CH 8

Legal considerations

Credentialing

• Regulates the practice of ATC’s

• Protects the layperson

• Insures competence of ATC’s

AT practice acts- see GA law.-defines the roles and responsibilities of the athlete, ATC and SAT-Varies from state to state

Types of Credentialing

• Licensure • Registration

• Certification • Exemption

Licensure

• Most restrictive form of credentialing

• Protects the rights of the public: limiting the practice of AT to those who have met the requirements of a licensing board established under the law

Licensure

• Licensure prohibits unlicensed persons from performing tasks reserved for AT’s under the law.

• Unlicensed persons can not call themselves Athletic trainers

• There may be an examination to become licensed. May or may not accept NATABOC

Licensure

• Once licensed, AT is subject to to laws/rules of the state practice act defining profession, scope of practice, etc.

• In some states AT is the only allied health profession where the practice act may define patient base

Registration

• Usually an exam is not required

• AT must meet standards of eligibility & pay a fee to be registered.

• Registration defines those able to call themselves AT’s = title protection

• The least restrictive form of credentialing.

Certification

• Not same as NATABOC

• Means person has submitted minimum credentials required of practioners and has taken some form of state exam.

• No title protection but may restrict application of specific skills and knowledge to persons who are regulated

Exemption

• May provide a legal basis for AT practice by exempting them from complying with the practice acts of other professions.

• Without exemption, AT’s would be in violation of the practice act of a licensed profession

• Usually applies to the PT practice act

Scope of Practice

• The practice of medicine is unlimited in scope when performed by allopathic of osteopathic physicians

• All other medical or allied health professions have a limited scope of practice subordinate to physicians

Scope of Practice

• Diagnosis, surgery, prescribing are ascribed to physicians

• Limited scope means the AHP (allied health profession (al)) works under the auspices of a physician

• AHP may apply their knowledge but within a narrow scope of practice.

Standards of Care

• Is the level of medical sophistication and competency that must be demonstrated by someone who has similar education and training to other members of a particular group.

• Different state regulation of AT means the standard of care may vary from state to state. State regulation may supercede agency standards.

Standards of Care

• Standards are used to provide evidence of a duty to act.

• NATABOC standards (see text) help to est. minimum requirements of action for practicing athletic trainers

• You WILL be held accountable to published standards of practice.

Terms

• Tort = legal wrong other than breach of contract for which the courts provide some remedy– Most often are negligence

– Two keys• Professionals have a duty to exercise the skills and and

knowledge normally employed by members of the profession to prevent unreasonable risk of harm to others

• Negligence = can be either an act of omission or commission

Terms

• Negligence– To prove Negligence 4 points must be

proven

1. Duty to use reasonable care to conform to a standard (Duty to Care)

2. Breach of duty

3. Causation

4. Damages/injury

1. Duty to act/care = usually is delineated in a contract, if no contract then interpretation is open.

2. Breach of Duty = the standard of care has been violated

1. Prevention2. Standard of care3. disclosure

3. Causation = determines that the actions led to damages and to what extent a person is responsible for the damages.

1. Foreseeable = causation occurs if the action that resulted in damages was forseeable

1. Using SATs can lead to liability (see text)

4. Damages = the act must be proven to have caused damages

Blond’s Torts

• Locality rule• Success not

guaranteed• Differing schools of

thought• Specialists• Novices• Unreasonable

standard

• Doctrine of informed consent

Negligence

• Proven by expert testimony or circumstantial evidence

• When est. damages are awarded

Reduce Risk

• Prepare for activity– Physical exams

– Monitor fitness levels

– Access activity levels

– Monitor environmental conditions

• Conduct of activity– Maintain equipment

– Instruct techniques

– Allow for adequate recovery time

Reduce Risk

• Injury Management– Make sure the MD is involved

– Eval injuries correctly and promptly

– Supervise

• Records Management– Document MD orders

– Document treatment plan

– Document treatment records

– Document progress

Professional Liability Insurance

• Always maintain

• Make sure you understand your coverage (what about when volunteering and you are not bound by a contract)

• Purchase as much coverage as you can afford

• Seabury and Smith used often

Defenses

• Statute of limitations

• Sovereign immunity

• Assumption of risk

• Good Samaritan laws

• Comparative negligence