PROFESSIONAL LIABILITY Lawsuits related to health care have greatly increased during the past decade, and the average liability award granted to a plaintiff who prevails in a medical malpractice case is now over $1 million. Professional liability is determined by the federal, state, and local laws governing the physician–patient relationship and relates to the standard of care, legal contracts, and informed consent. An important issue in the question of liability is the physician–employee relationship. Some factors impacting this relationship are discussed here. They include respondeat superior, standard of care, malpractice, res ipsa loquitur, statute of limitations, Good Samaritan laws, and defamation of character.
Respondeat Superior
Physician-employers are especially concerned that their employees have a complete understanding of the law. The Latin term respondeat superior literally means “Let the master answer.” This means that the physician is liable for negligent actions committed by that physician’s employees. In some cases and in some states, both the physician and the employee may be held liable.
In effect, under respondeat superior, the physician delegates certain duties to you, the medical assistant, and if you perform them incorrectly, the ultimate liability rests with the physician-employer. However, medical assistants and other health care workers can also be named in malpractice suits. For example, if you are authorized by your employer to draw a sample of blood from a patient and you inadvertently enter a nerve, causing permanent damage to the patient’s arm, then you may also be liable for that patient’s injury.
Because the physician’s medical license is jeopardized when errors are made, and because you, as a medical assistant, can also be held liable, it is vital that you have an understanding of the laws in your state.
Originally, malpractice insurance was purchased only by physicians. Now, however, many medical assistants purchase professional (malpractice) insurance as well. This is discussed later in the chapter in the section on medical malpractice insurance.
Physician’s Standard of Care Although a physician is under no obligation to treat everyone, once a patient is accepted for treatment, the physician has then entered into the physician–patient relationship and must provide a certain standard of care. This standard of care asserts that the physician must provide the same knowledge, care, and skill that a similarly trained physician would provide under the same circumstances in the same locality. The law requires only reasonable, ordinary care and skill.
The physician is expected to perform the same acts that a “reasonable and prudent” physician would. This standard also states that a physician will not perform any acts that a “reasonable and prudent” physician would not. Physicians are expected to exhaust all the resources available when they are treating a patient. These would include the following:
- Taking a thorough medical history
- Performing a complete physical examination
- Ordering and evaluating the necessary laboratory tests and imaging procedures Physicians are not expected to expose their patients to undue risk. If this standard of care is violated, the physician is liable for negligence.
Medical Assistant’s Standard of Care As a medical assistant, you must remember that your actions can have legal consequences for the physician who employs you. If you work outside the scope of practice for medical assistants in your state, you are at risk of being sued by a patient or the patient’s family. You are not held to the same standard of care as a physician, because of differing credentials, licensure, and education. However, you will carry out your duties under the direction of a physician, and therefore, you must use the same approved methods that a physician would use. For example, you must uphold the same standard of quality as any physician would when taking an electrocardiogram, drawing blood, and collecting specimens.
A medical assistant is not allowed to diagnose medical conditions, interpret electrocardiograms, or prescribe medications, because these are all within the area of the physician’s scope of practice (the normal range of duties and activities of a physician). In fact, medical assistants must continually use caution and be careful not to take on any tasks or duties for which they are not trained and that do not lie within the scope of practice of a medical assistant in the state where they are employed.
The actions of medical assistants reflect on their physicianemployers. Many duties performed by medical assistants could result in harm to the patient if not done properly. In some lawsuits, the physician has been found guilty of negligence because of improper performance of the medical assistant.