Understanding Medical Law in Healthcare Practice

1. Component 1: Introduction to Health Care and Public Health in the US Unit 6: Regulating Health Care Lecture c: Medicine, Professional Liability, and Medical Malpractice

2. Objectives • Describe medical law • Discuss what is meant by standard of care • Define statute of limitations • Describe the Good Samaritan Laws Health IT Workforce Curriculum Version 1.0/Fall 2010

3. The Law and Medicine • Medical Practice Acts • Every state has a law that describes how medicine will be practiced within the state. • This Act usually establishes the medical board for the state and protects the health and safety of the public. • This board establishes the licensure standards, credentials, and sanction processes and procedures, as well as define unprofessional conduct Health IT Workforce Curriculum Version 1.0/Fall 2010

4. The Law and Medicine (continued) • Some examples as how the law relates to medicine • Tort law- (intentional) a patient can sue a physician for medical or physical injury caused by the physician or the physician’s employee • Battery (unlawful touching)- no procedure can be performed without a patient’s consent: offering an arm to a phlebotomist to allow a blood draw is implied consent. Health IT Workforce Curriculum Version 1.0/Fall 2010

5. The Law and Medicine (continued) • Fraud can be committed by a physician with fraudulent billing practices—especially Medicare and Medicaid. This would be treating a patient for one disease and billing for a more expensive disease treatment. • Unintentional tort • A patient is injured as a result of health care professional not performing at the accepted standard of care. Health IT Workforce Curriculum Version 1.0/Fall 2010

6. The Law and Medicine (continued) • Negligence- • The failure or omission to perform professional duties to the accepted standard of care or without adequate training. • Malpractice- • Professional misconduct or practicing medicine with an unreasonable lack of skill Health IT Workforce Curriculum Version 1.0/Fall 2010

7. The Law and Medicine (continued) • Standard of Care • Refers to the reasonable skill and care that medical practitioners such as physicians, nurses, physician assistants, medical assistants, and phlebotomists must use according to their licensure and certification • Scope of Practice • Scope of duties that a health care professional is allowed to perform Health IT Workforce Curriculum Version 1.0/Fall 2010

8. The Law and Medicine (continued) • 8 principles for health care professionals to live by • Beneficence- • Helping others and engaging in activities that would benefit another • Fidelity- • Loyalty and faithfulness to others. • Implies that we will do what we are supposed to do Health IT Workforce Curriculum Version 1.0/Fall 2010

9. The Law and Medicine (continued) • Sanctity of life • Hold human life sacred • Integrity • Living by one’s principles, no matter what happens • Honesty- • Truthfulness in any situation Health IT Workforce Curriculum Version 1.0/Fall 2010

10. The Law and Medicine (continued) • Empathy • To understand a person’s feelings, even though one has never experienced another’s pain or anguish • Sympathy • Feeling sorry for a person • Compassion • Gentle, caring attitude towards all Health IT Workforce Curriculum Version 1.0/Fall 2010

11. The Law and Medicine (continued) • Prudent person rule- • A health care professional must give information to a patient that a reasonable person would desire before making a decision about diagnosis, risks and consequences of treatment, expected benefits, alternative treatments, prognosis with no treatment, and costs including the amount of expect pain Health IT Workforce Curriculum Version 1.0/Fall 2010

12. Professional Liability and Medical Malpractice • Medical malpractice • Professional misconduct or demonstrating an unreasonable lack of skill resulting in injury, loss, or damage to the patient • Fraud • Intentional concealment of the facts from another person for an unlawful or unfair gain Health IT Workforce Curriculum Version 1.0/Fall 2010

13. Professional Liability and Medical Malpractice (continued) • The tort of negligence • Malficence- doing evil by performing wrong or illegal act • Misficence- improper performance of an otherwise proper or lawful act • Nonficence- failure to perform a necessary action Health IT Workforce Curriculum Version 1.0/Fall 2010

14. Professional Liability and Medical Malpractice (continued) • Negligence is based on the 4 D’s: • Duty • Dereliction of duty • Direct or proximate cause • Damages Health IT Workforce Curriculum Version 1.0/Fall 2010

15. Professional Liability and Medical Malpractice (continued) • Statute of Limitations • The period of time that a patient has to file a lawsuit • The court will not hear a case after that time limit has expired. • The clock starts running after the problem is discovered or should have been discovered. • This law varies by state Health IT Workforce Curriculum Version 1.0/Fall 2010

16. Professional Liability and Medical Malpractice (continued) • Good Samaritan laws • State laws that protect the liability of a health care professional when providing emergency care to a victim • These laws do not protect the liability of a health care professional at work. • These laws are to encourage health care professionals to help victims during emergencies Health IT Workforce Curriculum Version 1.0/Fall 2010

17. Professional Liability • Duty • Responsibilities established by the physician-patient relationship • Duty of due care • Every healthcare professional owes a duty to act as a reasonable, prudent person with average intelligence would under the same or similar circumstances Health IT Workforce Curriculum Version 1.0/Fall 2010

18. Professional Liability (continued) • A health care professional is held to the standard of care as exercised by similar health care professionals in the same or similar community or geographic region. • This standard never varies for a particular profession—physicians are compared with physicians, nurses compared with nurses, etc. Health IT Workforce Curriculum Version 1.0/Fall 2010

19. Professional Liability (continued) • Proximate cause- • There is a cause and effect relationship between the action of the health care provider and the injury to the patient Health IT Workforce Curriculum Version 1.0/Fall 2010

20. Office of the Inspector General • This office was created by the US Department of Health and Human Services to • Provide legal services to DHS • Represents the federal government in civil cases • Imposes monetary penalties on health care providers found guilty of fraud • Issues fraud alerts Health IT Workforce Curriculum Version 1.0/Fall 2010