3 Essentials of the Legal System for Healthcare Professionals Journal Topic: What types of conduct might result in a physician’s loss of license to practice medicine.

Learning Objectives Define all key terms. List the four basic characteristics of state medical practice acts. Describe the three methods by which a state grants a license to practice medicine. Discuss conduct that may result in a physician’s loss of license to practice medicine. continued on next slide

Learning Objectives Identify the difference between licensure and certification. Discuss what the term standard of care means for the physician and what it means for someone in your profession. Describe the importance of the discovery rule as it relates to the statute of limitations. continued on next slide

Learning Objectives Discuss the importance of the phrase respondeat superior as it relates to the physician.

Medical Practice Acts Establish examining boards Provide baseline for practice of medicine Determine prerequisites for licensure Forbid practice of medicine without a license continued on next slide

Medical Practice Acts Specify conditions for renewal, suspension, and revocation of licenses Vary from state to state

Licensure of Physician Examination National Board Medical Examination (NBME) Federal Licensing Examination (FLEX) U.S. Medical Licensing Examination (USMLE) continued on next slide

Licensure of Physician Endorsement An approval or sanction Reciprocity Cooperation of one state in granting license to practice medicine to a physician already licensed in another state continued on next slide

Licensure of Physician Registration Occurs annually or biannually Physicians must pay a fee Physicians are required to complete seventy five hours of CME in a three year period

When Valid License Is Not Needed by a Physician When employed by federal medical facilities (but must be a licensed physician to practice medicine in some state) In an emergency While establishing residency When engaged solely in research

Revocation and Suspension Unprofessional conduct Falsifying records, gross immorality Commission of a crime Medicare/Medicaid fraud, rape, murder, larceny, narcotics conviction Personal incapacity Physical or mental incapacity

Licensure and Certification of Allied Health Professionals Graduate from accredited school and pass national exam of competency Certification Meet standards set by accreditation body and pass national exam of competency

Accreditation Voluntary request of official review by accrediting agency Examine policy and procedures of agency Must demonstrate that the institution maintains high standards Examples: JCAHO and CAAHEP

Standard of Care Ordinary skill and care that must be used by medical practitioners Must provide same knowledge, care, and skill that similarly trained physician and/or medical professional would provide under same circumstances Perform as "reasonable and prudent" person would perform

Physicians Are… Not obligated to treat everyone in case of emergency Expected to use reasonable, ordinary skill and care (not extraordinary) Expected to exhaust all resources available to them for patient care Not to expose patients to undue risk

Prudent Person Rule Also called the "reasonable person standard" Must provide following information to patient: Diagnosis Risk and consequences of treatment Expected benefits of treatment or procedure continued on next slide

Prudent Person Rule Must provide following information to patient: Alternative treatments Prognosis if no treatment Cost and expected pain Follow acceptable standard of care

Confidentiality Keeping private all information about patient No disclosure without written consent Medical Patient Rights Act A federal law that gives all patients right to have privacy respected and records held confidential

Statute of Limitations Period of time patient has to file lawsuit Usually one to three years Discovery Rule Begins when problem discovered or when the patient should have known of the injury

Good Samaritan Laws State laws help protect health care professionals and ordinary citizens from liability while giving care in emergency No one is required to provide aid – except in Vermont continued on next slide

Good Samaritan Laws Only required to act within limits of acquired skill and training Once you start you must continue until help arrives or you physically cannot continue

Respondeat Superior "Let the master answer" Employer liable for acts of employee within scope of employment

Employee's Duty to Carry Out Orders Duty to interpret and carry out orders Duty to clarify ambiguous or erroneous orders Duty to decline orders that appear dangerous for patient and to notify physician

Scope of Practice Must understand and work within scope of practice for discipline Must understand and practice within guidelines of profession Must understand and follow chain of command so no employee makes decision he or she is unqualified to make

Employer's Duty to Employees Responsibility to provide safe environment for employees and staff Most have liability insurance to cover accidents and unforeseen incidents May bond employees who handle money Some have liability insurance for auto if used for work-related business

Risk Management A practice used to control or minimize incidence of problem behavior that might result in injury to patients and employees and liability for physician/employer continued on next slide

Risk Management Identify risk behaviors and practices Develop and follow plan of action to eliminate problem behavior Address corrective actions in policy and procedure books and employee handbooks

Incident Report Means of documenting problem areas Should be used for all unusual occurrences, including: Falls Error in dispensing medication Needle sticks Any patient or employee complaint