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Ethics Flashcards

1
Q

General Supervision

A

The physical therapist is not
required to be on site for direction and supervision, but
must be available at least by telecommunications.

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2
Q

Direct Supervision

A
  • The physical therapist is physically present and immediately available for direction and supervision.
  • The physical therapist will have direct contact with the patient/client during each visit that is defined in the Guide to Physical Therapist Practice as
    all encounters with a patient/client in a 24-hour period.
  • Telecommunications does not meet the requirement of
    direct supervision
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3
Q

Direct Personal Supervision

A
  • The physical therapist or,
    where allowable by law, the physical therapist assistant is
    physically present and immediately available to direct and supervise tasks that are related to patient/client
    management.
  • The direction and supervision is continuous throughout the time these tasks are performed.
  • Telecommunications does not meet the requirement of direct personal supervision.
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4
Q

What can NOT be delegated

A

 Interpretation of referrals
 Examinations
 Provide physical therapy diagnosis
 Develop plan of care
 Conducting re-examinations
 Overseeing care/documentation/progress
 Performing discharges
 Screening (it is a component of an exam)
- Joint Mobs
- Sharp Debridement
- Dry Needling
- Any pt with unstable or unknown response

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5
Q

Re-Exam and Discharge

A
  • re exam, evaluation, and interpretation of results is PT
  • but a PTA can complete measures that a PT would use for re-exam or discharge
  • ROM
    -MMT
  • balance/gait
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6
Q

Off site PTA supervision

A
  • PT must be accessible by phone at all times
  • regularly scheduled and documented conferences with PTA
  • Need a supervisory visit by PT as requested by PTA or once a month
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7
Q

what does a supervisory visit include

A
  • on site re-exam
  • on site review of POC
  • Eval of needs and recommendations for utilization of outside resources
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8
Q

are PTs legally and ethically responsible for PTAs

A

yep

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9
Q

what is the only thing that PTAs are supposed to assist with

A

intervention

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10
Q

what does Medicare require in private practice

A

direct onsite PTA supervision

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11
Q

how does medicare pay not PTs

A
  • students: typically covered by part A; part B not covered but can participate with direction by PT who is not seeing other pts
  • PTA: covered but may required direct supervision
  • aides: nope
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12
Q

what makes a successful PT/PTA partnership

A
  • Know the strengths of the partner
     Communication is key
     Develop early expectations of each partner
     Mutual respect
     Be available to each other
     If it is an ongoing partnership, develop collaboration
    strategies, methods of communication handoff
     Be aware of the need for each other
     Successfully managing differences when they occur
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13
Q

fraud

A

An intentional deception or intentional
misrepresentation that a person makes to gain a benefit for which that person is not entitle

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14
Q

Abuse

A

Payment for items or services when there is no
legal entitlement to that payment, and the health care
provider has not knowingly and/or intentionally
misrepresented facts to obtain payment

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15
Q

waste

A

Overutilization of services or other practices that directly or indirectly result in unnecessary costs to
the healthcare system

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16
Q

false claims act

A
  • Imposes liability on any person who submits a claim
    to the federal government that he/she knows (or
    should know) is false
  • ya cant say ya just didnt know
  • Criminal false claims - jail and fines
  • whistleblower provision- private individual can submit to file lawsuit on behalf of US for violation of act
17
Q

Anti-Kickback Statute

A
  • kickbacks can distort medical decision making, cause over use, increase costs, result in unfair competition
  • forbids receiving payment for referring pt for services, equipment, any item that would be covered by medicare
  • criminal law- intent matters
18
Q

Physician Self- Referral Law (Stark Law)

A
  • services for Medicare and Medicaid if the physician
    (or immediate family member) has a financial relationship with that entity
  • includes ownership, investment interest, compensation
19
Q

exclusion statute

A

The Department of Health and Human Services is required to exclude health care providers and suppliers who have been convicted of the following crimes from participation in federal health care programs:
 Medicare Fraud
 Patient abuse or neglect
 Felony convictions for health care related fraud, theft, or
misconduct
 Felony convictions for unlawful manufacture, distribution,
prescription, or dispensing of controlled substance

20
Q

Civil Monetary Penalties Law

A

The Office of the Inspector General may seek civil
monetary penalties for a variety of criminal violations:
 Presenting a claim that the person knows (or should
know) is for a service or item that was not provided
 Presenting a claim that the person knows (or should
know) is for an item or service that is not eligible for
payment
 Violating the Anti-Kickback Statute

21
Q

ethics

A

systematic rational reflection on issues of right or wrong or regarding what we ought to do

22
Q

values

A

Subjective standards for what is right or wrong, good or bad

23
Q

laws

A

includes rules, administrative codes, and regulations created by administrative agencies to interpret or implement legislation

24
Q

4 concepts of ethics

A
  1. autonomy - right to self discrimination
  2. beneficence: promote good
  3. non-maleficence: preventing harm
  4. justice: fairness
25
Q

conflicts of interest

A
  • Exists when competing interests or obligations that
    prevent fulfillment of primary professional obligations

 Professionals wherever possible should avoid
conflicts of interest and the perception of conflicts
of interest

26
Q

RIPS Model

A
  • Allows for a step by step analysis which is most
    appropriate for situations in which there are two
    competing ethical principles at stake
  • Four steps
    1. Recognize and Define
    2. Reflect
    3. Decide
    4. Implement, Reassess, and Evaluate
27
Q

R - Realm

A

 Individual: Primary concern is the good of the
patient/client. Focus is rights, duties, relationships, and behaviors between individuals.
 Organizational: Primary concern is good of the
organization. Focus is on structures/systems that
facilitate the organizational goals.
 Societal: Primary concern at this level is the common good. Focus is on legal, financial,
constitutional, and cultural goals.

28
Q

IP - Individual Process

A
  • Moral sensitivity: Involves recognizing, interpreting, and
    framing ethical situations
  • Moral judgment: Requires deciding on right vs. wrong
    actions. This process involves generation options,
    selecting, and applying ethical principles
  • Moral motivation: Places a priority on ethical values
    over other values such as self-interests, status, or
    financial gain.
  • Moral courage: Involves implementing the chosen
    ethical action, including development of a plan and
    perseverance in the face of barriers and adversity
29
Q

Situation

A
  • Issue: Important values are present
  • Dilemma: Two courses of action may be taken, both of
    which fulfill a duty, but it is not possible to fulfill both
    obligations (right vs. right decisions)
  • Distress: You know the right course of action but are not
    authorized or empowered to perform it.
  • Temptation: Involves a choice between a “right” and a
    “wrong” in which you may benefit from the “wrong”
    choice
  • Silence: Ethical values are challenged, but no one is
    speaking about this challenge to value
30
Q

Kiddler’s Approaches to Solving Dilemmas

A
  • Rule-based: Follow the rules, duties, obligations, or
    ethical principles already in place
  • Ends-based: Determine the consequences or
    outcomes of alternative actions and the good or
    harm that will result for all of the stakeholders
  • Care-based: Resolve dilemmas according to
    relationships and concern for others
31
Q

recognizing ethical situations

A

 Legal test: Is something illegal?
 Stench test: Does it “feel” wrong?
 Front page test: How would you like this on the front
page of your local newspaper?
 Mom test: If I were my mother, would I do this?
 Professional Ethics Test: Does the Code of Ethics
prohibit or discourage this?

32
Q
A

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