law & ethics CH 1-3
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| health care practitioners | those who are trained to administer medical or health care to patients
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| litigious | prone to engage in lawsuits
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| reason to study law and ethics | lawsuits and money - cost of care
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| respondent superior | responsible for everyone they hire
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| legal statues or laws | ethical, moral, etiquette, and bioethics
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| ethical | belonging to a group
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| moral | your own value system
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| etiquette | good manners
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| defensive medicine | doctors who run a huge number of unnecessary test to prevent being sued
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| fraud | intentional or unintentional cheating of the system
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| abuse | nonlegal issue where you are being used
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| liable | held accountable
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| protocol | correct behavior in certain circumstances
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| 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
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| summary judgement | a legal term for stating that one party is entitled to win as a matter of law
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| how to appeal summary judgement | can only appeal to a higher court
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| allocation of resources | deciding should money be spent, have to have 100% agreement
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| unethical? | charging for prescriptions and not showing up for appointments
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| plaintiff | brings the lawsuit
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| defendant | defends against plaintiff
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| Dr. licensing | medical practice acts
reciprocity
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| medical practice acts | state laws
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| reciprocity | exchanges your medical license to their state without test, etc.
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| no license needed | military, doctors doing research (MD), emergencies, and good Samaritan law
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| good Samaritan law | protects you only as long as your doing your scope of practice (what you know)
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| revoking license | up to a board. drug conviction, conviction of a crime, and fee-splitting
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| fee-splitting | sending another doctor patients for a fee
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| practitioner national data bank | has all of a doctor practicing information
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| ambulatory care | patient on feet walking, no overnight care
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| Health Insurance Portability and Accountability Act of 1996 (HIPAA) | protects patient privacy and protects workers
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| medical practices | solo, partnerships, professional corporation, HMO, and PCP
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| solo | one doctor is an owner
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| partnerships | associations of many, financial strength
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| professional corporation | has a lot more perks and name ends with PC
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| health maintenance organization (HMO) | cost effective healthcare plan that combines health care costs and delivery
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| Federal False Claims Act | a law that allows individuals to bring civil actions on behalf of the government
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| checks & balances | judicial, executive, legislative
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| civil law | lawsuits
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| criminal law | crimes against the state
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| administrative | agencies
ex: IRS
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| 3 types of law | civil, criminal, and administrative
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| judicial branch | supreme court
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| executive branch | president
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| legislative | senate, house of representative
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| felony | more then one year in jail
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| bench trial | decided by judge
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| jury | usually done in criminal trial
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| jurisdiction | right and authority to hear the case
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| what makes a contract | offer, acceptance, age/subject, consideration
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| types of contracts | written, oral, implied, expressed
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| assault | making threats
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| battery | touching, hitting
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| fees for medical services | fair for area, fair debt collection, Dr's expertise, difficulty & time taking care of you
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| liable | accountable under law
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| precedent | decision made by judge that become rule of law without legislation aka case law
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| fraud | taking or attempting to take another person of their rights
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| most important aspect of a case | not the result, but that the case represents good law
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| law | conduct accepted as binding and enforced by controlling authority
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| ethic | behavior standards according to one's own concept of right and wrong
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| moral | behavior standards according to one's own concepts but formed through family, culture, and society
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| code of ethics | a list of principles intended to govern behavior
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| ethical guidelines | offers ways of dealing with situations to maintain behavior standards
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| Hippocratic oath | a pledge for physicians developed by Greek physician Hippocrates around 400 BC
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| American Medical Association Principles | a code of ethics for members written in 1847
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| bioethics | dealing with ethical implications of biological research methods
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| 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
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| etiquette | good manners
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| protocol | a code to follow correct behavior in a specific situation
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| courtesy | the practice of good manners
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| compassion | understanding on another's situation, feelings, and motives
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| common sense | practical judgement
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| critical thinking | the ability to use fewer emotions and more rational thinking
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| critical thinking steps | identify and clarify the problem, gather information, and evaluate the evidence
consider alternatives and implications
choose the best course of action
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| unlawful acts | unethical, unacceptable, and punishable by legal means
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| law | the minimum standard necessary to keep society functioning smoothly
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| what is one way to lose a license | conviction of a crime
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| 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
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| licensure | a mandatory process established by the state that grants the right to practice certain skills
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| certification | a voluntary process for people who meet certain requirements to be seen as experts in their field, usually national
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| registration | entry into an official record for those who meet certain requirements within a profession
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| accreditation | official approval for conforming to a specified standard
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| who can be accredited | healthcare facilities, managed care plans, and health care practitioner education programs
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| medical boards | each state's medical practice acts who purpose is to protect the health, safety, and welfare of health care consumers
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| allopathic | training doctors to intervene in the disease process, through the use of drugs and surgery
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| tertiary care settings | care settings providing highly specialized services
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| endorsement | process by which a license is awarded
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| associate practice | two or more doctors share everything but practice separately
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| group practice | three or more doctors sharing everything
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| managed care | providing medical services for a prepaid fee
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| indemnity | protects the insured against potential loss of money
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| Healthcare Integrity and protection Data bank (HIPDB) | established by HIPAA for reporting adverse actions taken by health care providers and suppliers
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| independent practice association (IPA) | a type of HMO that contracts with doctor who practice in their own offices
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| preferred provider organization (PPO) | independent healthcare facilities who contract with insurance carrier to provide medical care at a discount rate
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| physician-hospital organization (PHO) | healthcare plan in which doctors join with hospitals who contract with commercial carrier or HMO
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| primary care physician (PCP) | doctor responsible for all of patients care and referring if needed to a specialist, gatekeeper
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| point-of-service (POS) plan | allows member to seek healthcare from non-network doctor but pays more for care when given by PCP
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| open access | members may see any in-network doctor without a referral
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| Health Care Quality Improvement Act of 1986 (HCQIA) | established the National Practitioner Data bank
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| National Practitioner Data bank (NPDB) | established for health care entities to view doctors information throughout their career
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| telemedicine | remote consultation by patients with doctors through electronics
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| cybermedicine | form of telemedicine involving direct contact between patient and doctor usually for a fee
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| e-health | using the internet as a source of information for health and medicine
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| copayment | a set amount that each patient pays for each office visit
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| Patient's Bill of Rights | still has not become law
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| executive order | regulation issued by president that becomes law without approval of Congress
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| constitutional law | law that comes from the federal and state
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| case law | decision made by judge that become rule of law without legislation
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| common law | based on custom and tradition
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| statutory law | law passed by congress or state legislatures
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| substantive law | written law that regulate legal rights and obligations
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| procedural law | defines the rules used to enforce substantive law
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| misdemeanor | crime punishable by fine or prison for less then one year
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| prosecution | the government as plaintiff in a criminal case
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| tort | civil wrong done excluding a breach of contract
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| tortfeasor | the person guilty of committing a tort (civil wrong)
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| negligence | unintentional cause of harm committed with disregard for the consequences
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| expressed contract | written or oral agreement
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| implied contract | terms resulting from the actions of parties involved
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| statute of frauds | state legislation governing written contracts
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| third party payor contract | written agreement signed by party other then patient who promises to pay the bill
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| Fair Debt Collection Practices Act | federal statute prohibiting certain unfair actions by debt collectors
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| implied limited contract | may be created when a patient gives consent for emergency treatment to a doctor
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| why must a physician give the patient ample notice when withdrawing from a case | doctor may be charged with abandonment
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| the highest law of our country | the U.S. Constitution
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| what means of issuing a medical license is made by prior arrangement between two states? | reciprocity
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