CM2500 Law and Ethics -Bailey Chapter 2

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1. licensure A mandatory credentialing process 10. In all 50 states, medical practice acts
established by law, usually at the state level, -----------have
that grants the right to practice certain skills been
and endeavors. established by
statute to
2. Licenses to all physicians and nurses and for many other
govern the
practice are health care practitioners as well.
practice of
required in
medicine.
every state
for 11. What does the 1.Define what is meant by "practice of
Medical Practice medicine" in each state.
3. certification A voluntary credentialing process whereby
Act provide 2.Explain requirements and methods for
applicants who meet specific requirements
licensure.
may receive a certificate.
3.Provide for the establishment of medical
4. How is usually national in scope, and is most often licensing boards.
certification sponsored by a nongovernmental, private- 4.Establish grounds for suspension or
obtained? sector group. Certification by a professional revocation of license.
organization, usually through an examination, 5.Give conditions for license renewal.
signifies that an applicant has attained a
12. medical practice State laws written for the express purpose
certain level of knowledge and skill.
acts of governing the practice of medicine.
5. Registration is an entry in an official registry or record,
13. medical boards Bodies established by the authority of
listing the names of persons in a certain
each state's medical practice acts for the
occupation who have satisfied specific
purpose of protecting the health, safety,
requirements, made available to health care
and welfare of health care consumers
providers.
through proper licensing and regulation of
6. Accreditation is the process by which health care physicians and other health care
practitioner education programs, health care practitioners.
facilities, and managed care plans are
14. unprofessional Physical abuse of a patient.
officially authorized.Official authorization or
conduct for ▪Inadequate record keeping.
approval for conforming to a specified
medical ▪Failure to recognize or act on common
standard.
professionals symptoms.
7. to maintain an organization must undergo an on-site ▪The prescription of drugs in excessive
JCAHO survey by a JCAHO survey team at least amounts or without legitimate reason.
accreditation every three years. Laboratories must be ▪Impaired ability to practice due to
surveyed every two years. addiction or physical or mental illness.
8. reciprocity The process by which a professional license ▪Failure to meet continuing education
obtained in one state may be accepted as requirements.
valid in other states by prior agreement ▪The performance of duties beyond the
without reexamination. scope of a license.
▪Dishonesty.
9. when must a If a state license is required and reciprocity is
▪Conviction of a felony.
health not granted when moving to another state,
▪The delegation of the practice of
practitioner then the health care practitioner must apply to
medicine to an unlicensed individual.
take a state the state licensing authority to take required
license exam examinations in order to obtain a valid license 15. Minor do not fall under the heading of
to practice in the new state. disagreements misconduct.
and poor
customer
service
16. allopathic Means "different suffering" and refers to the
medical philosophy that dictates training
physicians to intervene in the disease
process, through the use of drugs and
surgery.
17. tertiary care Those care settings providing highly 29. Managed care are corporations that pay for and deliver
settings specialized services. health plans health care to subscribers for a set fee
using a network of physicians and other
18. Reciprocity —the process by which a valid license
health care providers. A system in which
from out of state is accepted as the
financing, administration, and delivery of
basis for issuing a license in a second
health care are combined to provide
state if prior agreement to grant
medical services to subscribers for a
reciprocity has been reached between
prepaid fee.
those states.
▪ 30. Capitation is a set advance payment made to
providers, based on the calculated cost of
19. Endorsement —the process by which a license may be
medical care of a specific population of
awarded based on individual credentials
subscribers.)
judged to meet licensing requirements in
the new state of residence. 31. The payment including contracted fee schedules,
from a percentages of billed charges, capitation,
20. A physician's conviction of a felony, unprofessional
managed care and others
license can be conduct, or personal or professional
plan to
revoked incapacity.
providers may
(canceled) or
be one of
suspended
several types,
(temporarily
recalled) for 32. Third party that the insurance company reimburses
means health care practitioners for medical care
21. There are four ▪Sole proprietorship ▪Partnership
provided to policyholders.
basic types of ▪Professional corporation
medical practice: ▪Group practice 33. Health Care A federal statute passed to improve the
Quality quality of medical care nationwide. One
22. sole A form of medical practice management
Improvement provision established the National
proprietorship in which a physician practices alone,
Act of 1986 Practitioner Data Bank.
assuming all benefits and liabilities for
(HCQIA
the business.
34. The Federal for individuals to bring civil actions on
23. associate practice A medical management system in which
False Claims behalf of the United States government for
two or more physicians share office
Act allows false claims made to the federal
space and employees but practice
government, under a provision of the law
individually.
called qui tam (from Latin meaning "to bring
24. partnership A form of medical practice management an action for the king and for oneself").
system whereby two or more parties These individuals, commonly known as
practice together under a written whistleblowers, are referred to as qui tam
agreement specifying the rights, relators and can share in any court-awarded
obligations, and responsibilities of each damages.
partner.
35. telemedicine Remote consultation by patients with
25. Advantages of include sharing the workload and physicians or other health professionals via
partnerships expenses, and pooling profits and telephone, closed-circuit television, or the
assets. Internet.
26. A major each partner has equal liability for the 36. cybermedicine A form of telemedicine that involves direct
disadvantage of acts, conduct, losses, and deficits of the contact between patients and physicians
partnerships is partnership, unless specific provisions over the Internet, usually for a fee.
that are made for these contingencies in the
initial agreement.
27. corporation A body formed and authorized by law
to act as a single person.
28. group practice A medical management system in which
three or more licensed physicians share
the collective income, expenses,
facilities, equipment, records, and
personnel for the business.