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law & ethics CH 1-3
| Question | Answer |
|---|---|
| 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 |
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