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law & ethics CH 4-6

liable accountable under law
standard of care level of performance expected from health care professional
duty of care the legal obligations to treat patients and sometimes nonpatients
reasonable person standard responsible for our actions or failure to act rationally
how can medical personal make sure to maintain patient privacy? place records outside doors facing toward the door, don't display patient photos with any identifiable marks
confidentiality holding information, not to be released to unauthorized people
privileged communication information protected within a relationship such as a doctor and patient
when can confidentiality be waived? for employment and that party pays the doctor's fees, records are subpoenaed, and waiver has been signed by patient
Malfeasance totally wrongful act can be illegal
Misfeasance legal act done badly/poorly
Nonfeasance did not act when should have
In negligence you have to prove the 4D’s Duty, Derelict(doing something wrong), Direct cause, and Damages
JCAHO Joint Commission on Accreditation of Healthcare Organizations
Res Ipsa Loquitor “the thing speaks for itself” common knowledge
damages monetary awards sought by plaintiffs in lawsuits
wrongful death statutes patient hurt and killed by medical personal, family members can sue
Summons and complaint written notification you are being sued and list of complaints by number, pay attention to time frame if you don’t respond you automatically loose the law suit
Subpoena when patient sues and they must sign waiver for release of information it will say exactly what patient wants done with records
Depositions sworn testimony outside of the court usually in a lawyer’s office, trying to see how strong your case is and poke holes in it
interrogatory written set of questions requiring written answers from a plaintiff or defendant under oath
Subpoena duces tecum the person is required to come with the record in court
testimony statements sworn to under oath
courtroom conduct dress properly, answer only the questions you are asked as short as possible
Alternative Dispute Resolution (ADR) techniques for resolving civil disputes without going to court, stuck with decision of mediator
what is the basis for most medical malpractice claims? unintentional tort of negligence
when a patient sues a doctor for negligence, who has the burden of proof the plaintiff or the defendant? plaintiff
types of damages general compensatory, special compensatory, consequential, punitive, and nominal
general compensatory violation of patient rights and dollar value need not be proved
special compensatory losses not directly caused by the wrong and dollar loss must be proved
consequential product defect and no limit on damages if personal injury
punitive harsh punishment and amount of damages may be set by law
nominal pateint wasnt hurt much and small token awarded
denial defense that claims innocence of the charges
Doctrine of informed consent risks, what if you do nothing, other options, why treatment needed
Defenses denial, contributory, technical, affirmative (something else caused the issue)
who owns the medical records the facility, give patient only copies
who owns the information in the medical records the patient
how do you correct a patient record patient must write letter, sign and state specifically what they want fixed, doctor makes sure mistake has been made,one line through bad information, put correction above, date and your initials
what to document Cxx appointments (cancelled appointments), Missed appointments, Refills, and Treatment refusals
Statute of limitations amount of time to bring a lawsuit to court
Public health statute state laws about communicable disease patient have that you have to report to the state department
Doctrine of professional discretion allows doctor to make judgment call to not release medical record to patient, usually people who are alcoholic, drug addict, mental problems
Emancipated minor living away from home, self-supporting, married, or military
how long do you have to Retain medical records 10 years Medicare so most places do this for everything, most pediatricians keep indefinitely
To get rid of record has to be destroyed so no one can ever read it like burning or shredding
Abortion laws vary state by state
res judicata "the things has been decided" claim cannot be retried if it has already been resolved
tails-coverage option available to doctors from former carriers to continue coverage for dates claims-made was in effect
prior acts insurance coverage supplement to claims-made that can be purchased from a new carrier when doctor changes carriers
self-insurance coverage subscribers contribute to trust fund to pay for potential damage awards
the statue of limitations is the same or varies by state varies
fiduciary duty doctor's obligation to patients based on trust and confidence
precautions to follow for a fax verify the phone number of receiving location, dont fax if others in room can view the material, dont leave unattended, dont discard without shredding, use fax cover sheet that states, "confidential: to addressee only. please return if recieved in error
those who must have agent to give consent minors, mentally incompetent, and those who speak limited or no english
Created by: 1374776920