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Intro 2 PT final

Module 9- malpractice/abuse/honesty

QuestionAnswer
name some ethical principles that drive our approach to care? "BANJO" Beneficience, Autonomy, NonMaleficence, Justice. (no O, just used it to make an acrynomn)
Define Beneficence doing good, what’s best for our patients. Actions that we do to demonstrate care. (Beneficence=Benefits/positive things)
define Nonmaleficence do NO harm (ex. don’t withhold info from our patients) (NOnmaleficence=NO)
Define Autonmy (WRT our approach with our patients) degree to which an individual can decide for themselves (question to think of though- how much should we coerce?)
Define Justice concept of culturally appropriate fairness when treating all patients. Not everyone should be treated the same, treat according to their needs
what 2 aspects need to be in alignment when caring for our patients? DEMONSTRATION of care (our actions/beneficence) & MOTIVE of care (benevolent character/attitude towards what we are doing)
difference btwn malady vs. illness Malady: negative medical condition Ex. Pain, disability, injury, loss of freedom/pleasure. Illness: how malady is perceived or experienced by individual, Subjectively defined. ex) malady=ankle sprain, illness= way worse for NBA player vs. secretary)
what is a determinant of intensity and duration of PT treatment Pain
what needs to be taken into account with a patient who has a high pain tolerance? Patients who have chronic pain, have a higher threshold of pain, but accompanied by underreporting of pain. Know that pain could exist. Don’t overtreat or overpush
what needs to be taken into account with a patient who has a low pain tolerance? Pateints with low pain tolerance, undertreating can be harmful or delay condition or not be cost effective.
Explain the strategy to reduce pain and suffering: try hARD. A: Acknowledge (presence of pain/suffering) R: Respect (that the patient is experiencing it). D: Demonstrate (concern for individual: Empathy, Sympathy, Caring, Compassion)
Empathy vs. Sympathy •Empathy: cognitive understanding of what another is feeling. “vicarious” (I could be you/in ur shoes)but not necessarily w/a sympathetic response. •Sympathy: is an emotion of concern, sharing of an individual’s sorrow or suffering.
Caring vs. Compassion Caring: doing something for another's well being. Compassion is what you want to do, deep sympathy in response to suffering with the desire to relieve it.
Name some of the problems with caring too much? (6 total) Invades patient privacy, Threatens patients’ autonomy (can create dependency),Invite bias + favoritism (threaten justice principle), Create inefficiencies (create admin probs, scheduling issues,) Compromise objectivity, Carry over to personal life of PT
Total Good vs Medical Good medical good- well being measure in terms of health. total good is their overall, unified well being including health, happiness, valuable personal relationships, meaningful work, etc.
what are Common patterns 4 physical abuse bruising patterns? • Central injuries: head, neck, chest & abdomen • Defensive posturing- forearms
what are some red flags when screening for domestic violence? • Injuries inconsistent w/explanation • Injuries during pregnancy • Perpetrator will not leave the individual alone with med provider
as a health professional, when MUST you report child abuse? Knowledge of REASONABLE SUSPICION of child abuse, abandonment or neglect by parent or person responsible for child’s welfare. (your name will be kept confidential, NOT anyonmous)
when MUST you report abuse of an adult? gun shot, life-threatening, or adult is considered "vulnerable" (ex. nursing home)
what do you need to report abuse for an adult in general ( who do not meet the "must-have" requirements)? informed consent (in Florida)
What do you need to do if abuse is identified (what is your behavior and clinical actions)? behavior- show SUPPORT & CONCERN. ("you are not alone, i believe you, no one deserves to be..). Clinically: document OBJECTIVELY, describe deamanor of patient (crying, upset, calm), use quotes, photograph if possible.
patient Over 18, non life threatening injuries, can you report it? no, need informed consent in FL
you have reasonable suspicion of child abuse, do you need to report it? you MUST report it
patient is 55+ and is being abused (bad bruising but not life threatening), non vulnerable, - can u report it? no, need consent.
T/F: o Male same sex partners are more violent than female same sex partners, who are then more violent then heterosexuals toward one another. True
Define Conflict of Interest situations in which individuals have interests that signif threaten their role responsibilities or that would do so for a typical person in their role
When disecting COI: "Situation in which individuals have interests that significantly threaten their role responsibilities or that would do so for a typical person in their role" define: Interest, role responsibilities and Typical person  Interest: and all potential benefits to the PT  Role respon: well delineated duties attached to formal assignment  Typical person: not a particular individual but the ‘typical’ person
Episodic vs Systemic COI (and examples of each) Episodic: arise from choices made voluntarily (covering for a supervisor on a holiday to get a better review) Systemic: arise frm the very structure of the practice or profession (FFS reimbursement- over treat patient to get more $$, physican referral
what COI has been more problematic for PTs? Systemic COI for Physician referral/vendors. vendors push their products/gifts and physican example with "you scratch my back, if I scratch yours"
What is Quid Pro Quo getting something for something (doesn’t have to be sexual in nature) • Threats of harm or offers of benefit at the workplace • Ex. Student brings in cupcakes, get an A
Fraud vs. Abuse (in Health care) Fraud is the INTENTIONAL MISREPRESENTATION of goods/services being delivered/not delivered (billing). and Abuse is when you IMPROPERLY MISUSE something (ex- wrong info 2 insurance co/data error, they pay you too much, you keep it.)
what is whistleblowing? o Reporting problems to the appropriate authorities when you suspect something is not being performed or done according to law or protocol
what are the 2 types of WB? • Permissible: serious harm to public is at stake • Obligatory: documented evidence that would convince authority that the situation does exist. And good reason that WB will rectify the problem!
Created by: tpostrel