain PHI * Organization limit physical access to medical facilities that contain electronic PHI * Organizations must conduct risks analyses to determine information security risk and vulnerabilities. * Organizations must establish policies and procedures that allow access to electronic PHI on a need to know basis. 19.
What are the civil penalties for violating HIPAA rules- Civil penalties for HIPAA privacy violations can be up to $100 for each offense, with an annual cap of $25,000 for repeated violations of the same requirement. 20. What are the criminal penalties for knowing, wrongful misuse of individual identifiable health information? * For the knowing misuse of individually identifiable health information: up to $50,000 and or one year in prison. * For misuse under false pretenses: up to $100,000 and or 5 years in prison. * For offenses to sell for profit or malicious harm: up to $250,000 and or 10 years in prison.
21. Confidentiality issues and mandatory disclosure 21. What are the six principles for preventing improper release of information from the medical office? 1. When in doubt about whether to release information, it is better not to release it. 2. It is the patient’s, not the doctor’s right to keep patients information confidential. If the patient wants to disclose the information, it is unethical for the physician not to do so. 3. All patients should be treated with the same degree of confidentiality, whatever the health-care professional’s opinion of the patient might be.
4. You should be aware of all applicable laws and of the regulations of agencies such as public health departments. 5. When it is 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. 6. Get written approval from the patient before releasing information.
For common situations, the patient should sign a standard release-of-records form. 22. Six principles are crucial for protecting patients’ confidentiality and avoiding lawsuits. They are (a) treat all patients with the same degree of confidentiality; (b) discuss situations with patients when it is necessary to break confidentiality; (c) get written approval from patients to release their information; (d) be aware of all applicable laws; (e) when in doubt, do not release information; and (f) remember that it is the patient’s right to keep information confidential, not the physician’s.
23. This act applies to businesses with 15 or more employees working at least 20 weeks of the year. The law prevents employers from discriminating in hiring or firing or firing on the basis of race, color, religion, sex, or national origin. Some states have laws that also prohibit discrimination based on marital status, parenthood, mental health, mental retardation, sexual orientation, person appearance, or political affiliation.
Title VII also address and defined sexual harassment. 24. Define Sexual Harassment Sexual harassment occurs in a variety of circumstances, and anyone may be sexually harassed. A man or a woman may be the victim or harasser, and the victim does not have to be the opposite sex. The victim may be the person being harassed or even a coworker who overhears the harassment. The victim has the responsibility to let the harasser know that the conduct is offensive.