The enactment of laws is carried out with the aim of regulating human behavior for the sake of the entire society ( Pozgar, 2011 ). Based on this, the United States (U.S) boasts different laws. Public law covers the relationship between the government and its citizenry while private law covers the relationship between individuals. Criminal law is an arm of the former while tort and contract action are part of the latter. There are three sources of laws in the U.S. Common law is as a result of judicial decisions while the statutory law is derived from state and federal legislatures. On the other hand, administrative law is dictated by the administrative agencies. Besides individual citizens, it is important for holders of public offices to acquaint themselves with these laws. Notable among these officers are healthcare administrators. Due to the magnitude of their responsibilities, healthcare administrators have to understand the legal aspects of the U.S healthcare system and the relevant laws and regulations ( Pozgar, 2011 ). Examples of laws that affect healthcare in the U.S include Health Insurance Portability and Accountability Act (HIPAA), False Claims Act, Stark Law and the Anti-Kickback Law. This paper is aimed at articulating my take on the value of professional conduct in the healthcare sector as the top administrator at Well Care Hospital . It will also highlight the implications of compromising the dictates of medical conduct and ethics amongst professional staff. Thirdly, it will analyze the four grounds upon which a plaintiff can prove medical negligence. Lastly, it will highlight the role of Well Care Hospital ’s governing board in extenuating the implications of non-compliance in accordance with the rules of practice articulated in board’s manifesto.
Professional conduct in healthcare
The healthcare sector is currently faced with myriad challenges. The problems have been exacerbated by such issues as globalization, emerging and re-emerging infectious diseases, new technologies as well as the growing inequality. In the wake of these issues, the need for ethical values and professionalism amongst healthcare practitioners is vital. According to Slomka et al. (2008), professionalism refers to “ ability to demonstrate ethical choices, values, and practices in decision-making and to commit to the practice of personal and professional values .” Morrow et al. (2011) reckon that professionalism should be viewed as a holistic concept or as a construct that is multi-faceted consisting of professional attitudes, identity and behavior. Informed by this, I reckon that ethics cannot be decoupled from professionalism in healthcare settings.
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Healthcare administrators in W ell Care Hospital manage the staff and liaise with other administrative personnel to ensure that the institution runs smoothly professionally, operationally and legally. They also have to balance the needs of employees, patients, the larger Happy Town community as well as the institution itself. The decisions they make have profound implications on peoples’ medical, economic, social and professional lives. Therefore, the administrators have to be guided by a professional code of ethics. Professionalism is required since both staff and patients rely on the administrators in accessing reliable, equitable and high-quality care. The administrators are also expected to avoid conflicts of interest, treat everyone equally and to report violations of the code to the relevant authorizes.
R amifications of compromis ing the boundaries of ethics and medical conduct by professional staff
The behavior of healthcare professionals towards their patients should be based on the patients’ best interest. Boundaries are therefore important for preserving the relationship’s integrity. Aravind et al. (2012) define a boundary as “ the edg e of appropriate professional behavior, transgression of which involves the therapist stepping out of the clinical role or breaching the clinical role. ” Boundaries articulate the accepted and expected social and psychological distance between healthcare practitioners and their patients ( Hanna & Suplee , 2012). Boundary issues are two-fold. These are boundary crossings and boundary violations. A boundary crossing arises when a practitioner deviates from standard therapeutic activity and may be non-exploitative, harmless and supportive of the healing process. Conversely, a boundary violation may be harmful to both the patient and therapy, and amounts to the patient's exploitation. Professionals may compromise these boundaries through engaging in sexual or romantic relationships with the patients, excessive self-disclosure, accepting or giving the patients gifts, influencing patients in changing their power of attorney or will, asking for favors or promoting their personal businesses.
Crossing or violating the boundaries of ethics and medical conduct results in numerous harsh ramifications. For instance, disclosing the personal information of a patient is against the privacy provisions as highlighted in HIPAA. When claims of sexual misconduct are made, the concerned healthcare professional is investigated by the licensing boards, and criminal and civil proceedings. He or she may also face civil liability in accordance with his or her state’s law. The professional may also be sanctioned by the state board leading to loss of his or her license. In case the state argues that the particular conduct is a misdemeanor or a felony, the individual is likely to face criminal liability ( Hanna & Suplee , 2012). This applies to a battery claim. Further, civil actions are likely in case of battery or intended infliction of emotional distress. The patient may put forth a negligence claim on the basis of psychological harm in case the patient-practitioner relationship doesn't end well. Subsequently, the state might also take civil actions resulting in a fine. In case the sexual involvement happened after the patient-practitioner relationship had ended, a patient can initiate a criminal or civil lawsuit against the healthcare professional.
State boards and courts pay more attention to state law violations. If civil cases don’t amount to criminal charge, the applicable Code of Ethics and the state’s practice act aid in interpreting the case. Defending such allegations as sexual misconduct is not easy. This is because professional liability insurance may not cover legal representation fees and damages ( Hanna & Suplee , 2012). Further, such cases may be taken up by the Health Integrity and Protection Data Bank availing the records to employers, individual healthcare providers and lawyers. Based on this information, the practitioner could be disqualified for federal Medicare or state Medicaid programs hence reducing his or her chances of future employment and ability to practice. Moreover, in case of sexual misconduct, the professional may be branded a sexual predator.
P rov ing medical negligence
Cases of medical negligence are common in the U.S and arise when a patient or his or her loved ones feel that a healthcare professional did not meet the expected standard of care. However, a plaintiff is required to prove that the specific practitioner acted negligently, resulting in the patient’s death or injury. The four legal elements that the plaintiff needs to prove his or her case include; the medical professional’s professional duty owed to the patient, existence of a breach of this duty, injury caused by the breach and the damages resulting from this injury ( Owen, 2006 ). The first element requires the plaintiff to prove that a doctor-patient relationship existed and that the doctor was expected to provide competent care by law. A prescription or related document can be used in this case. This is because it proves that the doctor had agreed to diagnose or treat the patient, in the process initiating a doctor-patient relationship. To prove the second element, the plaintiff has to specify the standard of care applicable in his or her situation and show that the health care provider did not meet this standard leading to the patient’s suffering and injury. In this process, the plaintiff has to provide another medical expert’s testimony. In this testimony, the expert has to define the expected standard of care and show that the defendant failed to meet this standard ( Owen, 2006 ). In proving that the breach of duty caused injury which resulted in damages, the plaintiff has first to confirm that the injuries suffered are directly associated with the doctor’s sub-standard care. This may require corroboration by a medical expert’s testimony. Lastly, the plaintiff ought to provide clear details of the damage that was sustained owing to the professional’s negligence.
D uties of the health care governing board in mitigating the effects of medical non-compliance Well Care Hospital ’s overall conduct is the responsibility of its governing board. The board is therefore tasked with the role of ensuring that medical-compliance is observed. It has achieved this by facilitating the development and implementation of a compliance program. To fast-track the process, the board has appointed a compliance officer and formed a compliance committee. Further, it has involved all employees since the program’s success is pegged on their participation. As outlined in its manifesto, the board has mitigated the effects of medical non-compliance in Well Care Hospital in numerous ways. These include developing, distributing and implementing written standards of conduct, policies and procedures. Secondly, appointing a compliance officer and forming a compliance committee has aided in mainstreaming compliance issues in the hospital’s administration. Besides deploying employee training and education programs, the board has leveraged open communication to allow employees to report compliance concerns immediately they arise. The board also ensures timely response to non-compliance by imposing corrective action including disciplining culprits if need be. Lastly, the board mitigates the effects of medical non-compliance by carrying out internal audits and monitoring as well as addressing inefficiencies in the process.
References
Aravind, V. K., Krishnaram, V. D., & Thasneem, Z. (2012). Boundary crossings and violations in clinical settings. Indian journal of psychological medicine , 34 (1), 21.
Hanna, A. F., & Suplee, P. D. (2012). Don't cross the line: Respecting professional boundaries. Nursing2018 , 42 (9), 40-47.
Morrow, G., Burford, B., Rothwell, C., Carter, M., McLachlan, J., & Illing, J. (2011). Professionalism in healthcare professionals. Report to the health and care professions council. London: HCPC .
Owen, D. G. (2006). The five elements of negligence. Hofstra L. Rev. , 35 , 1671.
Pozgar, G. (2011). Legal aspects of health care administration . Jones & Bartlett Publishers.
Slomka, J., Quill, B., desVignes-Kendrick, M., & Lloyd, L. E. (2008). Professionalism and ethics in the public health curriculum. Public health reports , 123 (2_suppl), 27-35.
