You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.
Discussion Question:
What are the potential ethical and legal implications for each of the following practice members?:
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice.
Expert Solution Preview
Introduction:
This scenario depicts a situation where a medical assistant has potentially engaged in illegal behavior by processing a prescription renewal request without proper authorization. The following questions will address the potential ethical and legal implications for different members involved, the strategies to prevent similar incidents, and the leadership qualities necessary to effect positive change in the practice.
1. What are the potential ethical and legal implications for each of the following practice members?
– Medical assistant: Stephanie, the medical assistant, may face legal consequences for processing a prescription renewal request without proper authorization. This action could result in harm to the patient, poor quality of care, and a violation of the medical practice act. Stephanie may also face disciplinary action and may lose her job.
– Nurse Practitioner: The nurse practitioner who supervises Stephanie may also face consequences for failing to implement proper procedures to prevent illegal behavior. The nurse practitioner may also be responsible for ensuring proper training and supervision of medical assistants.
– Medical Director: The medical director may be held responsible for ensuring that proper policies and procedures are in place to prevent illegal behavior and that staff members are adequately trained to follow them.
– Practice: The practice may face legal consequences for harboring illegal behavior and could potentially lose its license to operate.
2. What strategies would you implement to prevent further episodes of potentially illegal behavior?
– Implementing policies and procedures for prescription renewal requests that include proper authorization and documentation.
– Providing clear staff training on these policies and procedures.
– Reinforcing the importance of following these policies and procedures.
– Implementing routine audits to ensure compliance with policies and procedures.
3. What leadership qualities would you apply to effect a positive change in the practice?
– A leader in this situation should be able to communicate effectively with staff and patients.
– They should foster a sense of accountability and transparency among team members.
– They should be decisive and take immediate action to mitigate the situation.
– They should be adaptable and willing to implement change as needed to prevent similar occurrences.
– They should prioritize patient safety and quality of care in all decisions and actions.
