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60 Cards in this Set
- Front
- Back
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UTMB PA school |
Established Oct. 5 1891 |
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Old red |
Completed in 1890, by Nicholas Clayton made a red brick and granite 1900 storm- destroyed roof |
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UTMB 2011 |
80 buldings, 2500 students 4 schools- SHP, MS, GS, and nursing |
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UTMB core values |
Service, Diversity, community, education, teach, research, service |
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PA program important dates |
1971- accepted 6 students 1973- graduated 6 students 1974- first accredation 1994- first class UTPA 2001- first masters degree |
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PA programs nation wide |
11,000 students enrolled at one time 2008- 5,500 new graduates passed the PANCE |
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Program structure |
President, provost of insitution, dean of school of health, chair of PA program |
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postgraduate program |
1971- first program started 1976- norwalk hospital surgical program 1980- six post grad programs 2009- 44 post grad programs 2% of all PAs have done post grad program |
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Ethics |
is the study of human conduct, the determination of right or wrong of actions, the motives and ends of actions, and the establishment of principles for standards of conduct |
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morality |
derived from latin word "more" generally defined as a system of norms and rules for guiding human conduct |
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Normative ethics |
attempts to define the norms that are used to help guide and evaluate conduct
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Applied ethics |
type of normative ethic, form of narrative ethics that utilizes theories, arguements, and analysis to examine moral problems, practice and policies in professional practice |
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Non-normative ethics |
descriptive ethics, and metaethics |
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Descriptive ethics |
scientific study or moral conduct and beliefs- how presffesionals relfect on moral issues and how they actaully repond to htose tissue e.g. informed consent, child abuse, incompetent peers |
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Metaethics |
the study of concepts languages and methods that epople use to relfect on moral dilemmas and the logic and patterns of moral reasoning and rationels used to justfy decision |
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Ethical dilemmas |
an inherently difficult problem or siutaiton in which there are conflicting moral claims about the "right" thing to do |
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Ethical principles- 4 main |
autonomy, benefience, non-maleficence, and justice
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Other ethical principle |
Respect, veracity (truth telling) |
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autonomy |
an indivdual should be allowed to govern to the greatest extent possible his/her own life and choices implies a strong sense of self determination and acceptance of responsibility for one's own choices and actions |
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beneficence |
prima facie- duty to prevent harm and to provide benefits and promote good Four elements - duty to not inflict evil or harm -duty to prevent evil or harm - duty to remove evil -duty to do or promote good
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non-maleficence |
duty to not intentionally inflict harm- primum non nocere "above all do no harm" |
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pricniple of justice |
comparative treatment of individuals based on fairness, queslity or other criteria |
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futility |
lack of intended physiologic effect, low likelihood of survival to discharge, low likelihood of survival more than a few months, poor quality of life. Four concepts: physiologic futility, imminent demise futility, lethal condition futility, and qualitative futility |
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Quinlan |
pt has right to refuse treatment, court ruled in her favor, pt took off medical vent but still had nutrition lived for 9 years |
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Brophy v. new england sinai hospital |
court support that pt has the righ to end care |
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cruzan v. director |
fought to withhold nutrition, court sided with gaurdian |
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terri sciavo |
pt parents argued quality of life, husband and friend argued pt has told them her wishes |
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Artifical nutrition |
considered recieving nutrition in any form other thna the taking in of food and fluid throught he mouth |
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short term options artifical nutrition |
ng tube- larger able to give meds through dobhof- smaller unable to give meds |
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long term options artifical nutrition |
peg tube, surgical gastronomy, j-tube |
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Associated risk of long term options |
infeciton, tube malfunction, intolerance of feeding, use of restreaints, fluid overload/electrolyte imbalance, aspiration |
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Appropriate use of artifical nutrition |
when a return to normal quality of life is expected: reversible conditions, surgical recovery, incapcitated states expected to reverse, short gut syndrome |
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Patient self-determination act 1990 |
federal law requiring hospitals, HMOs, hospices, and home health organizations that particpate in medicaid or medicare to inform patients of their rights to make end-of-life medical desicions, It also requires that advance directives be maintained in patient's charts. |
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living wills |
allows pt to choose their treatment if terminally ill or have an irreversible condition - designates power of attorney, revocable by pt - needs 2 witnesses -punishment class a misdeamnor, and murder |
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Medical power of attorney |
person designated to make medical descisions when the patient is incapcitated, with out designation it goes to.. 1. spouse 2. adult child 3. parent 4. nearest living relative 5. clergy |
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DNR- do not resuscitate |
need two witnesses or notary and physician to sign off on. Need in hospital and out of hospital DNR. Can be revoked verbally at anytime Punishment class A misdeamnor and murder |
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inter vivos trust |
living trust created while person is alive, revocable or irrvocable |
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testamentary trust |
created in last will and testament- into effect upon death executor- must gather assests, pay debts, expenses, and taxes then distribute remaining assests to devisees under will |
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Subsitute |
provide comparable care, effective care, safe care, and patient satisfaction compared to the physician - Primary care 85%, adult practice 75%, pediatrics 90%, military 99% |
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complement |
enhances the services being provided by the physician |
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Factors that effect cost-effectiveness of PA |
practice arrangement, delegations, supervision, consultation rate with physician, clinical productivity |
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CME requirements |
100 hours every 2 years, 50 category 1 hours, 40 hours a year minimum |
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Liability |
court finds one party legally responsible for money damage to another party for injury or harm |
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Respondeat superior |
let the master answer |
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negligent superivsion |
lack of monitoring |
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negligent hiring |
not discovering previous wrong when hirin |
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The "captain of the ship" doctrine |
MD liable for employees, PA liable for their own actions |
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The "borrowed servant rule" |
servant is not in control of his or her own actions |
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Agency |
legal term meaning a relationship whereby one party is authorized to represent another Agent = PA, principal = physician supervisor Can be contractual (written) apparent (Verbal) inherent (principal is always liable no matter what) |
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Types of authority |
expressed- the orders from the principal are clearly defined implied- authority is based on a reasonable beleif |
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AMA guidelines of PAs |
you can't do what the physician can't do supervising physician must be available by phone must introduce yourself as a PA |
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Malpractice |
liability determined by court must prove negligence |
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Four components of negligence |
duty, breach of duty, proximal cause, and damages |
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AAPA resources to find a job |
become a member, call AAPA, review their website, order a salary-benefits profile |
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Types of insurace |
Occurance, claims made, and tail |
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Occurance insurance |
covers all alleged negligence during coverage regardless of when the claim is filed |
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Claims made |
covers all alleged negligence claims made during policy time period |
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Tail |
usually large premium- covers past negligent claims after other policy has eneded |
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Independent contractor |
you are on your own, no benefits, hourly pay, IRS taxes are on you |
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Employee |
part of the office staff, employment tax, pension beenfits, liability, IRS covered by employer |
