Term Paper on "Legal Aspects of Health Care"

Term Paper 5 pages (1908 words) Sources: 6 Style: APA

[EXCERPT] . . . .

Legal Aspects of Healthcare

In this 650-bed hospital we have a well-functioning staff that serves a region in the northeast section of the state. We provide a surgery department which includes same-day surgery and recovery, an emergency room with a 24/7 trauma unit and special procedures rooms, a heliport for safe and rapid transport of patients to and from distant locations, a state-of-the-art diagnostic imaging unit, including X=ray, mammography, ultrasound, MRI, and CT. We have a fully-accredited clinical lab, diagnostic and treatment cardiology services, physical therapy, a respiratory clinic, cardiopulmonary medicine center, a pediatric treatment clinic and wing, and comprehensive women's services. "Health care delivery has become mind-bogglingly complicated," says Ian Morrison, who is read regularly in the local newspaper, and many agree (Morrison, p. 1).

Our staff includes our President, Mr. Woods, our Sr. V.P. In charge of Business Development, Mr. Turnout, our Sr. V.P. In charge of Finance, Ms. Lambkin, our V.P. In charge of Hospital Support Services, Ms. Goad, and our V.P. In charge of Operations, Mr. Briend. We have a Risk Manager, Ms. June, who oversees a Board of Risk Managers at the hospital.

Our hospital places a tremendous emphasis on privacy and personal liberty, while holding the entities within to be legally accountable for their actions. We pride ourselves on prompt attention to any reports of mistakes or errors in judgment on the part of our hospital personnel in any area, including medical or personal relations. Our Risk Control Managers are called upon to investigate and report on any such incidences, whether it is a patient falling out of bed or the death of a patient on the operating table. It is our job to be vigilant and to keep risk for any kind of negative experience low. This ensures the viability of the hospital in the minds of the public, as well as ensuring low maintenance costs for insurance and liability suits.

In the hospital, we have a Respiratory Therapy Clinic with a therapist and technicians. Mr. Jones is the Respiratory Therapist. The duties of therapists and technicians overlap often in the clinic, but the therapist has a bigger responsibility than the technicians, as he consults with the physicians and health care staff to develop and change the plans for patient care. The respiratory therapist is also likely to provide therapy plans that are rather complex and require much independent judgment. Mr. Jones is also responsible for caring for patients on life support in the intensive care units (U.S. Department of Labor).

Recently, within one week, we had six complaints from both male and female patients regarding the actions and verbal communications of a male respiratory therapist, Mr. Jones. He was reported as making sexually suggestive remarks to two female patients, using what would be considered swear words. Another female complained that he touched her improperly while preparing the respiratory equipment for her to use, meanwhile making remarks that were sexual in content. Two male patients reported that Mr. Jones swore at them for no reason, a most improper communication in the respiratory therapy room.

Our Vice President in charge of operations, Mr. Briend, and Ms. Lambkin, our V.P. In charge of Hospital Support Services, on the orders of the president, Mr. Woods, called Mr. Jones to their office for a discussion, reminded him of his rights, advised him to seek the services of an attorney (just in case) and suspended him with pay for two weeks, pending an investigation. Meanwhile, the Risk Manager, Ms. June, set about to investigate the allegations. She interviewed nurses, doctors and attendants who might have overheard the therapist when he made sexually explicit remarks. His friends at the hospital and those who knew him among the staff were also questioned and responded that, indeed, Mr. Jones had recently begun to act very strange and would suddenly erupt in expletives, using vulgar terms. They were mystified as they recounted this formerly straight-laced gentleman, who was only 39 years of age, as suddenly turning rather foul-mouthed and speaking sexually laden swear words in front of his friends and sometimes to the patients.

Today the U.S. has "evidence-based medicine, clinical practice guidelines, courses in professional development, assessment, accountability, patient empowerment and total quality management" (Grol, p. 286) and yet we still have the same problems with staff and personnel that the most primitive hospitals in the past may have had. This means that we might expect to solve most of the problems that patients bring to the hospital, but it is unrealistic to expect a perfect team and a perfectly-functioning hospital. While the FDA watches carefully over the drugs that doctors administer and senators are concerned that drug makers disclose every detail of their research (Harris 2), the staff that treats the patients is still human and therefore liable to make mistakes and trip up now and again. The hospital administration tries to run a tight ship and not allow any slips in manners or behavior among the staff and medical personnel, still, from time to time there is a problem. At times it is because of misunderstandings, but sometimes a real error occurs, such as when a doctor leaves a sponge in while operating on a patient. In this case, the risk managers are able to pinpoint the time and person who left the sponge in. Then they make suggestions and the hospital board institutes a ruling regarding the supervision of such practices. In the case of sponges, our nurses count how many are laid out before surgery and then again after surgery, to make sure they leave the operating room with the same number of sponges they went in with.

In the case of Mr. Jones, it was found that he had Tourette's syndrome, with a coprolalia element that induced him to suddenly speak unacceptable words. It had been kept in control until lately, when Mr. Jones was not able, for some reason, to purchase his medication (What, p. 1).

There are many reasons for having a risk management program at one's hospital and this is one of the reasons. Many experts stress the need to incorporate risk management programs into every hospital setting so as to reduce negligence claims. A hospital's scarce resources needs to be directed toward care of the patients. Identification, analysis and control of risks enhances the good name, the assets and earning capabilities of a hospital (O'Donovan, p. 125).

Hospitals also carry quite a bit of medical liability insurance. Richard Abbott and his associates have reviewed the history of professional liability insurance and found that "Management of professional liability risk by the physician-led malpractice insurance company not only protects the economic viability of physicians, but also addresses patient safety concerns" (Abbott, p. 1106).

It appears that physician-owned malpractice liability insurance is the major provider of insurance for physicians and continues to be the primary source for what is called loss prevention, that is, monetary liability from lawsuits, and for risk management services. Some insurance companies provide risk managers to the hospitals. The risk managers report directly to the insurance company, which keeps the records until the statute of limitation runs out, even though there is no claim ever made against the physician.

Almost all hospitals and health care providers buy professional liability insurance for protection against malpractice claims. The terms in the contract of a typical malpractice insurance include the clause that the insurance company will accept financial responsibility for claims against the hospital up to a certain level of coverage to which the hospital agrees, within a fixed period, in return for fees for insurance (Committee, p. 95).

Should an attorney contact the hospital on behalf of a patient who is making a complaint, the hospital responds politely and cooperates with the attorney in producing whatever medical records he or she requests. There is no obligation to offer more to the attorney than is requested, and the attorney hired by the hospital and by the insurance company.

The last decade has seen many changes in the medical profession, from rising prices to a concern that doctors are being overworked as medical schools turn out plenty of doctors, but then they are dispersed. Medical professional liability have become increasingly important. There is an impression that everyone is out to sue doctors and get as much as several million dollars. Therefore the number of attempted falsification of symptoms is growing, while the number of suits is shrinking. People are still out to make a fortune from the doctors that serve them, so lawyers often do the screening, if it is found that the person has a legitimate claim against the doctor, the lawyer will take the case. If the person is either bluffing, telling falsehoods or exaggerates their injury, the attorney will discover this and withdraw the case. Therefore, statistically, the number of cases against doctors and hospitals are actually going down.

The impression that a larger number of cases is being brought against doctors is fueled by the impression that patients are more than… READ MORE

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