Module 9- malpractice/abuse/honesty
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| name some ethical principles that drive our approach to care? | "BANJO" Beneficience, Autonomy, NonMaleficence, Justice. (no O, just used it to make an acrynomn)
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| Define Beneficence | doing good, what’s best for our patients. Actions that we do to demonstrate care. (Beneficence=Benefits/positive things)
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| define Nonmaleficence | do NO harm (ex. don’t withhold info from our patients) (NOnmaleficence=NO)
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| 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?)
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| Define Justice | concept of culturally appropriate fairness when treating all patients. Not everyone should be treated the same, treat according to their needs
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| 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)
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| 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)
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| what is a determinant of intensity and duration of PT treatment | Pain
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| 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
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| 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.
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| 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)
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| 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.
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| 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.
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| 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
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| 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.
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| what are Common patterns 4 physical abuse bruising patterns? | • Central injuries: head, neck, chest & abdomen
• Defensive posturing- forearms
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| 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
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| 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)
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| when MUST you report abuse of an adult? | gun shot, life-threatening, or adult is considered "vulnerable" (ex. nursing home)
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| what do you need to report abuse for an adult in general ( who do not meet the "must-have" requirements)? | informed consent (in Florida)
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| 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.
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| patient Over 18, non life threatening injuries, can you report it? | no, need informed consent in FL
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| you have reasonable suspicion of child abuse, do you need to report it? | you MUST report it
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| patient is 55+ and is being abused (bad bruising but not life threatening), non vulnerable, - can u report it? | no, need consent.
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| 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
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| 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
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| 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
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| 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
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| 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"
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| 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
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| 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.)
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| 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
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| 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!
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