1. From Exam Room to Courtroom
Chapter 1
From Exam Room to Courtroom

2. Personal Protection It is important to protect yourself from:
Needless litigation
Loss of reputation
Loss of personal wealth
Loss of earning power
…by understanding basic principles of the law.

3. Importance of Legal Knowledge to Medical Office Personnel
Learn to avoid lawsuits through:
Understanding the nature and scope of the problem
Knowing the basics of the law
Recognizing situations that may lead to medical malpractice actions against you or your employer

4. Importance of Legal Knowledge to Medical Office Personnel
Learn to avoid lawsuits through:
Understanding the ingredients of a medical malpractice action
Practicing preventative procedures
Recognizing when you need an attorney 4

5. Informed Employee The informed employee must be aware of:
Contractual agreement with an employer
Issues of discrimination
Sexual harassment
Union membership and collective bargaining (where applicable)
State regulations such as state medical practice acts, federal and state legislation

6. Patient Protection – License
Licensure law, enacted to protect patients’ interests by defining the education and experience required to perform certain procedures
License
Indicates the basic minimum qualifications required by the state
License requirements
Control employers by setting standards for hiring that protect the public

7. Patient Protection – Licensing Boards
Licenses are granted by licensing boards.
Licensing boards have power to revoke licenses.

8. Patient Protection – Licensing Boards
Grounds for revocation vary slightly from state to state, but may include:
Unprofessional conduct
Substance abuse, alcoholism
Fraud in connection with examination or application
Conviction of a felony
Mental incapacity
Purporting to act as another medical professional
Forgery
Theft
Use of a legitimate license without the knowledge of the owner 8

9. Patient Protection – Privacy and Respect
The requirements of privacy and respect for the confidential relationship between physician and patient must be met.
Privacy and confidentiality have ethical as well as legal bases.
Permission to touch and the right to perform certain procedures are interwoven with state medical practice acts.

10. HIPAA
HIPAA is a federal law requiring every health plan and provider to maintain “reasonable and appropriate” safeguards to ensure confidentiality of health information. 10

11. Protecting the Public Health matters that must be reported: Births
Deaths
Venereal and other communicable diseases
Injuries from violence
Child and elder abuse
Blindness
Immunological proceedings
Industrial poisoning
Requests for plastic surgery to change a person’s fingerprints

12. Physician Protection
Physicians are vicariously liable for the behavior of their employees while the employees are working within the scope of their employment.
In the employment setting, this is known as respondeat superior—“Let the master answer.”
It is sometimes difficult to decide whether an employee is acting within the scope of employment.
The test is whether the behavior serves the interest of the employer or furthers the employer’s business.

13. Duty of the Physician
Once it has been established that there is a doctor-patient relationship, the doctor has a duty to the patient to diagnose and treat the patient’s injury with due care.
Due care
Assumes that the doctor possesses the qualifications and training to provide competent medical care for the patient
Requires the doctor to provide competent office personnel

14. Procedures Manual Should be properly written and identify employee’s:
Responsibilities for duty to care for the patient
Special qualifications for job tasks
Parameters of a job description
Behavior most likely be acceptable
Standards of professionals

15. Standard of Care
The distinction between professional and lay person is very important for employees working in health care positions.
To be classified as a professional, an individual must have an independent basics of professional knowledge from which to make an independent decision.

16. Parameters of the Responsibility in the Medical Office
Medical office personnel are the link between the patient the physician.
Thus it is crucial the employees:
Develop good relations between physician and patient
Understand legal issues in practicing medicine
Understand good staff-patient relations

17. Medical Assistants, State by State
Professional status of medical assistants has grown.
Many state laws and regulations either:
Do not acknowledge the existence of the medical assisting profession or
Do not authorize the delegation of some administrative and clinical duties to medical assistants

18. Medical Assistant Standard of Care
Some physicians allow medical assistants to perform certain functions.
The delegation of responsibility is based on the premise that the MA can perform the functions as well as the physician.
The medical assistant may be held to the same standard of care as the doctor.

19. Medical Assistant Scope of Practice
A medical assistant is neither licensed nor certified to practice medicine and cannot decide the course of treatment for a patient on behalf of a physician.
There is no scope of practice law governing a medical assistant, because the medical assistant is not allowed to practice medicine in any form.

20. Mid-Level Providers Mid-level providers:
Physician’s assistant
Nurse practitioner
Advanced practice registered nurse
The precise limitations vary from state to state, but mid-level providers serve to extend the physicians’ ability to render care for patients.

21. Practicing Medicine The practice of medicine is held to mean
diagnosis,
treatment,
and/or prescription
…for the prevention or cure of any
human disease,
ailment,
injury,
deformity,
or physical or mental condition.

22. Practicing Medicine
Scope of practice is practicing medicine within statutory guidelines and accepted standards.
Each individual who practices medicine is held to professional and/or statutory guidelines and accepted standards of care.