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law & ethics CH 1-3

health care practitioners those who are trained to administer medical or health care to patients
litigious prone to engage in lawsuits
reason to study law and ethics lawsuits and money - cost of care
respondent superior responsible for everyone they hire
legal statues or laws ethical, moral, etiquette, and bioethics
ethical belonging to a group
moral your own value system
etiquette good manners
defensive medicine doctors who run a huge number of unnecessary test to prevent being sued
fraud intentional or unintentional cheating of the system
abuse nonlegal issue where you are being used
liable held accountable
protocol correct behavior in certain circumstances
precedent legal cases won that are similiar to the current one trying to be won, so lawyers argue the current one should be won to
summary judgement a legal term for stating that one party is entitled to win as a matter of law
how to appeal summary judgement can only appeal to a higher court
allocation of resources deciding should money be spent, have to have 100% agreement
unethical? charging for prescriptions and not showing up for appointments
plaintiff brings the lawsuit
defendant defends against plaintiff
Dr. licensing medical practice acts reciprocity
medical practice acts state laws
reciprocity exchanges your medical license to their state without test, etc.
no license needed military, doctors doing research (MD), emergencies, and good Samaritan law
good Samaritan law protects you only as long as your doing your scope of practice (what you know)
revoking license up to a board. drug conviction, conviction of a crime, and fee-splitting
fee-splitting sending another doctor patients for a fee
practitioner national data bank has all of a doctor practicing information
ambulatory care patient on feet walking, no overnight care
Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects patient privacy and protects workers
medical practices solo, partnerships, professional corporation, HMO, and PCP
solo one doctor is an owner
partnerships associations of many, financial strength
professional corporation has a lot more perks and name ends with PC
health maintenance organization (HMO) cost effective healthcare plan that combines health care costs and delivery
Federal False Claims Act a law that allows individuals to bring civil actions on behalf of the government
checks & balances judicial, executive, legislative
civil law lawsuits
criminal law crimes against the state
administrative agencies ex: IRS
3 types of law civil, criminal, and administrative
judicial branch supreme court
executive branch president
legislative senate, house of representative
felony more then one year in jail
bench trial decided by judge
jury usually done in criminal trial
jurisdiction right and authority to hear the case
what makes a contract offer, acceptance, age/subject, consideration
types of contracts written, oral, implied, expressed
assault making threats
battery touching, hitting
fees for medical services fair for area, fair debt collection, Dr's expertise, difficulty & time taking care of you
liable accountable under law
precedent decision made by judge that become rule of law without legislation aka case law
fraud taking or attempting to take another person of their rights
most important aspect of a case not the result, but that the case represents good law
law conduct accepted as binding and enforced by controlling authority
ethic behavior standards according to one's own concept of right and wrong
moral behavior standards according to one's own concepts but formed through family, culture, and society
code of ethics a list of principles intended to govern behavior
ethical guidelines offers ways of dealing with situations to maintain behavior standards
Hippocratic oath a pledge for physicians developed by Greek physician Hippocrates around 400 BC
American Medical Association Principles a code of ethics for members written in 1847
bioethics dealing with ethical implications of biological research methods
ethics committee made up of people involved in patient's care such as doctors and family members for the purpose of reviewing ethical issues in difficult cases
etiquette good manners
protocol a code to follow correct behavior in a specific situation
courtesy the practice of good manners
compassion understanding on another's situation, feelings, and motives
common sense practical judgement
critical thinking the ability to use fewer emotions and more rational thinking
critical thinking steps identify and clarify the problem, gather information, and evaluate the evidence consider alternatives and implications choose the best course of action
unlawful acts unethical, unacceptable, and punishable by legal means
law the minimum standard necessary to keep society functioning smoothly
what is one way to lose a license conviction of a crime
how can sellers and manufactures be held legally responsible for defective medical devices and products fraud, breach of warranty, and misrepresentation of the product through untrue statements
licensure a mandatory process established by the state that grants the right to practice certain skills
certification a voluntary process for people who meet certain requirements to be seen as experts in their field, usually national
registration entry into an official record for those who meet certain requirements within a profession
accreditation official approval for conforming to a specified standard
who can be accredited healthcare facilities, managed care plans, and health care practitioner education programs
medical boards each state's medical practice acts who purpose is to protect the health, safety, and welfare of health care consumers
allopathic training doctors to intervene in the disease process, through the use of drugs and surgery
tertiary care settings care settings providing highly specialized services
endorsement process by which a license is awarded
associate practice two or more doctors share everything but practice separately
group practice three or more doctors sharing everything
managed care providing medical services for a prepaid fee
indemnity protects the insured against potential loss of money
Healthcare Integrity and protection Data bank (HIPDB) established by HIPAA for reporting adverse actions taken by health care providers and suppliers
independent practice association (IPA) a type of HMO that contracts with doctor who practice in their own offices
preferred provider organization (PPO) independent healthcare facilities who contract with insurance carrier to provide medical care at a discount rate
physician-hospital organization (PHO) healthcare plan in which doctors join with hospitals who contract with commercial carrier or HMO
primary care physician (PCP) doctor responsible for all of patients care and referring if needed to a specialist, gatekeeper
point-of-service (POS) plan allows member to seek healthcare from non-network doctor but pays more for care when given by PCP
open access members may see any in-network doctor without a referral
Health Care Quality Improvement Act of 1986 (HCQIA) established the National Practitioner Data bank
National Practitioner Data bank (NPDB) established for health care entities to view doctors information throughout their career
telemedicine remote consultation by patients with doctors through electronics
cybermedicine form of telemedicine involving direct contact between patient and doctor usually for a fee
e-health using the internet as a source of information for health and medicine
copayment a set amount that each patient pays for each office visit
Patient's Bill of Rights still has not become law
executive order regulation issued by president that becomes law without approval of Congress
constitutional law law that comes from the federal and state
case law decision made by judge that become rule of law without legislation
common law based on custom and tradition
statutory law law passed by congress or state legislatures
substantive law written law that regulate legal rights and obligations
procedural law defines the rules used to enforce substantive law
misdemeanor crime punishable by fine or prison for less then one year
prosecution the government as plaintiff in a criminal case
tort civil wrong done excluding a breach of contract
tortfeasor the person guilty of committing a tort (civil wrong)
negligence unintentional cause of harm committed with disregard for the consequences
expressed contract written or oral agreement
implied contract terms resulting from the actions of parties involved
statute of frauds state legislation governing written contracts
third party payor contract written agreement signed by party other then patient who promises to pay the bill
Fair Debt Collection Practices Act federal statute prohibiting certain unfair actions by debt collectors
implied limited contract may be created when a patient gives consent for emergency treatment to a doctor
why must a physician give the patient ample notice when withdrawing from a case doctor may be charged with abandonment
the highest law of our country the U.S. Constitution
what means of issuing a medical license is made by prior arrangement between two states? reciprocity
Created by: 1374776920