Administrative Requirements of Medical Assistants

Part A 

Response to the sales representative 

To handle the sale representative who has visited Dr. Henderson’s office, the assistant needs to stand his ground and insist that she (representative) is required to make an appointment. He should refuse to allow the representative to see the doctor. Hospitals need to develop strict policies which require representatives to make appointments and follow the rules of the facility (Grissinger, 2012). The unacceptably belligerent behavior of the representative is more reason why the medical assistant should keep the representative from seeing the doctor. This representative has displayed lack of respect for the protocol that the hospital has established. If the hospital is to achieve order and smooth operations, all stakeholders must follow the laid-down procedure. The mere fact that the representative supplies much-needed drug does not exempt her from the need to make an appointment instead of visiting the hospital unannounced.

Representative vs. scheduled appointments 

In his discussion on how hospitals should manage sales reps, Grissinger notes that the hospitals need to consult their policies (Grissinger, 2013). If the policy requires that the reps must make appointments, then this provision should be followed. The implication of this is that hospitals should insist that reps must make appointments. If hospitals allow reps to walk in as they please, they are setting the stage for chaos. The effective delivery of medical services calls for order and careful planning. It is noted in the case that the representative’s visit was unexpected since she had been to the hospital only a few weeks earlier. Letting her see the doctor would set a poor precedent and create the impression that sales representatives and other individuals can see the doctor as they please at the expense of the treatment of patients.

The factor of Dr. Henderson’s anxiety 

It is noted in the case that Dr. Henderson is usually eager and anxious to receive samples from the sales representative. His anxiety should not be considered as a factor when determining how to handle the sales rep. Sales reps are trained to exploit the personalities and circumstances of practitioners to make sales (Fugh-Berman & Ahari, 2007). It could be that the rep understands that the doctor desperately needs the samples and this is why she has targeted the doctor. Therefore, it is the duty of the medical assistant to end the exploitation and deny the rep access to the doctor.

Impact of diminished supply of samples 

It is noted that the hospital is running low on the samples that the rep supplies. This fact undoubtedly affects the situation since the doctor relies on the samples to treat a number of illnesses. The assistant may need to let the rep see the doctor for the samples to be replenished. There are occasions where the need to guarantee patient wellbeing takes precedence over strict adherence to hospital rules regarding such issues as appointments. This is one of those occasions. However, the representative must be reminded that the hospital has a policy that all individuals are expected to follow.

Assistant accepting samples 

It is understood that sales reps target a number of different practitioners. These include doctors, nurses and assistants (Grissinger, 2012). That medical assistants are among those that the reps target suggest that Dr. Henderson’s assistant has the authority to accept any or all of the samples. However, it is advised that before accepting the samples, the assistant should consult the doctor and ensure that the supply of the samples is in line with the hospital’s policy. This display of caution is intended to enhance accountability and shield the patients from potentially harmful drugs.

Part B 

When hospitals use different programs for electronic health records management, issues of cross-platform compatibility emerge. This is the challenge that Dr. Jonas faces. To address this challenge, Dr. Jonas needs to replace the different systems with a standardized one. Standardized EHR systems have been shown to facilitate cross-platform compatibility and clinical decision making (Zhang et al., 2013). Opening the systems so that authorized external parties can access records is another measure that can be implemented to address issues of compatibility (Hristidis, 2009). It is possible that Dr. Jonas has imposed restrictions that limit access to the records. If this is the case, he needs to lift the restrictions so that staff at one facility can access the records of another facility. However, care should be exercised so as not to violate the privacy of the patients. Of the two recommendations offered, standardizing the EHR software appears to be the most promising. This is because this option will eliminate the walls that make it difficult for staff at one facility to obtain records from a different facility. The main drawback of this option is that it is costlier as Dr. Jonas will need to acquire new software. However, the benefit that this option presents far outweigh the risks and disadvantages.

Part C 

Options for handling situation 

The coding assistant has two options that he could use to handle the situation. One, he could decide to do nothing. This option is dangerous as it could expose the hospital to the threat of legal action. Negligence is one of the greatest challenges that facilities face (Pandit & Pandit, 2009). Dr. Parker’s failure to indicate the complications and manifestations amounts to negligence and could hinder the hospital’s capacity to deliver care. This in turn would present the threat of legal action over negligent conduct. Two, the assistant may consult with Dr. Parker. He needs to point out to Dr. Parker that he failed to indicate the manifestations and complications in the encounter forms.

Preferred option 

Of the two options provided above, the second one is undoubtedly the best. This is because it will insulate the hospital against legal action. As already noted, law suits pose a serious challenge to hospitals. Another reason why the assistant needs to consult with Dr. Parker concerns the need to ensure that all patients receive adequate care and the hospital is fairly compensated for the services that it delivers. Another reason why the coding assistant needs to raise the issue with Dr. Parker is because this is in his best interest. Should any harm occur as a result of his failure to report to Dr. Parker, he could suffer blame and may even lose his job.

Consultations 

Before raising the issue discussed above with Dr. Parker, the assistant needs to consult Lisa Medina. Practitioners need to respect the hierarchy of authority where they work. It is disrespectful for one to bypass their immediate superior. Furthermore, bypassing one’s superior creates tension and resentment.

Part D 

Sarah’s course of action 

Sarah needs to calmly ask Nell to return home. When employers note that their employees appear drunk, they should offer to help instead of being quick to institute disciplinary action (Wilkie, 2017). They should also attempt to determine if there is some problem that has pushed the employee into drinking.

Sending Nell home 

Sarah needs to send Nell home. However, given that Nell is still drunk, she should not let her drive herself home. She should either place her in the care of a taxi driver or ask her husband to come and collect her. Driving while drunk is one of the major causes of traffic accidents and fatalities (“Statistics”, n.d). To ensure that Nell does not suffer any harm, Sarah should not let her drive home.

Reporting Nell 

One of the responsibilities that supervisors are required to execute is instituting disciplinary measures against employees who commit mistakes (OPM, n.d). Reporting these employees to higher authorities is among these measures. Sarah does indeed have the obligation to report Nell to Dr. Williams. As she reports her, she will be securing the wellbeing of the patients whom Nell offers services to. However, Sarah should not neglect to report that Nell has never shown up for work drunk before. This will help to create a balanced evaluation of Nell’s conduct.

Recording the incident 

Sarah needs to proceed and include Nell’s unacceptable behavior in her record. This is because drunkenness hampers the delivery of medical services. Alcohol impairs one’s judgment and makes it difficult for them to perform their job properly (Wilkie, 2017). Showing up for work drunk could also damage the hospital’s image. This is yet another reason why Sarah should record the incident. As she records this incident in Nell’s file, Sarah should underline the fact that Nell is a committed employee whose drunkenness is an isolated incident that has never been witnessed before.

Firing Nell 

. Showing up for work while drunk is sufficient ground for being fired. Companies are known to fire their employees for being drunk while at work (Watchtel, 2011). If an employment agreement stipulates that the employer may fire an employee who shows up drunk, then the employer will be acting legally when they fire such an employee as Nell (Wilkie, 2017). Before firing Nell, Sarah needs to examine her employment contract and the company’s policy. Even if Sarah establishes that Nell’s drunkenness is ground for firing her, she should refrain from taking this action. This is because Nell has only come to work intoxicated once. Sarah should opt for more lenient disciplinary measures such as suspension.

Blood and urine screening 

A supervisor may require an employee to undergo a drug and alcohol test. If Sarah asks Nell to undergo this test, she will be acting within her rights and authority. However, if the employment agreement does not expressly state that the employee must undergo drug tests, the employee may refuse the test (Wilkie, 2017). Sarah needs to proceed with caution when she requires Nell to undergo the blood and urine screening. She must confirm that Nell’s employment contract has a provision that requires her to submit to screening.

Notifying the police 

Notifying the police seems inappropriate and extreme. The situation is an internal matter that can be handled through the processes that the hospital has put in place. Besides, Nell’s actions are not illegal or criminal. They are only inappropriate and perhaps dangerous. Notifying the police would only be proper if Nell’s actions pose a direct threat to the wellbeing of her patients. This has not occurred yet since this is the first time that Nell has shown up for work while intoxicated.

Need for counseling 

Sarah is not obligated to refer Nell for counseling. However, she should still do this. Companies need to either provide employee assistance programs or refer their employees for counseling to enhance their wellbeing (Reagin, 2009). Through counseling, Nell will be able to recognize the error in her ways and choose a lifestyle that is consistent with her job. Moreover, counseling will see Nell keep her job as she recovers. It is pointed out that Sarah has never seen Nell showing up for work intoxicated. This suggests that Nell is an exceptional employee who respects the workplace. This single incident can be taken to mean that she is suffering through some personal problems. The counseling will enable her to address these problems.

References

Fugh-Berman, A. & Ahari, S. (2007). Following the Script: How Drug Reps Make Friends and Influence Doctors. Plos Medicine. DOI: https://doi.org/10.1371/journal.pmed.0040150 

Grissinger, M. (2012). Managing Visits from Pharmaceutical Representatives. Pharmacy & Therapeutics, 37 (5), 261,263. Retrieved 5 th November 2017 from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411226/ 

Hristidis, V. (2009). Information Discovery on Electronic Health Records. Boca Raton: CRC Press.

Office of Personnel Management (OPM). (n.d). Alcoholism in the Workplace: A Handbook for Supervisors. Retrieved 5 th November2017 from https://www.opm.gov/policy-data-oversight/worklife/reference-materials/alcoholism-in-the-workplace-a-handbook-for-supervisors/ 

Pandit, M. S. & Pandit, S. (2009). Medical Negligence: Coverage of the Profession, Duties, Ethics, Case Law, and Enlightened Defense- A Legal Perspective. Indian Journal of Urology, 25 (3), 372-378.

Reagin, A. (2009). An Employer’s Guide to Workplace Substance Abuse: Strategies and Treatment Recommendations. Retrieved 5 th November 2017 from

https://www.businessgrouphealth.org/pub/?id=f3151957-2354-d714-5191-c11a80a07294 

Statistics. (n.d). Retrieved 5 th November 2017 from https://www.madd.org/statistics/ 

Wachtel, K. (2011). The 13 most common reasons you’re likely to get fired. Retrieved 5 th November 2017 from http://www.businessinsider.com/the-13-most-common-reasons-why-employees-get-fired-2011-6?IR=T/#13-bitching-about-your-boss-or-company-on-facebook-or-twitter-1 

Wilkie, D. (2017). Drunk at Work: What HR can do about Employees Drinking on the Job. Retrieved 5 th November2017 from https://www.shrm.org/resourcesandtools/hr-topics/employee-relations/pages/drunk-on-the-job-.aspx 

Zhang, M., Velasco, F. T., Musser, R. C. & Kawamoto, K. (2013). Enabling Cross-Platform Clinical Decision Support through Web-Based Decision Support in Commercial Electronic Health Record Systems: Proposal and Evaluation of Initial Prototype Implementations. AMIA Annual Proceedings Symposium, 1558-1567 . Retrieved 5 th November2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900165/