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Legal Abbreviations

• HIPAA: Health Insurance Portability and Accountability Act

• URC: usual, reasonable, customary

• HITECH: Health Information for Economic and Clinical Health Act

• DNR: Do not resuscitate

• PHI: Protected healthcare Information

Legalities in the Medical Field: intro reading

• Please read pages 385-91

Legal vocab: In packets

• Use pages 385-391

Legal Vocab: Check your answersBreach Breaking the law or the terms of a contract

Confidentiality Private or secret

Informed consent An OK given to procedures and tests given by a client that acknowledges they are duly informed

Law of agency A legal doctrine according to which an employer is liable for acts performed by employees

Licensure Required for certain professions within a state

Moral Standards of behavior, based on personal value

Privileged communication Information held private within a protected relationship, such as that of a physician and client

Registration Name is listed on official record, satisfied requirements

Standard of care The level of performance expected of the health care worker in carrying out their duties

tort Civil wrong

Certification Passing an exam

Ethics Standards of behavior developed from moral values

Law A rule of conduct or actionLiable Legally responsible

Malpractice Failure of professional skill or learning that results in injury, loss, or damage

Negligence An unintentional tortReciprocity One state licensing authority will accept a person’s valid license from another

stateScope of practice On the job training activities a health care worker may carry out based on their

job description, level of training and qualifications

The 3 C’s Courtesy, compassion, common senseAdvanced directives Puts your health care wishes in writing, informing your family and MD of your

wishes if you are unable to make the decision

Confidentiality and Advanced Directives

•You only need to take notes on the purple information

HIPAA

THE PRIVACY RULE

Reviewed December 2012

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HIPAA • Health Insurance Portability and

Accountability Act

• patient’s health information is documented in a computerized format. Protecting this information has become vitally important.

• The first federal legislation (effective April 14, 2003) that attempts to protect a patient’s right to privacy, and the security and access of personal medical information and usage.

• Just read next slides

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HISTORY

• In 2000, patients that were newly diagnosed with depression received free samples of anti-depressant medications in their mail.

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HISTORY

•patients were concerned on how the pharmaceutical companies were notified of their disease.

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HISTORY•After investigation, the Physician, the Pharmaceutical company and a well known Pharmacy chain were indicted on breach of confidentiality charges.

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HISTORY•This is one example of why the Federal government needed to step in and assist in protecting patient privacy.

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Definitions• Privacy – state of being concealed; secret

• Confidentiality – containing secret information (medical record)

• Authorization – to give permission for; to grant power to

• Breach Confidentiality – to break an agreement, to violate a promise

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HIPAA• Privacy Rule

• Imposes restrictions on the use/disclosure of personal health information

• Gives patients greater protection of their medical records

• Hopefully provides patients with greater peace of mind related to the security of their information

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Protected Health Information• What is Protected Health Information (PHI)?

• When a patient gives personal health information to a healthcare provider, that becomes Protected Health Information (PHI)

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Protected Health Information• Examples of patients information

• Patients name or address

• Social Security or other ID numbers

• Doctor’s/ Nurse’s personal notes

• Billing information

ADVANCE HEALTH CARE DIRECTIVES

Resource: Margie Dino RN

WHAT IS AN ADVANCE HEALTH CARE DIRECTIVE?

An advance health care directive puts your health care

wishes in writing, informing your family and doctor of

your wishes if you become unable to make decisions or

communicate for yourself. An advance health care

directive takes the pressure off loved ones-they don’t

have to guess what you would have wanted.

An Advance Directive Has Three Parts:

• In the First Part:

• You name a person to be your agent.

• You also name an alternate in case your agent is unavailable.

• The agent legally makes decisions on your behalf in regards to health care – A Durable Power of Attorney for Health Care.

• In the Second Part:

• You can detail medical treatments you would or would not want and under what circumstances.

• Feeding tubes

• Ventilators

• What to do if your heart and breathing stop

• In the Third Part:

You can express your wishes about

organ and tissue donation

• Just read next slides

Think about it!Talk it over!

• Developing an Advance Directive involves thinking about what you would want for yourself and talking it over with those you trust.

• What would be your highest priority?

• To be pain free.

• To not be placed on a breathing machine.

• To have everything done to keep you alive as long as possible, no matter what quality of life would be.

Choosing an Agent:

• An agent must be 18 years of age and someone who knows you and who you believe will honor and respect your values and wishes even if they differ from their own. A spouse is not automatically recognized as a patient’s spokesperson in some states. The agent you appoint may be a family member, a friend, or even your attorney. It cannot be the owner or operator of a residential facility where you live or your health care provider, unless the person is related to you or is a co-worker.

• If you do not have anyone to appoint as an agent you can still complete the instructions for your care and this will provide your doctors with information to guide your care.

Exactly what does my agent do?

• Your agent will make decisions for you just like you would if you could. (It is very important that your agent and you talk about things related to your advance health care directive.)

• Your agent can choose your doctor, and where you receive your care, speak with your health care team, review your medical records and authorize its release, accept and refuse medical treatments and make arrangements for you when you die.

Making it Legal

• An advance health care directive does not need to be prepared by an

attorney, but does need to be properly signed and dated and either

notarized or witnessed by two individuals who are not the agent or the

alternate.

• Give copies to your doctor, your loved ones, and your agent.

• Keep the original in a safe place and have extra copies available for

when you need to go into the hospital or have a home care agency

involved in your care.

Extra Information• Experts recommend that an advance directive should be updated at

least every 10 years, in the event of a divorce, death of a spouse or agent, or if your agent should become incapacitated.

• Your advance directive is valid forever, unless you revoke it or state in the form a date on which you want it to expire.

• You can make up your own form but you must include your witnessed signature and a date.

• Remember an advance directive does not take the place of your own voice when you can speak and when you can’t, all options are still provided to your agent for them to make that choice for you. The advance directive and your agent are your voice as to what you would want.

Last but not least: The DNR

• DNR stands for Do Not Resuscitate.

• A pre-hospital Do-Not-Resuscitate form allows people to indicate that they do not want CPR started if something happens to them outside of the hospital. Normally, emergency medical personnel are required to start CPR for all persons; having this form protects people from CPR if they wish to forgo it.

• This form must be signed in advance by your doctor.

Your turn• The handout you will get is just one example of an

Advanced directive

• You can make up any information you want to

• Show to family/ guardians/loved ones

at some point.

Legal Outline• Using pages 385-398 & 398-400

Future FridaysHealth professions

Optometrists –

Optometrists perform eye exams to check for vision problems and diseases. They prescribe eyeglasses or contact lenses as needed.• Salary - $94,990 as of 5/10

• Duties –• Vision tests to check for problems• Check for diseases• Prescribe eyeglasses, contact

lenses, & meds• Therapy or rehab• Pre- & post- surgery care;

promote eye health.

• Educational Requirements –• undergraduate degree• Doctor of Optometry program (4 yrs)• state medical license.

• Work Environment –• Personal Office• doctors’ offices• retail stores• outpatient clinics• hospitals.

• Ophthalmologist – went to medical school and are physicians; after school they had a one-year internship and a residency of three or more years

• Duties -

• eye exams

• Medical eye care for conditions like glaucoma

• Surgical eye care for trauma like crossed eyes

• Diagnosis and treatment of eye conditions

• Plastic surgery for drooping eyelids

• http://www.youtube.com/watch?v=zpmwJMbPIvc.

Coroner/Medical Examiner

• What you do:• Also known as a forensic

pathologist• Medical doctors who perform

autopsies or other investigations to determine cause of death

• Education• Medical School plus additional

training• Bachelors degree (4 years)• Med School (4 years)• Residency (3 years)

• Where you can work:• Work indoors in labs and offices • Sometimes work outdoors at sites

where bodies are found • Often work on-call

• Pay: • 2010 median pay = $75,00.

• Ranges depending on experience and type of employment

Coroner/Medical Examiner: video

Pharmacist –

Pharmacists dispense prescription medications to patients and offer advice on their safe use.• Salary - $111,570 as of 5/10; $53/hr.

• Duties –• Fill prescriptions.• Drug interaction with other drugs• Drug instructions• Inform on side effects• Complete insurance forms• Oversee techs and interns• Keep records• Inform on medication therapies

• Educational Requirements –• undergraduate degree• Pharmacy College Admissions Test (PCAT)• Doctor of Pharmmacy program (4 yrs)• state medical license.

• Work Environment –• Pharmacies & drug stores.• Hospitals• Grocery stores• Deparment stores

• Technicians - help licensed pharmacists dispense prescription medication.

• Salary - *28,40 as of 5/10; $13..6/hr.

• Duties –• Take info needed to fill prescription.• Count tablets & measure amounts.• Mix medications like ointments.• Package & label prescriptions.• Accept payment & process insurance.• Do routine tasks like answering calls.

• Education Requirements –• High school diploma.• Exam

• http://www.youtube.com/watch?v=4pXUcxWLA7g.

Psychiatrist• What you do:

• Physicians who diagnose, treat, and help prevent disorders of the mind.

• Diagnose and treat mental illnesses through a combination of personal counseling (psychotherapy), psychoanalysis, hospitalization, and medication.

• Psychiatrists may prescribe medications to correct chemical imbalances that cause some mental illnesses.

• Education:

• Bachelors degree (4 years)

• Med School (4 years)

• Residency (3 years)

• Where you can work:

• Private offices

• Clinics

• Hospitals

• Outreach

• Pay:

• 2011 median pay = $170,250

Chiropractor -Treat patients with health problems of the musculoskeletal system, which is made up of bones, muscles, ligaments, and tendons.

• Salary - $67, 200 as of 5/10; $32/hr

• Duties –• Assess patient’s medical

condition.• Analyze patient’s posture &

spine• Provides musculoskeletal

therapy like adjustments.• Conduct diagnostic tests

like X-rays• Provide treatments like

heat pack• Advise patients on health

issues• Refer to other specialists.

• Educational Requirements –• 3 yrs of undergraduate or

bachelor’s degree• Doctor of Chiropractic

degree (4 yrs)• State medical licensure.

• Work Environment –• Solo or group practice.• Self-employed.

• http://www.youtube.com/watch?v=SSfAcp1XpeU.

Psychologist

• What you do:• Study mental processes and human

behavior by observing, interpreting, and recording how people and other animals relate to one another and the environment.

• Education:• Master’s, specialist, or doctoral

degree in psychology. • Also need a license or certification.

• Where you can work: • Independently, doing research or

working only with patients or clients• Part of a healthcare team,

collaborating with physicians, social workers, and others to treat illness and promote overall wellness.

• Those in private practice have their own offices and set their own schedules, often working evenings and weekends.

• Pay:• 2010 median income = $68,640/yr

Psychologist: video

The work of Psychologist: Video

Veterinary –Care for the health of animals.

• Salary - $82,040 as of 5/10; $39/hr.

• Duties –• Examine animals for health

problems.• Treat & dress wounds.• Perform surgery on

animals.• Test for & vaccinate.• Operate medical

equipment like X-rays.• Advise owners about

general care.• Euthanize animals.

• Educational Requirements –• Most applicate have bachelors

degree.• Doctor of Veterrinary

Medicine degree (4 yrs)• State medical licensure.

• Work Environment –• Private clinics.• Travel to farms.• Work outdoors.• Laboratory

• http://www.youtube.com/watch?v=ChFdU1Jqti4.

Massage Therapy

• What you do:• Treat clients by using touch to

manipulate the soft-tissue muscles of the body.

• Therapists relieve pain, rehabilitate injuries, reduce stress, increase relaxation, and aid in the general wellness of clients

• Education:• Vary state to state• Licensure often required• Often available through

postsecondary trade school

• Where you can work:• Spas, offices, clinics, fitness centers

• Pay:• 2010 median income = $34,900/yr

Massage Therapy: video

Laboratory Technologists –Collect samples and perform tests to analyze body fluids, tissue, and other

substances.

• Salary - $46,680 as of 5/10; $22/hr.

• Duties –• Analyze body fluids.• Collect & study blood samples for

transusions.• Operate equipment like

microscopes.• Use automated equipment &

computerized instruments for performing tests at the same time.

• Log data from tests & enter results into patient’s medical record.

• Discuss results & findings with Dr..

• Supervise or train medical laboratory technicians.

• Educational Requirements –• Bachelor’s degree in medical

laboratory technology. • Techs need associate’s degree.• State medical licensure

possibly.

• Work Environment –• Healthcare facilities.• Laboratories.

• http://www.youtube.com/watch?v=ciU3pFb2WKo

Dental Hygiene/Assistant

• What you do:• Hygiene: clean teeth, examine

patients for oral diseases such as gingivitis, and provide other preventative dental care

• Assistant: many tasks, ranging from patient care to record keeping, in a dental office

• Education:• Hygiene: Associates Degree

• Assistant: Accredited program

• Where you can work:• Hygiene: Dentist’s office

• Assistant: Dentist’s office

• Pay:• Hygiene:

• 2010 median pay = $68,250

• Assistant• 2010 median pay = $33,470

Dental Hygiene/Assistant: video

Surgical Technologists –Assist in surgical operations.

• Salary - $39,920 as of 5/10; $19/hr.

• Duties –• Prepare operating rooms

for surgery.• Sterilize equipment &

ensure adequate supplies for surgery.

• Prepare patients for surgery like disinfecting incision sites.

• Help surgeons & nurses during surgery by passing instruments.

• Educational Requirements –• High school diploma• Postsecondary certificate or

associate’s degree (~ 2yrs)

• Work Environment –• Hospitals.• Outpatient surgery centers.

• http://www.youtube.com/watch?v=2BxnyV-vxdw.

Medical Laboratory Technologist

• What you do:• Conduct complex tests to help detect,

diagnose, and treat diseases.• Blood bank technologists, or immunohematology technologists,

collect blood, classify it by type, and prepare blood and its components for transfusions.

• Clinical chemistry technologists

• Cytotechnologists examine cells for abnormalities that signal the beginning of a cancerous growth.

• Immunology technologists examine elements of the human immune system and its response to foreign bodies.

• Microbiology technologists examine and identify bacteria and other microorganisms.

• Molecular biology technologists perform complex protein and nucleic acid tests on cell samples.

• Phlebotomists collect blood samples.

• Histotechnicians cut and stain tissue specimens for pathologists

• Education:• Bachelor’s Degree (4 years)

• Where you can work:

• Health care facilities

• Laboratories

• Pay:

• 2010 Median Pay = $56,130/yr

Radiologist -A physician who reads & interprets X-rays of patients through cameras, machines, and imaging equipment

• Salary - $154,000 as of 1/13.

• Duties –• Preparing patient for image.

• Protecting patient from potential radiation danger.

• Reading/diagnosing image results.

• Work Environment –

• Hospital

• Clinic

• Different specialty areas

• Educational Requirements –

• Bachelor’s degree

• 4 yrs medical school

• 4 yrs residency training

• USMLE exam

• State medical licensure

• Certification in Radiology

• http://www.youtube.com/watch?v=9vxM8uKsmoA

Medical Doctor (M.D.)

• What you do:• Diagnose and treat injuries or

illnesses.• Examine patients, take medical

histories, prescribe medications, and order, perform, and interpret diagnostic tests.

• Education:• Bachelors degree (4 years)• Med School (4 years)• Residency (3 years)

• Where you can work:• Private offices• Clinics• Hospitals• Outreach

• Pay: • 2010 median pay = $166,400/yr

Medical Doctor (M.D.): video

Anesthesiologist

• What you do:• Physicians who administer

anesthetics prior to, during, or after surgery, or other medical procedures.

• Education:• Bachelor’s Degree (4 yrs)

• Medical School (4 yrs)

• Residency (4 years)

• Fellowship (1-2 yrs)

• Where you can work:• Hospitals

• Private offices

• Often on call

• Pay:• 2010 median wage = $187,00/yr

Anesthesiologist: video

Nurse Anesthetist

• What you do:

• Education:

• Where you can work:

• Pay: