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Laws & Regulations
Jennifer Kennedy
School of Behavioral Sciences, Liberty University
AMAO: Medical Office Ethics & Law
Professor Rebecca Farmer
May 29, 2023
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Laws & Regulations
We often hear the question, “what is the official policy for that?” or “what is our
procedure for handling this situation? Every position in an office should have a job description.
Some job descriptions are divided into two parts: the responsibilities required of each employee
and the listing of tasks to be performed by each employee. (Flight & Pardew, 20210) Job
descriptions are an essential part of the written standard office procedures and established
authority and responsibility for carrying out procedures. (Flight & Pardew, 2021) In addition to
the job description, each office should have a procedures manual. A procedures manual describes
in detail the way a task in the job description should be carried out. Written standard office
procedures help maintain high standards of patient care, protect against the omission of
important steps, ensure compliance with government and third-party regulations, and decrease
the possibility of a malpractice lawsuit. They aid in achieving risk management: the practice of
considering the risk of actions taken and taking steps to minimize the risks associated with them.
When there are office policies and procedures in place and the healthcare employee disregards
them, they could be negligent per se: conduct that is against common knowledge that, by its act,
without argument, can be declared negligent.
Some health care professionals such as a physician, nurse or even call center operators,
are introduced to situations where one decision can determine life or death. Having a procedure
in place in case such an emergency arises is detrimental. For example, in 1996 the case
involving a nurse at a Kaiser call center was left to make a critical decision without written
protocol. During the after-hours, a family had called the Kaiser call center for advice about their
infant running a 104-degree fever. The nurse recommended that the child be driven to a network
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hospital forty-five minutes from their home. The parents decided to circle back to the nearest
emergency room after driving halfway. Unfortunately, the infant suffered circulatory collapse
and lost both hands, and most of both legs. It is not known what the outcome may have been if
the nurse had told them to go to the nearest emergency room, but if a procedure had been in
place the nurse would have known to tell the parents to take the infant to the nearest hospital. As
a nurse, she should have known that giving those parents advice could have severe
consequences.
Many patients will telephone with emergency problems. Remember that the caller may be
confused, distraught, rude, or even unable to give a clear account of what is occurring. Skillful
management by the telephone receptionist may be sight saving and even lifesaving. Therefore,
the staff member should be courteous, compassionate, efficient, and informative in telephone
conversations. The Board of Directors of the American Academy of Ophthalmology has offered
the following guidelines to reduce litigation risks:
Always confer with the doctor if you have questions relating to the call
Take down the caller's number and promise to call back if in doubt about the correct
answer to a question
Avoid giving general medical advice or discussing diagnoses
Answer questions in a friendly but noncommittal manner and refer to the ophthalmologist
for definitive answers
Do not forget to return the call as soon as possible because often the patient is extremely
anxious
Try to determine the following:
oThe caller's name, address, and telephone number
oThe essence of the problem
oWhen the symptoms first occurred and their duration.
If the patient has an emergency problem and the physician is unavailable, it is best to
advise the patient to see another physician or obtain emergency room care immediately. (“Office
Efficiency and Public relations,” 2013)
