Law and Health Care System Administration
Justify your position about the importance of the physician-patient and hospital-patient
relationships
The doctor-patient relationship is a keystone of healthcare practice. It is also a medium
for obtaining information, diagnosing and planning, accomplishing compliances and providing
support. It is an important tool in market savvy since it is a determining factor on whether people
will join and retain a particular healthcare institution. The doctor-patient relationship is a
component of contemporary medical ethics (Speedling & Rose, 1985). This relationship is
significant because there is need for the patient to develop confidence in the competence of his or
her doctor. The hospital-patient relationship is important to both parties since a patient will be
able to trust the medical services of a particular institution and is also in a position to obtain
personalized healthcare; while the institution is able to obtain and retain clients through a good
reputation of treating patients well (Lichtenberg et al, 2004). A hospital should constantly
establish and sustain good relationships with its patients for it to remain competitive (Kavaler &
Spiegel, 2003).
Determine how contract principle and breach of warranty apply to the health care setting.
Contracts between patients and healthcare providers are either implied or express. Under
both contracts, the patient is obligated to pay for treatment from the healthcare provider while the
healthcare provider is obligated to diagnose and treat the patient using appropriate medical
standards and guidelines. If the healthcare provider does fails to provide the expected treatment,
he commits a breach of contract or warranty. For instance, if a patient gets a plastic surgeon to do
a particular nose job and after the surgery she does not get the nose she was promised, the patient
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may use the contract principle to sue the surgeon for damages. Another instance in which the
contract principle and the breach of warranty may apply in healthcare practice is with regards to
defective products including orthopedic implants. Despite the fact that in most cases, surgeons
installing the defective product are not always held liable, there are some jurisdictions where the
claims may apply to surgeons if they gave their opinion on the quality of the implants (Hunter &
Salzman, 2007).
Analyze the four elements of proof necessary for a plaintiff to proof negligence
Clinical negligence relates to claims against health care providers. It is also known as medical
negligence. For a plaintiff to succeed in such a claim, he or she must prove the following:
a) Duty of Care: The health care provider owed him a duty of a care, that is, the duty not to
occasion injury to the claimant.
Generally, it is not hard to prove that a health care provider owes the plaintiff a duty of care.
The duty of care applies to all healthcare professionals such as doctors, therapists, ambulance
service, mental healthcare team and laboratory workers. They have a duty of protecting patients
from foreseeable dangers capable of causing injury. They are supposed to ensure that equipment
is not defective so as to lead to injury. In addition, they are required to take preventive steps
necessary for a safer hospital environment. For instance, health care providers have a duty to
ensure that patients are prevented from getting accidental shocks while using electronic treatment
devices. They should exercise reasonable care while performing their work in order to prevent
harm or mitigate certain immediate medical needs (Kavaler & Spiegel, 2003; Gosfield &
Reinertsen, 2005).
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b) Breach of Duty: The health care provider breached the duty of care.
The plaintiff is required to prove that what the healthcare provider breached falls within the
standard of reasonable competency. The test is whether the healthcare professional did not meet
the standard of reasonableness that any other professional would have met while performing his
or her work. This is called the “Bolam test”. The court has in the recent past inclined to the
position that in case of reliance on a body of medical opinion to prove negligence, the plaintiff
must also prove the logic and reasonableness of such medical opinion. The duty of care applies
in matters relating to advice, treatment and diagnosis. It is also important to note that a medical
professional may be held liable for breach in case where there is no duty of care but the
professional guarantees the plaintiff a certain result which does not occur. In some cases, the
only claim is that the healthcare professional has been negligent. For instance, where a surgeon
amputates a different leg, the presumption is that he is negligent and the burden is on him to
prove otherwise (Hunter & Salzman, 2007).
c) Causation: The claimant suffered harm out of the breach.
The plaintiff must show that he was harmed either directly or indirectly through the breach of
duty by the health care provider. This requirement is usually difficult to prove. It may be easy to
show that the healthcare provider committed a wrongful act or omission but it is difficult to show
that the injuries suffered by the plaintiff are as a result of the negligent act. Sometimes, a breach
may occur but the plaintiff does not suffer any harm. In such cases, the plaintiff does not get any
compensation (Kavaler & Spiegel, 2003).
d) Actual Injury: The harm resulted into damage or other losses.
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The plaintiff, after establishing breach and harm, must also establish the damage resulting
from the harm which includes physical injury and financial loss. The injury must be a
recognizable psychiatric injury such as adjustment disorder, nervous shock or post-traumatic
stress. The court attempts to place the plaintiff back to his original position before the injury
occurred by determining the pecuniary value to be awarded to the injury in relation to previously
decided cases. Nonetheless, not all damages are recoverable. The court does not award remote
damages which could not have been reasonably foreseen. Compensation usually includes awards
for pain and suffering as well as for loss of amenity. This form of compensation is known as
“general damages”. The court also awards “special damages” to cover for any past or future
financial losses suffered by the plaintiff as a result of the negligence. Practically, general
damages may be very small, so that the damage awarded to the injury is very low compared to
the damage awarded for future loss (Hunter & Salzman, 2007).
Discuss the function and responsibilities of the governing board of a health care
corporation.
The functions and responsibilities of the governing body of a health care corporation are
numerous. The major function is policy and decision making. The board plans policies and
strategies. It also implements and adheres to the general mission of the healthcare corporation
(Kavaler & Spiegel, 2003).
The board provides oversight of staff supervision and the operations of the health care
institution. It appoints members of the administrative and medical staff and ensures that they
conduct their work in accordance with the codes of conduct and health care practice. It is the
function of the board to define clinical privileges and oversee lay administrators and medical
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staff performances. It sets disciplinary measures in line with state and federal health care practice
and implements them, making sure that any staff member who does not work in accordance with
the legal requirements faces appropriate disciplinary measures. It is therefore important that the
board be properly structured and composed in order to promote efficiency in the functioning of
all areas of the healthcare corporation. The board makes sure that the people given privileges
provide quality care. To promote the efficiency of this strategy, it monitors the credentialing
quality and peer review processes (Gosfield & Reinertsen, 2005).
The board also has the responsibility of appointing a competent executive officer who is
responsible for establishing an effective administrative team to make strategic and financial
decisions. The board is required to enhance a culture of quality and safety, promote performance
and get involved in state projects, provide financial resources, review adverse events and monitor
activities and results. It should be able to hold itself and the management accountable.
Furthermore, certain community members such as businessmen and bankers are also
stakeholders in the governance of a health care corporation.
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References
Gosfield, A. G., & Reinertsen, J. L. (2005). The 100,000 lives campaign: crystallizing standards
of care for Hospitals. Health Affairs, 24(6), 1560-1570.
Hunter, D., & Salzman, J. (2007). Negligence in the Air: The Duty of Care in Climate Change
Litigation. University of Pennsylvania Law Review, 155(6), 1741-1794.
Lichtenberg, P, Heresco-Levy, U. &Nitzan, U. (2004). The Ethics of the Placebo in Clinical
Practice”. Journal of Medical Ethics, 30(6):551-554.
Kavaler, F., & Spiegel, A. D. (2003). Risk management in health care institutions: a strategic
approach. Jones & Bartlett Learning.
Speedling, E. J., & Rose, D. N. (1985). Building an effective doctor-patient relationship: from
patient satisfaction to patient participation. Social Science & Medicine, 21(2), 115-120.