The case study of Jerry McCall, one of the medical assistants in Dr. William’s office, describes one of the many challenges that occur on a daily basis while working in a doctor’s office. There are many different levels of staff present in an office that have an array of different job duties and scopes of practice. Jerry was presented with a patient that was in need of a prescription refill on a medication that he is not allowed to issue without direct authorization from the physician. Unfortunately for Jerry he was covering a lunch break and the only one in the office at that time.
There are a number of different ethical decisions that Jerry is faced with in which we will cover below. Jerry’s medical training as a medical assistant does not include the release of any type of refill of prescription medications without the authorization or direction from the physician. The scope of practice for a medical assistant includes performing “administrative and certain clinical duties under the direction of physician. Administrative duties may include scheduling appointments, maintaining medical records, billing, and coding for insurance purposes.
Clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and administering medications as directed by physician” (Medical Assistant Job Description, 1997-2013). It is also stated in the case study that Jerry is a Licensed Practical Nurse, which is also only to refill a prescription under the direction of the physician. Would it make a difference if the medication requested were for control of high blood pressure that the patient critically needs on a daily basis?
There should not be a difference between what types of medications Jerry is asked to authorize to refill for a patient. This type of duty is not part of the medical assistant’s scope of practice. There are other alternatives that Jerry can turn to in order to problem-solve this situation that will be discussed below. If Jerry calls in the refill and the patient has an adverse reaction while flying, is Jerry protected from a lawsuit under the doctrine of respondent superior?
The doctrine of respondent superior is a “legal doctrine most commonly used in tort, that holds an employer or principal legally responsible for the wrongful acts of an employee or agent, if such acts occur within the scope of the employment or agency” (Cornell University Law School, 2010). This is stating that the physician is also responsible and can be held accountable for the actions of Jerry. Jerry must practice within the scope of practice set for medical assistants and within his job description.
The physician can be held liable by the patient and can have charges pressed on him based on this doctrine. The advice I would have for Jerry is to make sure he is looking at this situation as if it were the governing board for medical assistants looking at the same issue. He should not make a decision that is above his job description and out of his scope of practice. This could cause serious problems leading to Jerry possible losing his job. Jerry has a code of ethics that he needs to abide. The patient’s safety should be what Jerry is concerned with.
Major legal and ethical issues that may affect Jerry’s decision are very clear in this situation. If Jerry authorizes this prescription without the physician’s direction he is practicing outside of his scope as a medical assistant and will lose not only his job, but his license. Ethically, he is knowingly performing an illegal act and can be held accountable for this in a court of law. Some problem-solving methods that might be helpful to assist in making an ethical decision are for Jerry to review his code of ethics.
This will educate Jerry that “the code of ethics of American Association of Medical Assistants shall set forth principles of ethical and moral conduct as they relate to the medical profession and the particular practice of medical assisting, render service with full respect for the dignity of humanity, and uphold the honor and high principles of the profession and accept its disciplines” (Fremgen, 2009, p. 328). Another ethical way to problem-solve this issue it to simply call the physician to let him know this patient is in need of a refill which needs to be called in as soon as possible for the patient.
This will place the responsibility back to the physician where it should be. Jerry should instruct the patient that authorizing a refill without the physician’s direction is against the law, and Jerry will notify the physician right away to make him aware of the patient’s needs. In conclusion, Jerry should stick to his code of ethics as a medical assistant and handle the prescription dilemma as any medical assistant should do within his scope of practice.
Jerry should also take into consideration that any ethical decisions he makes can result in the physician he works for being held accountable for Jerry’s actions. The advice for Jerry to call the physician to make him aware of the patients needs would allow him to make the best ethical and legal decision available. Like any working professional, Jerry is held to a code of ethics that he took a vow to uphold, and should remember this when dealing with the safety of any patient.