Clinical Medical Assisting Chapter 1: The Medical Assistant and the Healthcare Team

Objectives Discuss the history and profession of medical assisting Understand the scope of practice for the medical assistant and describe the function of the healthcare team Compare/ contrast civil and criminal law and identify the three major areas of civil law that affect the medical profession Describe the measures to take for disposal of controlled substances

Objectives (con’t) Compare/ contrast civil and criminal law and identify the three major areas of civil law that affect the medical profession Describe the measures to take for disposal of controlled substances Explain the differences between expressed and implied contracts Discuss the ethical guidelines for healthcare providers, giving at least four examples

Chapter Overview Medical assistants will be faced with many moral, ethical, and legal dilemmas throughout their career that will test not only themselves, but the patients for whom they are caring.

The History of Medical Assisting In 1934 Dr. M. Mandl, felt that there was a demand for medical assistants.

Medical Assisting in Healthcare Today Medical assistants practice in a variety of healthcare settings, although the majority of them work in outpatient practices.

The Healthcare Team The medical assistant is a member of a team of highly skilled individuals with different levels of training and education that work for the patient.

Medical Doctors Medical doctors are allopathic physicians, and are the most recognized.

Doctors of Osteopathy Doctors of osteopathy practice homeopathic medicine a conservative approach when prescribing medications to their patients.

Registered Nurses Registered nurses work in hospitals, clinics, in ambulatory settings, research, education, and home health.

Nurse Practitioners Nurse practitioners diagnose and prescribe medications to patients and focus on preventative care and prevention of disease.

Licensed Practical and Vocational Nurses Administers drugs, assess patients, and chart patients’ progress when allowed by state law.

Phlebotomist Are trained to draw blood from a vein and process the specimen by labeling it correctly and making sure it is prepared properly for the test ordered.

Pharmacist Distributes drugs and advises patients, physicians, and other healthcare professionals on dosages, interactions, and side effects of the prescribed medication.

Scope of Practice What a medical professional may and may not do based on his or her training, experience, and competency.

Medicine and Law Regulations ensure risks are kept to the minimum with employees' and patients' safety in mind.

Legal Considerations Ethical conduct is based on a person's sense of moral values.

Principles of Medical Ethics Autonomy - patient has the right to make his or her own decisions Justice - helping the patient make informed healthcare decisions Beneficence – focusing the intent on what is best for the patient Non-malfeasance - not harming the patient

Criminal and Civil Laws Laws are rules of conduct that require everyone to behave the same way or face punishment.

Criminal Law A crime made against the state or government Misdemeanor - a minor or small crime punishable either with fines or imprisonment for less than one year Felony - a more serious crime and involves punishment of fines and imprisonment for more than one year Treason - an attempt to overthrow the nation's government

Civil Law Acts against a person, a business, or the government.

Plaintiff The person who brings suit and initiates a complaint requesting damages, and who has a burden to prove the allegation brought against the defendant.

Defendant Person who is being charged with the complaint.

Administrative laws Laws and legal rules that govern the administration and regulation of both state and federal agencies.

Tort A civil wrong or a wrongful act, it can be intentional or unintentional.

Unintentional Torts Occurs when a healthcare provider injures a patient either by not using the ordinary care that another provider would given in the same circumstance or by performing or failing to perform an act that a reasonable healthcare provider would have performed.

Four Elements of a Tort Duty of care Breach of duty to perform Injury caused by the breach of duty Damages, injury, or loss suffered

Consent A person has the right to agree or refuse medical treatment as well as the services and procedures that are suggested by the physician and carried out by the physician and his or her staff.

Implied consent Presumed consent, normally in a non-written fashion, such as a patient putting his or her arm down and rolling his or her sleeve up when informed by the medical assistant that he or she needs to perform venipuncture.

Informed Consent Usually a written form signed by the patient that he/ she understands what is going to be involved in the procedure, consents to the treatment, and is advised of the risks involved, expected outcomes, alternative treatments, and the risk if no procedure is performed.

Battery Any willful or intentional touching by one person against another person's will or using an object or anything put in motion by the aggressor that causes bodily harm.

Three Elements of Battery The unauthorized touch or use of an object must happen in action with the defendant. It must include an intentional cause of harm or offensive contact by unauthorized touching or use of object. There has been unauthorized touch or harmful or offensive contact with the person

Assault An intentional act by a person who threatens bodily harm or attempts to create injury through force, strike, or harm.

Libel A false or defamatory statement in written words.

Slander A defamatory statement that is spoken in words that are intended to damage a persons’ reputation, profession, or means of living.

Contracts Exists when two parties meet in agreement and can be between two parties, an individual, or a corporation.

Four Contract Elements An agreement made in good faith and not under duress. There must be something of value for each party of the agreement - the patient pays for the physician’s services. The contract must be of legal subject matter such as the physician holds a valid medical license. There must be a contractual capacity meaning the patient must be of age and capable of understanding all terms and conditions.

Three Areas of Civil Law that Affect Medical Professionals Medical liability/negligence Confidentiality Consent

Medical Liability/Negligence Is also known as malpractice

Four D’s of Negligence Duty – a documented relationship between the physician and patient Derelict - proof that the physician did not comply Standard of Care Direct cause - damages were a direct cause of the physician's actions with a breach of duty Damages - the patient suffered an injury or loss

Confidentiality A most sacred ethical aspects of healthcare, the medical assistant must remember that the medical record is confidential and private documentation of healthcare information between the physician and the patient and should never be violated.

HIPAA Standards and Goals Health Insurance Portability and Accountability Act was introduced in the 1990s and became effective in April, 1996.

Living Wills A document that speaks for the patient when the patient cannot speak for themselves expressing their wishes regarding medical treatment and life-sustaining efforts.

Medical Power of Attorney Gives the right of making medical decisions to another person who is responsible for carrying out the patient's wishes.

Advance Directives Patients right to refuse treatment, choose their advance directives under the state law, and choose the discontinuation of life-sustaining equipment or the refuse it altogether.

Codes of Ethics and Their Impact in Medicine The physician will do his or her best for the patient, even if treating the patient isn’t in the best interest of the physician.

Ethical Guidelines for Healthcare Providers Promotes the values that are essential for good communication and enhance trust, accountability, mutual respect, and fair medical care.

Medical Emergencies in the Office Can be any circumstance in which a person becomes ill or has an injury or an episode that requires an immediate action and/or decision.

Obligations and Disease Transmission in Emergency Situations Applying basic principles of proper aseptic techniques (infection control) along with taking proper safety measures for the patient and yourself will improve the likelihood of minimizing disease transmission during emergency caregiving.

Summary Medical assistants perform both administrative and clinical duties, making them one of the most versatile health professionals in the medical field. Advanced medical assistants may seek higher degrees, work in research, teach, or perform other advanced duties such as act as practice managers while exploring different paths in their careers.