Risk Management Objective 3: Explain legal issues and legal terminology.

•Injury is damage to the body that restricts activity and/or causes disability.

• Those who participate in sports and other physical activities, risk sustaining an injury.

•Sports Medicine professionals should try to minimize the risk of injury as much as possible.

Risk Management: Types of Sports

•Athletes use their body to deter or punish opponents. (Intent of the sport.)•Risk of injury relatively high.

COLLISION

FootballRugby

Ice Hockey

Risk Management: Types of Sports

•Contact occurs, but is not the intent of the sport and discouraged by rules.•Traumatic and overuse injuries are common.

CONTACT

BasketballBaseballField HockeyLacrosseRodeoSoccerSoftballWater PoloWrestling

Risk Management: Types of Sports

•Sports where players are separated such that contact is unlikely without violation.•Acute, traumatic injuries still occur, but the incidence of chronic, overuse related injury is greater.

NON-CONTACT

ArcheryBadmitonBowlingCrew/rowingCross country runningCurlingFencingGolfGymnasticsSkiing/SnowboardingSquashSwimmingDivingTennisTrack & FieldVolleyball

Legal Terminology

It is assumed that an individual who participates in an activity and is injured as a result of the ordinary risk associated at the activity will not have grounds for negligence.

Assumption of Risk

Legal Terminology

Touching someone without their permission.Battery

Legal Terminology

Doing something (commission) or failing to do something (omission) that a reasonable person would or would not do under similar circumstances.

Commission & Omission

Legal Terminology

Failing to inform a participant of potential risks and dangers. When dealing with minors, failing to warn parents or obtaining consent.

Failure to Warn

Legal Terminology

Health Insurance Portability and Accountability ActHIPAA

Law that mandated four main areas of change for business in the health care industry.

•Privacy of health information•Standards for electronic transactions of health information and claims.•Security of electronic health information.•National identifiers for providers.

Legal Terminology

Being informed of all procedures and the potential risks and benefits of each.

Informed Consent

Legal Terminology

The legal responsibility to act in a reasonable and prudent manner. Failure to perform in such a manner makes you legally liable.

Liability

Legal Terminology

When an individual commits a negligent act while providing care.

Malpractice

Legal Terminology

Failure to use ordinary or reasonable care. In order to prove, four basic elements must be shown:

•Duty of care – an individual has the responsibility to provide care.•Breach of duty – conduct of provider falls short of that duty. Usually commission or omission.•Injury or damage – results of the breach of duty.•Proximate cause – the injury or damage directly related to the breach of duty.

Negligence

Legal Terminology

Provides reasonable and prudent care expected as compared to someone with similar education and experience.

Standard of Care

Ethical Conduct and Associated Issues

Sports medicine professionals must act at all times with the highest standards of conduct and integrity.

Ethics can be defined as a system of moral principles or standards governing conduct and knowledge of right and wrong.

Ethical Conduct and Associated Issues

Federal legislation that opens up services, facilities, and opportunities to people with disabilities.

Americans with Disabilities Act (ADA)

Ethical Conduct and Associated Issues

Many people believe fair play and sportsmanship to be the “golden rule” of the sports world.

Fair Play and Sportsmanship

Some ethical issues related to fair play/sportsmanship include:

•Cheating•Performance Enhancing Drugs•Drug Testing

Ethical Conduct and Associated Issues: Fair Play and Sportsmanship

Manifests itself in several ways in the world of athletics.

Is victory due to training and talent, or cheating?

Cheating

The pressure of failing is too much to deal with. No one wants to be a failure.

Ethical Conduct and Associated Issues: Fair Play and Sportsmanship

Substances used for the express purpose to perform better athletically.

Performance Enhancing Drugs

Ethical Conduct and Associated Issues: Fair Play and Sportsmanship

A common tool used to try to deter the use of performance enhancing drugs.

Drug Testing

Ethical Conduct and Associated Issues

Each career area has guideline regarding what you can and cannot do. Make sure you are staying within the boundaries of your training and complying with local and federal laws.

Scope of Practice

Ethical Conduct and Associated Issues

An addition to the 14th Amendment in 1972. No person shall be excluded on the basis of gender or be denied the benefit of any education program or activity receiving Federal financial assistance.

Title IX - Gender Equity

Ethical Conduct and Associated Issues

•Our cultural traditions value winning, and why not since it is part of the reason sports exist. •What we fail to teach our children, students, athletes, and society in general is that the honest pursuit of anything carries with it the responsibility to do it right.

Winning At All Costs

Ethical Conduct and Associated Issues

•Be familiar with medical histories of athletes, clients, or patients.•Carry liability insurance.•Be informed and current in changes in the standard of care through continuing education.

Clinician Risk Reduction

Ethical Conduct and Associated Issues

Demonstrate appropriate documentation.•Implement a comprehensive record-keeping system.•Critical in litigation, as well as with communication between members of sports medicine team.•Pre-participation exams, insurance forms, personal data, rehab programs, progress charts, etc.•In a legal situation, “if it wasn’t written down, it didn’t happen”!•Injury reporting forms and injury tracking software are available online.

Clinician Risk Reduction (con’t)

Ethical Conduct and Associated Issues

SOAP Format – a medical documentation method•S = Subjective: Information that the patient reports.•O= Objective: Information that can be measured and expressed in a standard format.•A= Assessment: What decisions are made with the information gathered.•P = Plan: Course of treatment to be carried out.

Clinician Risk Reduction (con’t)

Ethical Conduct and Associated Issues

• Follow physician’s orders and recommendations.

Clinician Risk Reduction (con’t)

• Have an Emergency Action Plan:• Develop separate EAP for each field, gym, court, etc.• Include policies for removal of protective equipment.• Emergency communication needed.• Have keys to doors, gates or padlocks easily accessible.• Hold an annual meeting with all involved to review EAP.• Carry contact information for athletes and coaches at all times.

Ethical Conduct and Associated Issues

Clinician Risk Reduction (con’t)

• Always stay within your scope of practice.• Maintain qualified and adequate supervision of facilities, employees, and equipment.• Maintain good rapport with athletes, parents, coaches, physicians, clients and colleagues. (Sports Medicine Team)