- What are the potential ethical and legal implications for each of the following practice members?
Medical Assistant
As an experienced medical assistant, Stephanie understands the way that prescription refills work and although she may have believed that she was making the NPs life easier by submitting a refill for the antibiotic, this type of negligence is not only unethical but illegal.
Medical assistants work directly under provider supervision (Balasa, 2018). Stephanie likely ‘signed off’ for the NP by forging her signature or overriding the system. Despite the strong rapport between office members, this behavior is unacceptable. One study found that incidents involving errors in diagnosis and prescriptions are the most likely to result in severe harm of patients in primary care (Loerbroks, Vu-Eickmann, Dreher, Mambrey, Scharf, & Anger, 2022).
Nurse Practitioner
Although the nurse practitioner was not aware of Stephanie’s act, this mistake falls on her as well. The Medical Assisting Scope of Practice: Federal and State Updates (Balasa, 2018), outlines legal principles as they pertain to medical assistants. “If a medical assistant performs a task not permitted by state law, both the delegating provider and the medical assistant may be subject to legal sanctions” (Balasa, 2018). With this in mind, it is essential that the nurse practitioner understands and verifies all actions of their delegees and ensure that tasks performed are within their scope of practice. Ethically, it is the nurse practitioner’s responsibility to share this error with the practice and she will have to face consequences as well – negligence of supervision.
Medical Director
The medical director will also face consequences as they oversee their employees and are responsible for their actions. Medical directors have a written agreement that states their responsibility on behalf of a practice. Legal implications that do not follow this agreement may include lawsuits and practice fines (Simpson, 2021).
Practice
The practice that this occurred at would also be held responsible as these dilemmas impact the entire organization. The practice’s response is also important – do they sweep it under the rug or do they acknowledge their employee’s mistake and attempt to create a better healthcare system?
The legal doctrine ‘let the master answer’ is a form of liability that holds an organization or the higher-level employers at fault for a situation (Silver, 2023). The goal is to hold the practice liable as they are responsible for their employees.
- What strategies would you implement to prevent further episodes of potentially illegal behavior?
To prevent further episodes of potentially illegal behavior, I would first focus on the motive for one’s actions. If someone simply does not understand their scope of practice, I would ensure that adequate time is devoted to go over policies and regulations. If one feels too overwhelmed in their position, I recommend going over the budget to see if another employee can be hired to reduce the stress.
In my opinion, Stephanie’s decision to engage in this act was not a malicious intent. Perhaps, she was dealing with multiple patients at once and thought she was making a simple decision by refilling Mrs. Smith’s prescription. Of course, the entire practice will have to deal with the consequences, which are extremely serious.
I think another reason for individuals to engage in potentially illegal behavior is a poor work environment. Specifically, feeling overwhelmed, unhappy, or just burnt out. Promoting a healthy work environment not only leads to happier employees, but increases patient care and promotes patient safety (Loerbroks, Vu-Eickmann, Dreher, Mambrey, Scharf, & Anger, 2022).
- What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice.
To create a strong organizational culture and positive work environment, the leaders must set a healthy tone for its employees. I am really passionate about leading by example as others will follow. The social learning theory is a model that portrays how one’s behavior can influence others (O’Donnell, 2023). In my opinion, implementing ethical values into a work place will inspire others to behave similarly.
It is important to build strong relationships with employees, while setting clear guidelines and expectations. This leads to a healthy work environment and stronger communication, minimizing risks of potentially illegal behavior. Working together as a team rather than competitively can promote positive change.
Side note: One of the sources I used is greater than five years old, however, it is the most updated version of Medical Assisting Scope of Practice that I could find and believe it was important to include in my discussion.
References
Balasa, D. A. (2018) Medical assisting scope of practice: Federal and state updates. https://www.aama-ntl.org/docs/default-source/other/live-ceu-handout-final.pdfLinks to an external site.
O’Donnell, G. (2023). Leadership strategies to prevent unethical employee behavior. Walden Dissertations and Doctoral Studies. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=15663&context=dissertations
Silver, K. (2023). When should the master answer? Respondeat superior and the criminal law. Criminal Law and Philosophy, 18, 89-108. https://doi.org/10.1007/s11572-023-09659-7Links to an external site.
Simpson, Z. (2021). Health care clinics targeted for medical doctor requirements. Florida Healthcare Law Firm. https://floridahealthcarelawfirm.com/blog-medicaldirector/#:~:text=Failure%20of%20an%20appointed%20medical,to%20fulfill%20their%20statutory%20duties.