Hints from newsletter Flashcards

1
Q

According to the Texas Occupations Code, what are the rules regarding physician dispensing of drugs in a rural area?

A

May dispense dangerous drugs when there is no pharmacy and may even be reimbursed for the cost of supply without obtaining a license to practice pharmacy.

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2
Q

When may a physician supply drugs to a patient?

A
  • To meet patient’s immediate needs
  • May also give free samples when it adheres to a course of treatment and as long as they are properly labeled, untampered, and free of charge.
  • When in a rural area and there is no pharmacy.
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3
Q

How should an amendment or correction to a medical note or dictation be completed?

A

Mark or identify the mistake by drawing one line through the error, initial and date it, and then clearly identify the correction or amendment.

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4
Q

When may a physician advertise that they board certified?

A

May only use the term if the specialty board is a member board of the American Board of Medical specialties or the Bureau of Osteopathic Specialists or the American Board of Medical Oral and Maxillofacial Surgery.

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5
Q

What restrictions exist for the advertisement of a medical service?

A
  • you may not materially misrepresent the cost or character of the service
  • you may not advertise a service that is not subject to verification (e.g., cure for incurable disease)
  • you may not advertise professional superiority over another physician
  • ads may not contain testimonials
  • ads cannot waive co-payments or deductibles
  • At the time any advertisement is placed, a physician must possess information that substantiates the truthfulness of any assertion, omission or representation of material fact set forth in the advertisement.
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6
Q

Can a physician ad contain testimonials?

A

No.

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7
Q

Can a physician advertisement waive co-payments?

A

No

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8
Q

Can a physician advertisement waive deductibles?

A

No

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9
Q

What must a physician possess in order to treat worker’s compensation patients?

A

Approval by the Texas Department of Insurance

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10
Q

What must a physician possess in order to produce use or transfer radioactive materials?

A

A special permit or license is required.

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11
Q

What is Texas law regarding third trimester abortions?

A

Texas law proscribes third trimester abortions of viable unborn children except if the physician concludes in good faith that the abortion is necessary to prevent the death of the mother, or is substantial risk of serious impairment to the physical or mental health of the mother, or if the fetus has a severe and irreversible abnormality as identified through reliable diagnostic procedures.

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12
Q

What sort of business partnerships may a physician and non-physician form?

A

None. Physicians may not join business entities with mental health professionals such as psychologists, professional counselors or social workers.

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13
Q

What is the difference between and HMO and PPO?

A

An HMO is composed of doctors and hospitals that join to provide health care for a comprehensive predetermined fixed fee.
A PPO is an organization of physicians who provide care for patients covered by traditional insurance plans at a reduced cost with employees and their insurance companies retaining most of the financial risk.

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14
Q

Transfer of a child for a thing of value is a third degree felony. What conditions are exceptions to this under the Texas Penal Code?

A
  1. When the thing of value is a fee paid to a child-placing agency
    - a fee paid to an attorney or physician for services rendered in the usual course of legal or medical practice
    - a reimbursement of legal or medical expenses incurred by a person for the benefit of the child
    - a necessary pregnancy-related expense paid by the child-placing agency
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15
Q

What health care workers are generally prohibited from performing an exposure prone procedure?

A

Those infected with HIV, or with Hepatitis B and are HBeAg positive

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16
Q

What is the license renewal policy if the physician leaves the state and doesn’t renew his/her license?

A

A. > 1 year = cancelled license
B. 1 - 2 years = physician must reapply as if getting a new license but it does state the board may reissue a new license to a person whose license was automatically cancelled without examination it if was less than two years
C. > 3 years = physician must apply for new license and take the JP exam again

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17
Q

What are the license requirements for those who practice telemedicine on Texas patients?

A
  • Must have a state license in good standing in the state in which they practice
  • Be certified in a medical specialty approved by the American Board of Medical Specialties
  • Passed the Texas JP Exam
  • Cannot physically practice medicine in the state of Texas
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18
Q

What circumstances allow the board to issue a confidential rehabilitation order?

A

Self-reported use of drugs or alcohol
Judged to be of unsound mind
Findings of physical or mental impairment
Discovery that provider suffers from a potentially dangerous limitation

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19
Q

What sort of orders and findings from the Board are confidential?

A

Non-Disciplinary Rehabilitation Orders

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20
Q

What is the single major cause of lost malpractice lawsuits?

A

Inappropriate and inadequate medical record keeping

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21
Q

How long must a physician keep a medical record?

A

At least 7 years but if the patient is younger than 18 then the physician must keep the records till age 21 or for 7 years whichever is longer.

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22
Q

How soon must requests for copies of medical records be answered?

A

15 business days after receipt of the written request.

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23
Q

How long does a physician’s malpractice insurer have to notify the Board regarding any lawsuits or payments on malpractice claims?

A

30 days (uninsured physicians must report themselves)

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24
Q

How long must restriction of clinical privileges be in place for it to be required that these restrictions be reported to the Board?

A

30 days

25
Q

What must termination of a patient involve?

A

Allowance of a 30 day grace period for continual treatment until care is transferred to another physician

  • written notification to patient by return receipt mail
  • statement of the reason for termination
  • clear statement of termination date
  • provision of sources to assist patient in finding another physician
  • offer to transfer patient’s records
26
Q

What prescriptions can physician assistants write?

A

Schedule III-IV drugs

NOT Schedule II drugs nor Schedule I because they require triplicate

27
Q

What law enables pharmacists to dispense substituted generic drugs?

A

The Texas Pharmacy Act

28
Q

How soon must a physician report a case of tuberculosis?

A

Within one working day

29
Q

How soon must a physician report a case of pertussis?

A

Within one working day

30
Q

How soon must a physician report a case of anthrax?

A

Immediately

31
Q

How soon must a physician report a case of salmonella?

A

Within 7 days

32
Q

How soon must a physician report a case of gonorrhea?

A

Within 7 days

33
Q

How soon must a physician report a case of syphilis?

A

Within 7 days

34
Q

What happens if a physicians fails to notify local health authorities of a reportable disease?

A

They may be charged with a class B misdemeanor.

35
Q

What must a physician do in cases of family violence and domestic abuse?

A

Must document findings in chart
Offer to contact local authorities
Provide information about nearby shelters to the abused spouse
(all these exclude cases of elderly or child abuse which have different requirements)

36
Q

When can the board suspend a physician’s license?

A

The Board shall revoke, suspend, or deny a physician’s license if the Board determines that, through the practice of medicine, they physician poses a continuing threat to the public welfare.

37
Q

What is the difference between deferred adjudication and a conviction for the purposes of the Texas JP Exam?

A

There is no differences for the purposes of the exam.

38
Q

What type of crime requires report to the Texas Medical Board within 30 days?

A

Any felony. Also misdemeanors involving moral turpitude, fraud or abuse under the Medicare or Medicaid program or narcotic violations. Do not wait till the time for renewal of your medical license to report a conviction listed above.

39
Q

If a physician is charged with a DWI and convicted does he or she have to notify the Board within 30 days if the conviction does not involve moral turpitude?

A

No but the physician must notify the TMB at the time of their license renewal of a conviction or deferred adjudication.

40
Q

Who can serve as decision makers for a comatose or incapacitated or mentally ill patient and in what order of priority?

A
  • Spouse
  • Adult child who has the waiver and consent of other qualified adult children
  • A majority of the patient’s reasonably available adult children
  • Patient’s parents
  • The individual clearly identified to act for the patient by the patient before he or she became incapacitated.
41
Q

What is the order of priority for execution of an Anatomical Gift if the donor status is unknown (coma and not on driver’s license)?

A
Spouse
Adult Child
Either Parent
Adult Sibling
There must also not be any opposition by a member of a higher or same priority class that objects to the donation.
42
Q

Who may donate under the Texas Anatomical Gift laws?

A

any individual > 18 who has testamentary capacity may donate all or any part of his/her body.
A person younger than 18 may make a gift on the driver’s license but the gift is not effective without the approval of the person’s parents or legal guardian.

43
Q

What must a physician disclose in order to make payments for lab or pathology services?

A

Must disclose the name and address of the laboratory on the bill and the net amount paid to the laboratory.

44
Q

What does Texas Mental Health Code Sec. 572.002 involve?

A

Voluntary psychiatric admission

45
Q

Who may voluntarily admit themselves for psychiatric care?

A
  • Persons 16 years old and older
  • A married or formerly married under 16 year old
  • The person’s parent managing conservator or guardian if the person is younger than 16 years of age and has not been married.
46
Q

How long does a physician have to conduct a physical exam on an admitted psychiatric patient?

A

72 hours for voluntary admissions

12 hours for involuntary admissions

47
Q

What are the limits on a physician’s ability to delegate the carrying out or signing of a prescription drug order?

A

Four Pas or advanced practice nurses or their full-time equivalents practicing at the physician’s primary practice site or at an alternate practice site under Section 157.0541 unless a waiver is submitted

48
Q

What are the physician’s duties when a patient is found to have a communicable disease?

A

Report to local health dept or Dept of State Health Resources

  • To instruct patient in measures for preventing the spread of such disease
  • This does NOT include a duty to inform and educate the spouse and other people who are in close contact.
49
Q

What are the laws regarding Child Abuse reporting in Texas?

A
  1. A non-professional must make a report immediately

2. A physician is required to report not later than the 48th hour

50
Q

If a physician does not possess medical liability insurance, when must he/she report any complaint or malpractice suit to the Board?

A

Within 30 days

51
Q

If parents object to a newborn screening texas based on grounds of conflict with religion, what liability does the physician have if he or she does not adminster the screening?

A

The physician shall not be held liable or responsible for failing to administer the tests.

52
Q

What must be acquired prior to performing newborn screening tests like PKU and hypothyroidism?

A

Consent and approval of the parents

53
Q

How many prescription refills may a PA write for?

A

Up to a 90 day supply including the original prescription

54
Q

What are the criteria for a valid alternate practice site for a physician’s prescription writing delegation abilities?

A

An alternate practice site may not be located up to 75 miles from either the delegating physician’s resident or primary practice site. (The previous maximum was 60 miles and the physician’s residence was not part of the definition)

55
Q

What is a physician’s on-site requirement for alternate practice sites?

A

10% of the hours of operation of the site each month that the PA or APN is acting with delegated prescriptive authority.

56
Q

How must a delegating physician review the medical charts of his APNs or PAs?

A

The physician must review at least 10% of the each mid-level practitioner’s charts and may now do so electronically from a remote location.

57
Q

Must a physician register his/her delegated prescriptive authority to PAs or APNs?

A

Yes, effective from 1/31/2010.

58
Q

If a waiver for the normal limitations of prescription delegation is sought, what is the maximum waiver allowed?

A

The board may not allow a physician to delegate prescriptive authority to more than a total of six PAs or APNs or their full-time equivalents. (The normal limit is four.)

59
Q

When is the board required to remove any record of a formal complaint filed at the State Office Administrative Hearings?

A

If the complaint was dismissed more than five years before the date of the update and:

1) was dismissed as baseless, unfounded or not supported by the evidence
2) or no action was taken against the physician’s license as a result of the complaint

The Board is required to remove any record of an investigation of medical malpractice claims or complaints that the board is required to investigate under Section 164.201 (3 suits in five years) if:

1) Investigation was resolved more than five years before the date of the update
2) no action was taken against the physicians’s license as a result of the investigation