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.
Case Study Questions:
1. What are the potential ethical and legal implications for each of the following practice members?
oMedical assistant
oNurse Practitioner
oMedical Director
oPractice
2. What strategies would you implement to prevent further episodes of potentially illegal behavior?
3. What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice.
4. A scholarly resource must be used for EACH discussion question each week.
Expert Solution Preview
Introduction:
In this scenario, a medical assistant has potentially engaged in illegal behavior by handling prescription requests without permission from the prescriber. This case raises important ethical and legal questions for all practice members to consider. As a medical professor, it is important to discuss these issues with medical college students to prepare them for potential scenarios they may face in their future practice.
1. What are the potential ethical and legal implications for each of the following practice members?
o Medical assistant
There are potential ethical and legal implications for the medical assistant who handled the prescription request without permission from the prescriber. This behavior raises questions of patient safety and appropriate medication management. The medical assistant may have violated state and federal laws governing medication prescriptions and may face legal consequences.
o Nurse Practitioner
The nurse practitioner is responsible for ensuring appropriate medication management and safe prescribing behaviors. In this scenario, the nurse practitioner did not provide the prescription, and therefore is not directly responsible for any illegal behavior. However, the nurse practitioner has an ethical obligation to investigate the situation and ensure that appropriate steps are taken to prevent similar occurrences in the future.
o Medical Director
As the medical director of the practice, there are ethical and legal responsibilities to ensure that all staff members follow appropriate policies and procedures regarding medication management. The medical director may face legal consequences if the practice is found to be negligent in ensuring prescription policies are followed.
o Practice
The practice must ensure that all staff members are appropriately trained and follow policies and procedures regarding medication management. Failure to do so may result in legal consequences and damage to the practice’s reputation.
2. What strategies would you implement to prevent further episodes of potentially illegal behavior?
To prevent further episodes of potentially illegal behavior, it is recommended that the following strategies be implemented:
– Ensure that all staff members receive thorough training on prescription policies and procedures.
– Implement clear policies around medication management and prescribing.
– Implement a system for tracking and reviewing prescription requests and refills.
– Establish systems for staff members to report any concerns or potential violations.
3. What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice.
To effect a positive change in the practice, leadership qualities such as accountability, transparency, and effective communication are crucial. It is important to establish a culture in which all staff members feel comfortable reporting concerns and discussing potential violations. Regular training and education, as well as establishing clear policies and procedures, can also help foster a culture of compliance and safety. Additionally, effective leadership requires a willingness to take accountability for mistakes and work collaboratively with staff members to find solutions and prevent future incidents.
4. A scholarly resource must be used for EACH discussion question each week.
A scholarly resource that may be helpful for this scenario is the article “Prescribing Practices: Roles and Responsibilities of Primary Care Physicians and Pharmacists” by Jessica L. Reynolds and Rachel H. LaCounte. This article discusses the importance of clear communication and collaboration between primary care physicians and pharmacists in ensuring appropriate prescribing practices. It highlights the need for proper medication management policies and procedures to ensure patient safety and avoid potential legal consequences.
