MedicoLegal Issues
What is legislation which requires all patients to receive an adequate medical screening examination that evaluates the presence of a medical emergency.
Emergency Medical Treatment and Active Labor Act (EMTALA)
Impaired is defined as the inability to practice medicine with reasonable _____ and _____. *Half points if you get ½ answer correct*
Safety and Skill
What is the most common cause of cognitive impairment in individuals over the age of 65?
Alzheimers Disease
PAs are mandated reporters and we have a responsibility to report any suspected abuse of _______, _______, ________, and other vulnerable populations.
children, elders, domestic partners/spouses
True or False: Principlism is a common ethical theory that states that we should act out of courage, justice, charity and wisdom.
False - Virtue states that we should act out of courage, justice, charity and wisdom. Principlism states that we should act out of a prima facie duty that is obligatory based on the principles of beneficence, justice and non-injury.
True/False: PAs can determine if a patient is in active or false labor if they are providing the examination within their scope of practice outlined by the hospital
TRUE
T/F: The AAPA states that PAs have an ethical responsibility to identify and assist impaired members of the healthcare team.
TRUE
Cognitive impairment is commonly seen in patients with dementia and delirium, but which other individuals can also be affected?
Stroke patients, traumatic brain injuries and intellectual disabilities
In the case of child abuse who needs to be made aware that a report is being filed.
Parent or Caregiver
_________ is the common principle of freedom of choice, self-determination and privacy.
Autonomy
Autonomy is the common principle of freedom of choice, self-determination and privacy. Under this principle, patients have a right to choose treatments or behaviors so long as they do not intentionally inflict harm on others.
What is the most common cause of EMTALA violation?
Failure to properly screen and failure to stabilize the patient.
T/F Burnout is most commonly seen in the mid-career years.
FALSE
This tool can be used to detect cognitive impairment quickly in older adults and consists of two main components: (1) a 3 item recall test for memory and (2) a clock drawing test
Mini-Cog exam
Documentation of the history and physical must be clear and concise, as well as provide as much detail as possible. How should the historian’s own words be documented?
In Quotes
This is the common principle that states that we should not inflict harm on others.
Non-maleficence
Nonmaleficence - we should not inflict harm on others. However, we must balance harm with benefits (ex: benefits may outweigh harm and vice versa).
What must be done if a patient is determined to have a medical emergency and they are unable to pay or are uninsured?
They must receive stabilizing treatment.
List 3 common factors leading to provider burnout.
EMR, long hours, conflicts between work/home/within the workplace
The CPT code 99483 allows for PAs to bill for cognitive impairment and assessment of care planning ONLY if they have assessed and documented 6 other key history elements in addition to the Mini-Cog exam/staging of impairment. Name at least 3.
Thorough medication review, ADLs/Decision making, evaluation of behavioral issues, safety assessment, caregiver assessment, advanced planning (end of life and palliative care)
PAs should be familiar with the ________ that apply and the _______ that must be contacted if any abuse is suspected.
Statues, Agencies
This common ethical theory states that we should do what provides the greatest good for the greatest amount of people.
Utilitarianism
Utilitarianism is a common ethical theory in the United States that states that we should do what provides the greatest good for the greatest number of people.
What must be done if a hospital receives a patient from another facility that may be in violation of EMTALA?
The possible violation must be reported to CM.
What are 3 signs of provider burnout?
Depersonalization, diminished sense of accomplishment, cynicism, loss of fulfillment, emotional exhaustion.
After a full assessment and diagnosis has been complete, health care providers should proceed to develop a ______ that outlines the patient’s full assessment, diagnoses and health care needs/resources including management of behavioral issues or community resources referrals.
Written care plan
Give 3 signs of a person being trafficked?
has a pimp, is a minor performing sexual acts, unable to come and go from place to place, works long hours without breaks and has unusual restrictions at work, lives in housing that prohibits free entry and exit, appears malnourished, exhibits signs of PTSD/anxiety/depression/trauma, may have tattoo brandings on body, few or no personal possessions (including identification), is accompanied by someone else that speaks for patient.
True or False: Beneficence is a common principle that states we must act in the best interest of our patient and that we should work to prevent harm to our patients.
True
Beneficence is the common principle that we should work to prevent harm to our patients. We must act in the best interest of the patient.