CE/CME Questions and Objectives
August 1, 2006 3 minutes read
CE/CME Objectives
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Participants who complete this activity will be able to:
- identify high-risk patients and practices within the ED;
- discuss a standard of care in the ED for treatment of conditions that may be considered as high-risk;
- explain conditions and practices in which informed consent is required in the ED;
- cite methods of minimizing risk in the ED setting.
CE/CME Questions
35. An ED physician who works as an independent contractor at a hospital ED can be found liable for malpractice committed by physician extenders who are hired by the hospital but work in conjunction with that physician:
A. if the physician extender is seeing patients on behalf of the hospital and does not report to the physician.
B. if the physician extender is seeing patients on behalf of the hospital and does not report to the physician, but the physician voluntarily countersigns the physician extender's charts for treatment rendered without his supervision
C. the physician utilizes the services of the physician extender at times when the ED is busy and directs the physician extender during the care of some, but not all patients during that time; and the cause of action arises from during a time when the physician extender is not helping the physician.
D. All of the above.
36. An ED physician who works as a hospital employee obtains a consultation in a complex case from a private practice cardiologist, who does not see the patient herself. She instead sends a cardiology physician extender who leaves his recommendations in the chart, which the ED physician follows. The patient sustains a cardiac arrest and dies. Who is likely to be liable?
A. The ED physician, if she did not follow reasonable recommendations.
B. Only the physician extender because he acted outside his scope of authority and without adequate supervision
C. The cardiologist because she was the supervisor of record of the physician extender.
D. None of the above. There was no patient-physician relationship.
E. A and C
37. Physician extenders are employed by a hospital to perform routine admissions for patients admitted through the ED. The physician extender performs the history and physical examination, makes a tentative diagnosis, and writes orders. The physician extender must notify and consult with each attending physician of record at the time of admission regarding the plan of care. Which of the following statements is correct?
A. In the case of a misdiagnosis that leads to a breach in the standard of care, the physician extender alone is responsible until the attending physician formally sees the patient and concurs with the physician extender's diagnosis and treatment.
B. In the case of a breach in the standard of care, liability is limited to both the physician extender and the attending physician who jointly share full responsibility.
C. In the case of a breach in the standard of care, liability is likely to be shared by the physician extender, the attending physician, and perhaps the hospital.
D. In the case of a breach in the standard of care, the hospital alone is liable under the doctrine of respondeat superior.
38. A contracting ED physician works side by side with physician extenders who are employed by the hospital. The physician extenders see only the low acuity patients and use hospital algorithms to triage and treat these patients. Which one of the following statements is true?
A. The ED physician should not co-sign the physician extender charts, even if he is asked to do so by the medical records office, unless he has personally evaluated the patients and at least concurred with the treatment rendered.
B. The ED physician should avoid consultations from the physician extenders.
C. The hospital can bill for the physician extender services as "incident to" since a supervising physician is present at the point of care.
D. Nurses are not required to accept orders written by a physician extender unless the order is ratified by the attending physician.
Answers: 35. D; 36. E; 37. C; 38.A.
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