Professional Regulation and Criminal Liability Paper Essay Example for Free

Professional Regulation and Criminal Liability Paper Essay The principle of the Hippocratic Oath is one of the oldest binding documents in history. The oath states: I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion. In purity and according to divine law will I carry out my life and my art. I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft. Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves. Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private. So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate. (U.S. National Library of Medicine, 2014) Medical Board of California The Medical Board of California is the agency responsible for regulating physicians, surgeons and other allied health professions. The members of the board are appointed by the Governor of the state and have a four year term legislature. It is the responsibility of the members of the board to meet as one deliberating body. In addition, the board members are required to learn about policies and statutes of both licensing and enforcement functions. California Licensure Physician Statute There is no single physician licensure statute in the state of California. Instead, physician licensure rules have been interspersed within the California code. Physicians wishing to practice medicine in California are required to obtain a full medical license issued by the state. Furthermore, there are no administrative regulations or state statue for granting a  special or limited license to practice in the state remotely via telemedicine. The California licensure does not allow for license reciprocity between any states but allows physicians for consultative services without having to receive a full medical licensure. Moreover, licensed physicians in the military in any of the states, either a military physician officer or a civilian contract employee, are allowed to care for fellow military members without having to receive additional licensure. In the event of an emergency situation, a physician is allowed to administer care regardless if the physician is licensed in that part icular state. A physical examination is required by the California Medical Board Licensure to allow administration or prescription of medication over the internet. Investigative Role The investigative team consists of physicians that are a critical component to the board as they base its disciplinary actions on the opinions of physicians and not board staff. Physicians play a distinct role in the investigations. The board receives and reviews incoming complaints in the Central Complaint Unit (CCU). The physicians determine if there is a need for formal investigation by board investigative staff or if the complaint is largely resolved by a preliminary review of the medical records and the accompanying physician narrative statement. Medical experts are asked to review case materials and must clearly articulate whether the physicians care under review fell below the standard. They must give their opinion if there is a potential violation of the Medical Practice Act. Business and Professions Code Section 2050-2079 According to the Federation of State Medical Boards, the 10th Amendment police power grants states the right to regulate the practice of medicine. Section 2052 of the Business and Professions Code states that any person who practices or attempts to practice, or who advertises or holds himself or herself out as practicing, any system or mode of treating the sick or afflicted in this state, or who diagnoses, treats, operates for, or prescribes for any ailment, blemish, deformity, disease, disfigurement, disorder, injury, or other physical or mental condition of any person, without having at the time of so doing a valid, unrevoked, or unsuspended  certificate as provided in this chapter or without being authorized to perform the act pursuant to a certificate obtained in accordance with some other provision of law is guilty of a public offense, punishable by a fine not exceeding ten thousand dollars ($10,000), by imprisonment pursuant to subdivision of Section 1170 of the Penal Code, b y imprisonment in a county jail not exceeding one year, or by both the fine and either imprisonment (California Business and Professions Code, 2014). Civil Complaint Process The two major categories of incoming complaints to the Medical Care Board of California by the consumers are quality of care and personal conduct. All complaints require physician review and all complaints which are not closed by CCU staff are referred to one of the boards district offices for formal investigation. According to the Medical Board, each district office is staffed with a supervising investigator, five investigators, a deputy attorney general, an investigator assistant, clerical support staff and one or more medical consultants (The Medical Board of California, 2014). Risk Management Quality Assurance It is important that physicians are credentialed and are given privileges in any health care organization prior to practicing medicine. Physicians must receive training and education in risk management and review of federal and state regulations mandates. A successful risk management strategy is to improve the quality of patient care and reduce the probability of an adverse outcome or a medical malpractice claim. Its objective is to reduce the risk to patients and liability to the physician. Furthermore, the foundation for risk management is the standard of care. Tracking the quality of care of physicians must include Ongoing Professional Practice Evaluations (OPPE) and a peer review committee within an organization. Criminal Prosecution for Malpractice Physicians are in a unique position in regard to the law by the nature of their work. A physician may face a charge of criminal negligence, manslaughter, or second-degree murder if a patient in his care suffers severe or lethal injuries. â€Å"Negligence law offers plaintiffs the legal framework upon which to build their civil suit. A plaintiff in a medical  malpractice action must satisfy four elements-duty, breach, causation and damage- in order to prevail. In a negligence case, the wrongdoers actions are compared to what would be expected of a reasonable and prudent person in the same or similar circumstance† (Monico, Kulkarni, Calise, 2013). The practice of medicine is full of uncertainties. In some cases, bad outcome is the result of physician negligence. The patient and/or his family may institute a civil suit for malpractice if they believe that the bad outcome was a result of the physician’s actions. It is very rare that a prosecutor decides the facts of a ca se warrant a charge of criminal malpractice. The prosecutors must see a repetitive negligent behavior that constitutes to a pattern that can be documented before criminal charges can be filed. Conclusion The medical profession has many dedicated people who give themselves and sacrifices for the sake of saving lives. Physicians practice their profession according to the Hippocratic Oath. Furthermore, the have learned the rules and regulations mandated by the Federal and State government in health care delivery. Quality of health care is an important objective of CMS. Physicians are required to adhere to the standards of quality care and the delivery of it. When physicians get in trouble with the law, they have to face various criminal and civil charges based on the severity of their case. In the current trend, doctors commit white-collar crimes when they take kickbacks, order questionable procedures, overbill patients and insurance companies, and bill for services they did not provide. The Medical Board of California ensures safety and protection of health care consumers through proper licensing and regulation of physicians by means of various objective enforcement of the Medical Practice Act. References California Business and Professions Code. (2014). Business and Professions Code Section 2050-2079. Retrieved from http://www.liginfo.ca.gov/cgi-bin/displaycode?section=bpcgroup Medical Board of California. (2013). Guide to the Laws Governing the Practice of Medicine by Physicians and Surgeons. Retrieved from http://www.mbc.ca.gov/about_laws/laws/_guide.pdf Monico, E., Kulkarni, R., Calise, A. (2013). The Criminal Prosecution of Medical Negligence. Retrieved from http://www.ispub.com/IJLHE/5/1/5237 The Medical Board of California. (2014). Laws and Regulations. Retrieved from http://www.mbc.ca.gov/about_us/laws/ U.S. National Library of Medicine. (2014). The Hippocratic Oath. Retrieved from http://www.nlm.nih.gov/hmd/greek/greek_oath.html

The Plight of the Late Nineteenth Century American Farmer Essay

The Plight of the Late Nineteenth Century American Farmer From the early beginnings of America to well into the nineteenth century, America has been dominantly an agricultural country. Farming and the country life have always been a great part of the American culture. Thomas Jefferson even expressed his gratitude for the farming class by saying Those who labor in the earth are the chosen people of God, if ever He had a chosen people, whose breasts He, has made His peculiar deposit for substantial and genuine virtue. The American culture was built upon farming and agriculture but since the end of the civil war and the abolition of slaves, things have changed dramatically to the American lifestyle. This time brought on the Industrial Revolution which sparked many factories and new ways of transportation across America. There were many acts passed to encourage the agricultural lifestyle still such as the Homestead Act of 1862, the Timber Culture Act of 1873, the Desert Land Act of 1877, and the Timber and Stone Act passed in 1878. As a result of these acts, farm income dropped and new machines and methods or systems to farm such as sharecropping and tenant farming became available and made it much easier to increase crop yields. The people who had the smaller farms, uncultivated land, or limited resources could not compete against the farms who were bigger, better, and more modernized with the new technology. After many people failed on the farms, they were seen heading to t...

The Fundamentals of Cognitive Theories of Motivation

In this paper I will be aiming to cover the following areas. Firstly an overview of the fundamentals behind the cognitive theories of motivation, focusing on three main theories – Equity theory, Expectancy theory and Goal setting theory. Within these theory bases I will outline some of the developmental research that has been occurring, particularly those studies which have added empirical evidence to consolidate or expand on the basic theories. Secondly I will show some practical applications of these theories and evidence of how successful they have been or could be within an organisational environment. Finally a short comment on the adaptability of these models to an international context which has become a dominant feature of current literature in this increasing time of globalisation. The Cognitive Theories – An Overview Motivation can be visualised as the energising force that provides the impetus to make people act. More specifically it is â€Å"the individual internal process that energises directs and sustains behavior; the personal force that causes one to behave in a particular way† (Olsen, 1996, p.1). It is a fundamental concept for management to understand in learning to comprehend the way individuals will behave within a work place context. The cognitive theories of motivation aim to develop this understanding by focusing on the action and choices made in the motivation process. The focus is on the processes that occur within a person's mind, which influence their decision to act. (Wood, Wallace, Zeffane, Schermerhorn, Hunt, Osborn (1998)) They rely on the assumption that behavior is purposeful and being undertaken to achieve a desired outcome or goal. This means that analysing the way choices are made between a variety of perceived outcomes can provide valuable insight into understanding why and how individuals choose to act. Equity theory relies on the way people make comparisons of both effort/return and with those around them, arguing that â€Å"when people gauge the fairness of their work outcomes in comparison with others, felt inequity is the motivating state of mind.† (Wood et al p 183) People resolve the felt inequities by working in such a way as to restore a sense of equity. The equity comparison occurs on two levels. The first is an individuals subjective assessment of whether the effort required will be commensurate with the benefits achieved. The second comparison occurs on a social level using those around as a yardstick against which to measure the individuals own sense of equity. Studies (Adams 1963 in Wood et al; Vecchio 1981) have generally supported this theory. A number of recent studies have sought to develop this principle further. By looking at the relationship between Equity theory and Interpersonal Attraction (Griffeth, Vecchio & Logan 1989) the authors were seeking to determine whether an attraction (or hostility) between the individual and their referent other had any influence upon the way they perceived and reacted to inequities. Their research, through a cross referencing technique of equity factors and attraction factors, provided results that indicated that attraction was indeed a contributing factor in the way individuals perceived equity balances. Although this does not undermine the essentials of equity theory, it adds the need to consider how and with who referent comparisons are made, as extra considerations when using the model. Meanwhile Barr & Conlon (1994) have been looking at the impact of distribution of feedback (both group and individuals) upon individual intentions. In particular for us, this study brings into question the applicability of equity theory assumptions within a group context. It proposes that, in a group setting, where other members would act as referents and rewards are distributed equally based on group performance, individuals would make equity comparisons within the group before deciding whether to persist. This was thought to override the impacts that feedback would otherwise cause. The results supported this contention. It showed that where the impact of individual feedback worked to create a perception of underpayment (due to perceived greater effort than other group members) that individuals were less interested in continuing the behavior that they believe led to the underpayment. Thus the social comparison effect was strong enough to override any of the individual positive feedback received. The study illustrates that social comparison within a group, where felt inequity is present, can have an impact on performance, and equity theory provides a good model for predicting this impact. Once a goal is selected, it allows people to channel their energies toward goal achievement. Four factors are stated as being important in goal setting to stimulate performance (Knowles 1991). These are The theory comes into use within the domain of â€Å"purposefully directed action.† Basically it states that the simplest and most direct motivational explanation of why some people perform better on work tasks than others is because they have different performance goals. (Ryan 1970 in Latham & Locke 1990). While much of the research has previously surrounded assigned goals, more emphasis is now being placed explicitly on self regulation. That is, the extent to which individuals will use goal setting, self monitoring and self rewarding/ self punishing behavior to attain a goal. (Latham & Locke 1990) This may especially be useful in breaking a larger goal down into more specific stepping stone goals. The implication for managers from the study is that the addition of skills in self regulation, acquired through experience, training or effort will lead to a greater likelihood of goals being achieved. Victor Vroom (1964, cited in Wood et al, 1998) developed one of the most widely used models for the understanding of the motivation process. It aims to predict the effort that will be expended by a person in completing a task. It argues that goals are chosen according to the relative attractiveness of the outcome. Diagrammatically it can be represented as follows The contention is that the motivation to work results from the product of Expectancy, Instrumentality and Valence. (M=E x I x V) These elements are defined as follows: Expectancy is the probability of the extent to which the individual believes that a given level of achieved Work Performance will follow work effort. Instrumentality is the probability assigned that a given level of achieved performance will lead to various work outcomes. Valence is the value attached by the individual to those work outcomes. (Wood et al 1998) The implication of the model is that managers need to take into account the importance of the task being achieved along with the likelihood of the task being achieved and the likelihood that the task achievement will lead to a reward that has value to the individual. An individual requires all these factors to provide the impetus to exert the work effort. The fact that the theory does not attempt to specify the types of rewards that will motivate particular employees gives it a robustness that can be useful in application. Klein (1991) has been looking to clarify the relationship between goal setting and expectancy theories. Traditional theoretical approaches suggested viewing â€Å"expectancies and attractiveness as interacting to influence goal choice, with goals being the more direct determinants of effort† (Klein 1991 p 231). However there is also some competing evidence (Garland 1985) which contradicted this view contending that goal attributes affect expectancy theory constructs rather than resulting from them. Klein's study hence sought to expand evidence of how the expectancy theory constructs relate to goal choice, goal commitment and performance. His findings replicated those of Garland. The perceived explanation for this for this was that goals form a dual role of being targets to shoot for as well as standards for evaluating one performance. The research into combining the two theories is continuing, with much discussion currently surrounding â€Å"issues of causal ordering, measurement and the meanings of those measurements†. (Klein 1991 p 230) It appears that we have to wait on the world of academia to conduct more research before a widely accepted combination of the two models evolves. Practical Applications of the Cognitive Theories I now wish to bring in a number of specific examples of how and where these theories can and have been applied. Using Goal Setting to improve Safety Behavior. An application area of particular interest has been the use of goal setting techniques in improving safety performance On an anecdotal level I have seen this prove successful at my own work site at a steelworks at Western Port. I have seen much evidence of the positive use of goal setting techniques in an attempt to address the behavioral component of safe working practices. The focus upon systematic monitoring of safety related behavior and the provision of extensive feedback in conjunction with widely accepted goals on injury performance at a crew and organisational level has seen safety performance improve by over 50% in under two years (BHP Western Port Lost Time Injury Statistics). However it is difficult to read too much into the improvement given that a number of other initiatives are also being concurrently undertaken. A study into the UK construction industry (Marsh, Robertson, Phillips, Duff 1995) provides some empirical support for the premise that hard, specific goals with wide feedback of the results of ones behavior can lead to positive changes in safety behavior. This study found that by using quantitative measures of awareness and review sessions, that the intervention was having positive impacts, supporting my own anecdotal evidence. It supports the notion that clearly identified and well publicised safety targets can perform a crucial role in influencing safety behavior.

Contribution Of Technology On Sustainability - 1595 Words

Contribution of technology to Sustainability Introduction Our dependence on technology to solve environmental problems around the word is really significant, owing to the universal ignorance to make the social, economic and political changes that are deemed to be necessary to reduce growth in production and consumption. Yet again the amount, kind and nature of technological changes required to counteract the growing environmental damage caused by increases in production, consumption and other humanly activities would have to be fairly dramatic. But the question remains, can such a dramatic and radical redesign, structuring and reshaping of our technological systems occur without causing drastic social changes and will it not require a†¦show more content†¦Following fig1.1 indicates the onset of industrialization along with major industrial development and their impact on carbon emission worldwide. In 1890 the Diesel engine became available and was used in ships, locomotives and also in automobiles which directly influenced the rate of carbon emission from fossil fuels. The above fig1.2 indicates that the temperature rose faster from 1975 to now than from 1880 to 1975, and so did CO2. It also indicates that the temperature has been highest recently and so has CO2. A clear relation between Technological development (industrialisation), Carbon emission and Global temperature can be established from the above facts. It is evident that advances in technology have largely been responsible for creating our unsustainable, globalised economy, some of the major technological development in human history has have impacted environment adversely. But as much as technology is making things difficult, it also offers some powerful solutions for sustainability. From the 1970s to 1990s the increase of carbon emissions decreased slightly, in part due to the construction and operation of large nuclear power plants worldwide. At the same time, fossil-fired equipment became more efficient and natural gas-fired combined-cycle power plants with high efficiency levels went into operation. In