PublicHealth-JurisprudenceSyllabus15-16Rev1

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PUBLIC HEALTH / JURISPRUDENCE (MEDICAL LAW)

CMD 325 (80325)

Rocco Petrozzi, DPM

Course Coordinator

COURSE SYLLABUS

Third Year

Spring Semester

2015 – 2016

Credit Hours: Two (2)

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I. C O U R S E R A T I O N A L E

The health care community has an obligation to serve the medical needs of society. As such, each student of podiatric medicine should become familiar with the issues and concerns confronting society and the methods of addressing those needs. Public health issues facing the United States and the entire world population necessitate a concerted multidisciplinary effort. The topics covered in this course are essential to the understanding of the scope of these issues as well as insight into possible solutions.

With the privilege of practicing podiatric medicine come certain legal responsibilities and obligations by which each practitioner must abide. Both business and civil law are presented in this course to prepare the student of podiatric medicine for successful practice.

This course in public health/jurisprudence will present information about public health, community health, occupational/ environmental health and medical law. The principals and procedures presented in this course are essential to the comprehensive practice of podiatric medicine.

Prerequisites for this course are successful completion of all first and second year courses.

II. INSTRUCTIONAL STRATEGY

This is a specialized course where instruction will come from experts in their respective fields. Instruction will come via traditional lecture format and nontraditional means such as case presentation and critical thinking scenarios. The first half (seven lectures) of the course will be devoted to Public Health. The second half (six lectures) of the course will be focused on Medical Law/Jurisprudence. The course addresses fundamental issues with regard to Public Health and medical-legal issues pertaining to the practice and profession of podiatric medicine. This will provide the podiatric medical student with a working knowledge of the basic principles of Public Health and Medical Law.

III. COURSE TIMES AND ATTENDANCE

This course will meet weekly (as outlined in the lecture schedule) on Tuesday mornings from 8:00 AM to 10:00AM during the spring semester of the third academic year. Attendance is expected for the duration of every lecture. Attendance may be taken and used in final grade determination. ***Please note: The Public Health component of CMD 325 is delivered 100% online. All of the lectures are recorded, both audio and video, by faculty from the Kent State University College of Public Health. They will be housed in the current course MediaSite Library (Third Year Spring Public Health). The assigned readings for each lecture are shown below.

On Tuesday October 20, 2015 at 9:00am, Assistant Dean Ken

Slenkovich will be present at the College of Podiatric Medicine to

discuss the course requirements, including the required Group

Project.

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IV. FACULTY / INSTRUCTORS

Rocco Petrozzi, DPM - Course Coordinator/CPM contact - Office Location – 2

nd floor faculty suite

CPM-Independence campus - Office phone number: 216-916-7474 - [email protected]

-Office Hours: Monday (PM), Wed (PM), Thurs (AM) Ken Slenkovich, MA - Assistant Dean and Senior Instructor - Department of Health Policy and Management

- [email protected] - Office phone number: 330-672-6504

Jeff Hallam, PhD - Professor and Chair

- Department of Social and Behavorial Sciences

- [email protected]

- Office phone number: 330-672-0679

Mark James, PhD, MS - Professor and Chair

- Department of Biostatistics, Environmental Health

Sciences, and Epidemiology

[email protected]

Lynette Phillips, PhD, MSPH - Associate Professor

- Department of Biostatistics, Environmental Health,

Sciences and Epidemiology

[email protected]

- Office phone number: 330-672-6324

Jonathan VanGeest, PhD - Professor and Chair

- Department of Health Policy and Management

- [email protected]

- Office phone number: 330-672-6514

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V. MAIN GOALS OF THE COURSE

I. Public Health in Podiatric Medicine

1. The Podiatric medical student should acquire a working knowledge of the essential purpose of public health in general and as it pertains to podiatric medicine, essential public health functions, and healthy people 2010 as mandated by the federal government.

2. The Podiatric medical student should acquire basic knowledge of the concepts of statistics

in public health as well health care. The elements of both parametric and non-parametric statistical testing will be covered. Statistical tests related to podiatric medicine will be emphasized.

3. The Podiatric medical student should acquire basic background in study structure related

to podiatric medicine and concepts of the epidemiologic process.

4. The Podiatric medical student should develop basic knowledge with regard to behavioral

health concepts, models and theory and how this shapes health policy in the federal government and how this relates to the future of podiatric medicine.

5. The Podiatric medical student should acquire a working knowledge of the concept of

leadership, theories of management, mission statements, vision statements and strategic plans and their relationship to podiatric medicine.

6. The Podiatric medical student should develop an understanding of basic concepts of ethics

as well as the legal basis for the institutional review board process (IRB) and basics of grant the importance of ethical principles related to podiatric medicine.

II. Medical Law / Jurisprudence

The podiatric medical student should acquire a thorough knowledge of (the):

1. Federal, state and local legal systems.

2. Government regulations of podiatric medicine

3. Causes and procedures involved with medical malpractice

4. Government administrative compensation systems (i.e. Medicare, Medicaid, Worker's Compensation)

5. Legal issues affecting podiatric medical practice (i.e. liability insurance,

practice organizations, HIPAA, and hospital staff privileges)

6. Risk management; the necessity and methods of practicing defensive medicine in today’s medical-legal environment

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VI. STUDENT RESPONSIBILITIES

It is expected that students attend every lecture. Students are responsible for all lecture materials presented, class handouts, assigned/required readings and written projects, film and/or tapes/electronic documents. Students are responsible for completing any required assignments as directed by the instructor. It is the student's responsibility to learn the material for the course. Students who have difficulty with the material or questions should contact the speaker/lecturer for individual topics or the course coordinator. It is the student's responsibility to seek assistance for any difficulties or questions. It is the student's responsibility to seek assistance in a timely manner prior to the time of examinations or assignment deadlines.

VII. LEARNING RESOURCES

PUBLIC HEALTH ASSIGNED READINGS:

Lecture #1 –

1. Baker, EL, Potter, MA, Jones, DL, et al. The public health infrastructure and our nation’s health.

Annu Rev Public Health 2005; 26:303-318.

2. Tilson H, Berkowitz B. The public health enterprise: Examining our twenty-first-century policy

challenges. Health Aff 2006; 25: 900-10.

3. Mensah, G.A. et al article, Law as a tool for preventing chronic diseases; Expanding the spectrum

of effective public health strategies. Preventing Chronic Disease: Public Health Research,

Practice, and Policy 2004;1(2):1-6.

4. Helfand, A.E. Podiatric Medicine and Public Health: Concepts and Perspectives. Am Podiatr Med

Assoc 88(7): 353-359, 1998.

Lecture 2 -

1. Crisford et al. (2013). Understanding the physical activity promotion behaviours of podiatrists: a

qualitative study. Journal of Foot and Ankle Research. 6:37.

2. Knight KM., Dornan T., Bundy C. (2006). The diabetes educator: Trying hard must concentrate

more on behaviour. Diabetic Medicine, 23, 485-501.

3. Gabbay et al. (2011). Motivational interviewing by podiatric physicians: A method for improving

patient self-care of the diabetic foot. Journal of American Podiatric Medical

Association. 101(1), 78-84.

Lecture #3 –

1. Greenhalgh T. How to read a paper. Statistics for the non-statistician. I: Different types of data

need different statistical tests. BMJ 315(7104):364-366, 1997.

2. Greenhalgh T. How to read a paper. Statistics for the non-statistician. II: “Significant” relations

and their pitfalls. BMJ 315(7105):422-425, 1997.

3. D’Addato S., Tartagni E., Dormi A., Ballarini G., et al. Can peripheral arterial disease be early

screened in a podiatric setting? A preliminary study in a cohort of asymptomatic adults. European

Review for Medical and Pharmacological Sciences. 16:1646-1659, 2012.

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Lecture #4 –

1. Shibuya N., Davis M.L., Jupiter D.C. Epidemiology of foot and ankle fractures in the United

States: An analysis of the National Trauma Data Bank (2007 to 2011). Journal of Foot & Ankle

Surgery 53:606-608, 2014.

2. Felcher A.H., Mularski R.A., Mosen D. M., Kimes T.M., et al. Incidence and risk factors for

venous thromboembolic disease in podiatric surgery. Chest 135:917-922, 2009.

Lecture #5 –

Ethical Codes

1. Belmont Report: National Commission for the Protection of Human Subjects of Biomedical and

Behavioral Research. (1979). Ethical principles and guidelines for the protection of human

subjects of research. http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html

2. Nuremberg Code. http://www.hhs.gov/ohrp/archive/nurcode.html

3. World Medical Association Declaration of Helsinki.

http://www.wma.net/en/30publications/10policies/b3/index.html

U.S. Government Regulations

1. Department of Health and Human Services

Office of Human Research Protection (OHRP)

http://www.hhs.gov/ohrp

2. Financial Disclosure by Clinical Investigators

21 Code of Federal Regulations Part 54

http://www.fda.gov/RegulatoryInformation/Guidances/ucm126832.htm

3. Health Insurance Portability and Accountability Act (HIPAA)

http://aspe.hhs.gov/admnsimp

4. Protection of Human Subjects

21 Code of Federal Regulations Part 50

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm

5. Protection of Human Subjects

45 Code of Federal Regulations Part 46

http://www.hhs.gov./ohrp/humansubjects/guidance/45cfr46.html

Lecture #6 –

1. Bernheim RG, Melnick A. Principled leadership in public health: Integrating ethics into practice

and management. J Public Health Manag Pract 2008;14: 358-66.

2. Watkins, MD. How managers become leaders. Harvard Business Rev., June 2012.

Lecture #7 –

1. Jacobs, J.A., et al. Tools for implementing an evidence-based approach in public health practice.

Preventing Chronic Disease 2012; 9: 110324. Published online 2012 June 21.

doi: 10.5888/pcd9.110324

2. Davis, M.V. et al. Informing the national public health accreditation movement: Lessons from

North Carolina's accredited local health departments. Am J Public Health 2011; 101(9): 1543-

1548.

3. Mercer, S.L. et al. Guiding the way to public health improvement: Exploring the connections

between the community guide’s evidence-based interventions and health department accreditation

standards. J Public Health Management Practice 2014; 20(1): 104–110.

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Medical Law

Lecture materials are drawn from a number of sources, many of which (such as court opinions) are only available in law libraries. Several sources which students may find helpful are kept in the college library.

ADDITIONAL MATERIAL FOR RECOMMENDED/ASSIGNED READING MAY BE DISTRIBUTED THROUGHOUT THE COURSE DURING CLASS AT THE DISCRETION OF THE INSTRUCTOR.

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VIII. COURSE REQUIREMENTS/STUDENT EVALUATION: 1. The evaluation for the entire course will be based on the total points earned in the course.

Any of the following may be counted as part of the available points in the course: Unannounced or announced quizzes, class participation, writing briefs assigned during the medical law classes, critical thinking assignments/scenarios, group projects/assignments, and final examination. Successful completion and subsequent point assignment for writing briefs, critical thinking assignments/scenarios, and group projects/assignments will be determined by the faculty/instructors. The final grade will be based on the TOTAL points earned in the course vs. the total points available.

2. The number of questions on any examinations may vary and will be announced prior to the examination. There may be pop quizzes given during the classes. Home assignments may be given out in both the public health and medical law portions of the class. This is at the discretion of the individual instructors / lecturers. Attendance may be taken and used for determination of class participation where applicable.

3. The final grade will be determined utilizing the following grade scale:

A - 90-100% B - 80-89% C - 70-79% F - 0-69% FAILURE

The course coordinator has the prerogative of scaling scores for the course.

4. Examination format will be primarily multiple choice and true/false, but may consist of essay, fill-in-the-blank, short answer or matching. The format of questions and number of question will be announced prior to the examination and will be at the discretion of the individual lecturers. Make up examinations will not be the same as the original examinations. The number and format of the questions for make-up examinations will be at the discretion of the course coordinator.

5. It is the responsibility of the individual student to be thoroughly knowledgeable of all

policies and procedures in the Kent State University Catalog that pertain to the College of Podiatric Medicine. Students should be particularly familiar with policies and procedures concerning examinations, re- examinations, make-up examinations, excused absences and grading.

6. Any time a student is experiencing academic difficulty, he/she should seek appropriate consultation and guidance. The Division of Podiatric and General Medicine is always willing to help students manage academic difficulties encountered during/with the course. Problems with the course should be brought to the attention of the CPM course coordinator, Dr. Petrozzi. Questions about an individual lecture should be directed to the instructor delivering the material.

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Public Health PUBLIC HEALTH GROUP PROJECT: The public health portion of your grade will be based

on the successful completion of a group project that is worth 100 points. (See Group Project Grading

Rubric). The class will be divided into small groups of 5-6 students to work on the project. The

assignment is to apply the concepts covered in the lectures and readings to a relevant podiatric

medicine issue. Specifically, the group assignment is to design a community/clinical initiative

aimed at screening, education, follow-up, and treatment/referral of at-risk individuals for diabetes,

peripheral arterial disease, skin cancer, obesity, tobacco use, or osteoporosis (Select at least ONE

area to focus on). Each group must develop a Powerpoint presentation with voice recording. All

members of the group must participate in the presentation. Presentations should be no more than 15

minutes long.

The Project must include the following components:

1. Mechanism for conducting a community-level epidemiological analysis.

2. Process for identification of an appropriate behavioral change intervention.

3. Identification of important community partners including their roles and

responsibilities (e.g., screening site, behavioral intervention site, referral partner).

4. Identification of the role and responsibilities of podiatric physicians and their staff.

5. Plan for funding and sustaining the initiative.

Medical Law/Jurisprudence

1. This portion of the course will be primarily lecture format; however student participation will be strongly encouraged. Class discussions of cases will be incorporated to reinforce appropriate important principles. Students will be called upon to participate in these discussions.

2. Prepared notes and other materials may be distributed for some lectures in the course. Students will be expected to take notes to augment any lecture materials.

3. The listed lecturer may also employ other content experts in his field to aid in the instruction

of the course at his discretion.

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IX. COURSE SCHEDULE

Lecture #1: Week of October 19, 2015

Overview of Public Health Ken Slenkovich

This lecture will provide an overview of the history, essential public health functions,

organization of the public health system, and Healthy People 2020 initiative. These concepts

will be related to podiatric medicine.

Lecture #2: Week of October 26, 2015

Social and Behavioral Sciences in Public Health Jeff Hallam

This lecture will provide a basic introduction to behavioral concepts, models, and theory and

will relate this to issues of relevance to podiatric medicine.

Lecture #3: Week of November 2, 2015

Biostatistics for Clinicians Lynette Phillips

This lecture will introduce the student to basic concepts of statistics in public health as well as

health care. It will cover elements of both parametric and non-parametric testing. Statistical

tests related to podiatric medicine will be emphasized.

Lecture #4: Week of November 9, 2015

Epidemiology for Clinicians Lynette Phillips

This lecture will introduce epidemiologic concepts that are important to clinicians.

Lecture #5: Week of November 16, 2015

Ethics in Public Health, Podiatric Medicine and Grant Writing Mark James

This lecture will review the basic concepts of ethics in health care and public health, as well as

the institutional review board process (IRB). There will also be a brief description of the

mechanics of grant funding and sources of grant funding.

Lecture #6: Week of November 23, 2015

Health Services Administration and Leadership Jonathan VanGeest

This lecture will provide a basic introduction to the concepts of leadership and organizational

change, public health administration, and strategic management of health organizations.

Lecture #7: Week of November 30, 2015

Strategic Planning and Performance Measurement in Public Health Ken Slenkovich

This lecture will provide an overview of techniques used in the public health and health care

fields to produce hi-performing people, programs, and organizations.

Public Health Group Project: Due by Tuesday, December 15, 2015 @ 5:00pm

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Lecture #8: Tuesday, January 5, 2016 The courts and the legal system TBD

Description: This lecture will provide an overview and introduction to the courts and legal system in the United States. It will include Law and its sources, the court systems, and alternative dispute systems.

Lecture #9: Tuesday, January 12, 2016 Medical malpractice: Civil procedure and negligence law TBD

Description: This lecture will provide instruction concerning the causes and procedures involved in medical malpractice. This will include issues such as negligence, breach of duty, and damage.

Lecture # 10: Tuesday, January 19, 2016 Medical malpractice and defenses: The doctor as a witness TBD

Description: This lecture will describe the role of the doctor of Podiatric Medicine as a witness in a court of law. This will include the obligation to testify, protection from libel, slander and malicious prosecution, privilege, and methods and content of testimony.

Lecture #11: Tuesday, January 26, 2016 Medical malpractice: Anatomy of a lawsuit; E-mail in practice TBD

Description: This lecture will discuss how most cases end up as lawsuits, the different parts of a lawsuit, and how to best handle and participate in a lawsuit if the need arises. Additionally, the

lecture will discuss the use of email in today’s podiatric practice, some of the common

pitfalls and some practical tips for use of email. It is also anticipated that this lecture will

cover any items not addressed in the first series of lectures.

Lecture #12: Tuesday, February 2, 2016 Governmental regulation of podiatric medicine Liability insurance, practice organization, hospital staffs TBD

Description: This lecture will provide instruction on the various governmental regulation of the practice of podiatric medicine through licensing laws, criminal laws and controlled substance regulation. It will cover professional liability insurance as it applies to the practice of Podiatric Medicine, the legal considerations of practice organization, the rules and regulations which govern hospital staff privileges, and the relationship between a doctor and his employees which is governed by a number of Federal and State laws.

Lecture #13: Tuesday, February 9, 2016 Laws governing compensation for services TBD

Description: This lecture will cover the various compensation for services rendered and applicable law. Included in this lecture will be Compensation Direct from the Patient, Workers compensation, Medicare, Medicaid, Private insurance.

Medical Law Exam: Thursday, February 18, 2015 (9:00am-11:00am)

Dates, lecturers, contents and order of lectures are subject to change

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X. S A S S T A T E M E N T ( S t u d e n t A c c e s s i b i l i t y S e r v i c e s ) University policy 3342-3-01.3 requires that students with disabilities be provided reasonable

accommodations to ensure their equal access to course content. If you have a documented

disability and require accommodations, please contact the instructor at the beginning of the

semester to make arrangements for necessary classroom adjustments. Please note, you must

first verify your eligibility for accommodations through Student Accessibility Services.

Contact [email protected] (KSUCPM) or visit www.kent.edu/sas for more information on

registration procedures.

X I . P L A G I A R I S M a n d C H E A T I N G Plagiarism is using the intellectual property of others without attributing it to them. In

accordance with University policy 3342-3-01.8, plagiarism and cheating are serious offenses.

Students guilty of cheating on exams or other assignments may face disciplinary action up to

and including expulsion from the university. Referring to notes, books, or unauthorized

Internet sites; looking at another student’s paper or computer screen; or talking during an

exam will be construed as evidence of cheating.

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X I I . GOALS AND OBJECTIVES

Public Health A. Title: Overview of Public Health / Public Health in Podiatric Medicine

i. Goals of Major Topic: This lecture will demonstrate an essential background on public health, essential public health functions, and healthy people 2010 as mandated by the federal government. It seeks to relate these concepts to podiatric medicine.

ii. Objectives: 1. Define public health 2. Core curriculum of public health 3. Discuss sub-disciplines of public health 4. Legal aspects of public health 5. Describe the essential public health services and how they are

interconnected 6. Podiatric medicine’s role in public health 7. Funding for public health 8. List and discuss HHS agencies 9. Describe the role of the federal government, state government and local

governments and their various offices and agencies, in the provision of health care in the United States.

10. Discuss evidence based medicine, the various types of studies and how this concept is used to determine patient care.

11. Ohio Revised Code (ORC) title 37 12. National Public Health Performance Standards Program 13. Effective public health advocacy 14. National health objectives

B. Title: – Biostatistics for Clinicians i. Goals of Major Topic: This lecture will introduce the student to basic concepts of

statistics in public health as well health care. It will cover elements of both

parametric and non-parametric statistical testing. Statistical tests related to

podiatric medicine will be emphasized.

ii. Objectives: 1. Define and discuss biostatistics 2. Have a working knowledge of biostatistics and know how to apply the

different biostatistical rates presented 3. Understand difference between descriptive and inferential statistics 4. Discuss difference between different types of data

5. Describe and discuss probability

6. Mean, variance, standard deviation

7. Median, mode, range, interquartile range

8. Chebyshev’s Theorem and empirical rule

9. Frequency distributions

10. Discuss z and t scores

11. Central limit theorem

12. Difference between estimate and true value

13. Hypothesis testing and P value

14. Inferential statistics

15. Parametric vs. Non-parametric tests

16. Discuss Chi square

17. Test for homogeneity vs. Test for independence

18. Meta-analysis

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C. Title: Epidemiology for Clinicians

i. Goals of Major Topic: This introduction will give the students a basic background

in study structure related to podiatric medicine and concepts of the epidemiologic

process.

ii. Objectives: 1. Define and discuss epidemiology and associated concepts 2. Incidence vs. prevalence

3. Epidemiology diagnosis vs. clinical diagnosis

4. History of epidemiology

5. Uses of epidemiology and its core functions

6. Epidemiology and Healthy People 2010 Initiative

7. Epidemiology and podiatric medicine

8. Case control study vs. cohort study

9. Inferential epidemiology

10. 2 x 2 contingency table

11. Discuss risk, relative risk, and attributable risk

12. Null

13. Sensitivity vs. specificity

14. Positive vs. negative predictive value

15. Test efficiency

16. Levels of prevention

17. Epidemiology and surveillance

18. Disease registries, CDC, vital statistics

D. Title: Social and Behavioral Sciences in Public Health

i. Goals of Major Topic: This lecture will give a basic introduction to behavioral

health concepts, models and theory and how this shapes health policy in the federal

government and how this relates to the future of podiatric medicine.

ii. Objectives: 1. Describe the importance of human behavior in podiatric medicine 2. Discuss the theory and models of human behavior

3. Explanatory theory vs. change theory

4. Define and discuss the three levels of influence and how they relate to

public health and podiatric medicine

5. Health belief model

6. Stages of change model

7. Transtheoretical model

8. Theory of planned behavior and theory of reasoned action

9. Precaution adoption process model

10. Interpersonal theory/model

11. Social cognitive theory

12. Conceptual model of reciprocal determinism

13. Diffusion of innovation model

14. Social marketing

15. Everett Rogers’ five steps of diffusion

16. Stages of diffusion of innovation in organizations

17. Preceed proceed model

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E. Title: Health Services Administration and Leadership

i. Goals of Major Topic: This lecture will introduce the student to the concepts of

leadership, theories of management, mission statements, vision statements and

strategic plans and their relationship to podiatric medicine.

ii. Objectives: 1. Discuss health services administration 2. Legal and administrative applications

3. Management theories and models

4. Maslow’s hierarchy of needs

5. Herzberg’s two factor theory

6. Victor Vroom’s expectancy theory

7. Locke’s goal setting theory

8. Five principles of good management

9. Styles of management

10. Organizational culture

11. Strategic planning

F. Title: Ethics in Public Health, Podiatric Medicine and

Grant Writing

i. Goals of Major Topic: This presentation will introduce the student to basic

concepts of ethics as well as the legal basis for the institutional review board

process (IRB) and the importance of ethical principles related to podiatric

medicine.

ii. Objectives: 1. Overview of ethical principles 2. Nuremberg code

3. Helsinki declaration

4. Belmont report

5. Institutional review board

6. Informed consent in research vs. medical practice

7. Various elements of ethics

8. Principlism

9. Consequentialism

10. Deontology

11. Moral particularism

12. Pluralism

13. Moral rules

14. Social contract

15. Rawls view

16. AMA code of ethics

17. Case method

18. Definitions of death

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Medical Law / Jurisprudence A. Title: The courts and the legal system

i. Goals of Major Topic: This lecture will provide an overview and introduction to the

courts and legal system in the United States. It will include law and its sources, the

court systems, and alternative dispute systems.

ii. Objectives: 1. Explain the differences, and the resolution of conflicts among:

Constitutions and Charters, Legislation (statutes or ordinances),

Administrative Regulations, Judicial Decisions, Privately-made Laws

2. Describe a typical State Court system

3. Describe the Federal Court System

4. Be aware of alternative dispute resolution forums and procedures

5. Define terms used to identify the parties to a lawsuit and list and describe

the procedures involved in pleading, pre-trial preparation, trial and appeal

B. Title: Medical malpractice: Civil procedure and negligence law

i. Goals of Major Topic: This lecture will provide instruction concerning the causes

and procedures involved in medical malpractice. This will include issues such as

negligence, breach of duty, and damage.

ii. Objectives: 1. List the elements of negligent malpractice and in particular: Describe the

standards of care required of a doctor, and the special standard of care

required of a specialist. List and explain what kinds of acts and omission

exemplify a breach of the doctor’s duty of care, skill knowledge and

attention. Explain the elements considered in determining the amount of

damages to be awarded to a patient who is injured by his/her doctor’s

negligence. Summarize the principal defenses available to a doctor who is

sued for negligent malpractice.

2. Explain and describe the need for, and form, content and circumstantial

requirements of effective informed consent.

3. Explain the contractual nature of the doctor/patient relationship and how a

doctor might be liable for breach of contract.

4. Summarize other torts, which sometimes arise in a medical context, such as

invasion of privacy, assault, battery and defamation.

5. Understand the concept and requisites of informed consent.

6. Understand patient rights and practitioner rights in the doctor/patient

relationship.

7. Compare tort liability and breach of contact liability.

8. Identify the most common intentional torts

9. Know when a doctor may be liable for the acts or omissions of a nurse, an

assistant, or another doctor.

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C. Title: Medical malpractice and defenses: The doctor as a witness

i. Goals of Major Topic: This lecture will describe the role of the doctor of Podiatric

Medicine as a witness in a court of law. This will include the obligation to testify,

protection from libel, slander and malicious prosecution, privilege, and methods and

content of testimony.

ii. Objectives: 1. Summarize when a doctor may be required to testify in a legal proceeding,

and state the nature and significance of a subpoena and a subpoena duces

tecum.

2. Recognize that certain communications between doctor and patient are

privileged and may not be the subject of testimony unless the patient

waives the privilege or protection from testimony would work a fraud or

conceal a crime.

3. List and explain the procedure and sequence of witness testimony on direct

and cross-examination.

4. Summarize the significance of opinion testimony, the requirement that a

witness be qualified as an expert before questions eliciting opinion

testimony, and the use of hypothetical questions in eliciting opinion

testimony.

5. List and describe the contents of a medico-legal report.

6. List and describe how to prepare to testify as a witness, and how to work

with attorneys in medico-legal matters.

D. Title: Medical malpractice: Anatomy of a lawsuit; E-mail in practice

i. Goals of Major Topic: This lecture will discuss how most cases end up as lawsuits,

the different parts of a lawsuit, and how to best handle and participate in a lawsuit if

the need arises. Additionally, the lecture will discuss the use of email in today’s

podiatric practice, some of the common pitfalls and some practical tips for use of

email. It is also anticipated that this lecture will cover any items not addressed in the

first series of lectures.

ii. Objectives: 1. Examine complexities and pitfalls that may ultimately lead to patient

decision to file suit

2. List and describe the various aspects of a lawsuit

3. Discuss happenings with notification of suite

4. Discuss appropriate response to notification of suit and action to be taken

5. Discuss intricacies of lawsuits and physician participation in the

proceedings

6. Discuss use of email in practice with regard to correspondence for patient

and personal use

7. Describe common pitfalls with regard to use of email in podiatric practice

8. Describe and discuss practical tips for using email from a liability

standpoint

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E. Title: Governmental Regulation of Podiatric Medicine AND Liability insurance, practice

organization, hospital staffs

i. Goals of Major Topic 1: This lecture will provide instruction on the various

governmental regulation of the practice of podiatric medicine through licensing laws,

criminal laws and controlled substance regulation.

ii. Goals of Major Topic 2: This lecture will cover professional liability insurance as it

applies to the practice of Podiatric Medicine, the legal considerations of practice

organization, the rules and regulations which govern hospital staff privileges, and the

relationship between a doctor and his employees which is governed by a number of

Federal and State laws.

iii. Objectives 1: 1. Recognize that regulation comes primarily from state legislatures, and that

it may vary from state to state.

2. Recognize that regulation of Podiatric Medicine is an application of the

government's power to protect the public health, safety, morals and welfare

(police power) and that the power to regulate is limited by constitutional

guarantees of due process.

3. Identify the general requirements for obtaining and renewing a license to

practice Podiatric Medicine.

4. Be aware of the general grounds for revocation or suspension of a license to

practice Podiatric Medicine.

5. Review the rights of a Podiatrist who is threatened with revocation or

suspension of his license to practice.

6. Distinguish between criminal and civil procedure; compare crimes and

torts.

7. List the procedural steps in a criminal case from complaint through appeal.

8. List and explain the general classification of controlled substances, the

restrictions on the prescription of controlled substances, and the methods of

enforcement of controlled substance regulations.

iv. Objectives 2: 1. Explain the contractual nature of insurance, and describe the risks covered

and excluded by professional liability insurance policies and the major

differences among policies available to doctors.

2. Indicate the insured's obligations to the insurance company to make a

complete and honest application, to notify the insurer promptly of claims,

and to cooperate with the insurer in dealing with and defending against the

claims.

3. Describe the insurer's obligation to the insured to defend against covered

claims, to make good faith efforts to settle, and to pay when contractually

required.

4. Recognize the risks of practicing without insurance, and that there are

devices to reduce personal exposure to liability even without insurance but

that these devices are not altogether risk free.

5. List and explain the basic terms of an employment contract

6. Describe the basic legal attributes of a partnership, the principles of cross

liability among the partners and the nature of a partnership as a conduit for

tax purposes.

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7. Describe the basic legal attributes of a corporation, the historical tax

reasons why professionals incorporated, recognize that a few tax

advantages still linger.

8. Describe the nature of and limitations on contractual covenants against

competition.

9. Recognize that privileges may be denied, suspended or revoked only if

constitutional due process requirements are satisfied.

10. Recognize that certain requirements for initial or continuing staff privileges

are valid but that certain types of discrimination as to staff privileges are

prohibited.

11. Recognize that a doctor whose privileges are denied, suspended, revoked or

threatened may have procedural rights.

12. Outline hospital organization and committee structure as well as authority

F. Title: Laws governing compensation for services

i. Goals of Major Topic: This lecture will cover the various compensation for services

rendered and applicable law. Included in this lecture will be compensation direct

from the patient, worker’s compensation, Medicare, Medicaid, and private insurance.

ii. Objectives: 1. Recognize that the doctor-patient contract determines the doctor's

compensation.

2. Recognize that in the absence of a stipulation in the contract the doctor will

be entitled to receive the reasonable value for the services he rendered.

3. Recognize that persons in certain relationships with patients may be liable to

the doctor for fees arising from services rendered to the patient.

4. Describe the basic tactics and explain the risks involved in suing to collect

a fee.

5. Explain the basic nature of worker's compensation as a no-fault method of

compensating people for injuries sustained in the course and scope of their

employment.

6. Explain the basic mechanics of a worker's compensation claim, while

realizing that there is considerable variance among states.

7. List and describe the basic features of basic (Part A) and supplemental (Part

B) Medicare coverage and the fact that certain podiatric procedures are

excluded from Medicare coverage.

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XIII. AACPM Learning Objectives

Public Health

1. Differentiate between health care, medical care, and public health. 3.7

2. Define illness and disease. 3.9

3. Distinguish between epidemic, endemic, and pandemic. 3.7

4. Outline the historical evolution of health care in the United States, including the changes in

organizational structure, social structure, and technology. 2.4

5. Describe changes of the following disease patterns as health care has evolved in the United

States

a. epidemics of acute infectious diseases affecting population groups 3.0

b. acute infectious and traumatic events affecting individuals 2.9

c. chronic diseases

d. special chronic diseases (related to genetic make-up, environmental hazards and

individual lifestyle) 2.9

6. Discuss events that have lead to changes in disease patterns as health care has evolved in

the US. 2.7

7. List and describe the major subsystems of the American health care system. 3.0

8. List and describe the pathophysiologic processes involved in disease Production. 2.4

9. Describe indicators and predictors of health services utilization. 2.7

10. Discuss factors contributing to an increase in health care spending. 2.6

11. Discuss the origin and development of health insurance in the United States. 2.4

12. Describe the historic models of health care in England, Canada, Germany, and Cuba. 2.1

13. List and describe the categories of health insurance in the United States. 3.0

14. List and describe regulatory interventions used to regulate and monitor the health Care

System. 2.9

15. Define quality assessment. 2.9

16. List and describe the three major criteria areas upon which quality assessment is based. 2.7

17. Define quality assurance. 2.9

18. Explain Professional Review Organization (PRO). 3.0

19. Explain risk management. 2.9

20. Describe the mission and basic layout of the Department of Health and Human Services

(DHHS). 3.0

21. List the various agencies of the United States that provide or use public health services. 2.6

22. Explain the function of the Surgeon General. 2.6

23. List and describe the ten essential public health services. 2.9

24. Relate the ten essential public health services to the clinical practice of podiatric medicine.

2.9 25. Explain the goals and focus objectives of “Healthy People 2020.” 3.0

26. Describe how “Healthy People 2020” relates to, and affects the clinical practice of

podiatric medicine. 2.9

27. Define the function of the state and local health departments. 2.6

28. Discuss advocacy as it relates to the profession of podiatric medicine and the patient. 2.4

29. Describe stakeholdership and its relation to everyday practice and program development.

2.0 30. Define Health Belief Model and Transtheoretical Model in relation to interpersonal health

and human behavior. 3.3

31. List the steps and discuss how the Health Belief Model is used in patient education. 2.6

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32. Discuss the use of the Transtheoretical Model in treating addictive behavior such as

smoking, sex, and alcoholism). 2.0

33. Outline Everett Roger's Diffusion of Innovation Model of Behavior (population health and

human behavior model), including its five stages and usefulness in podiatric medicine. 2.0

34. Define social marketing and list the 4 Ps of social marketing.

35. Discuss the use of social marketing in program development for the purposes of providing

podiatric medical services. 2.3

Biostatistics

1. Define and calculate the measures of central tendency. 3.7

2. Define and calculate the measures of dispersion. 3.9

3. Differentiate continuous, discrete, ordinal (ranked), nominal (categorical), and

dichotomous data types. 3.7

4. Compare normal, binomial, and skewed distribution. 3.3

5. Define inferential statistics. 3.4

6. Differentiate the central limit theorem from central tendency. 3.0

7. Differentiate between independent and dependent, variables. 4.0

8. Describe the role of hypothesis testing in research. 4.1

9. Differentiate clinical significance from statistical significance. 4.0

10. Compare reliability and validity. 3.9

11. Define the P value and describe its role in supporting or rejecting the null hypothesis. 4.0

12. Explain null and alternative hypotheses. 3.9

13. Distinguish between type one (alpha) and type two (beta) errors. 3.3

14. Define confidence interval. 3.3

15. Describe the standard error of the mean and how this plays a role in the confidence

interval. 3.0

16. Differentiate parametric versus non-parametric testing and recognize the indications and

contraindications of each test. 2.9

17. Describe the interrelationships among test efficiencies (function of the assumptions made

by the test and data types employed), sample size and magnitude of effect, and statistical

significance. 3.1

18. Select the appropriate test to measure trends, differences and interactions. 3.4

Jurisprudence in Public and Community Health

1. Differentiate between constitutional laws, statutes, administrative laws, and common laws.

3.1 2. Describe the importance of scope of practice in the practice of podiatry. 4.0

3. Describe legal ramification of the False Claims Act and define Qui Tam Enforcement.

3.1 4. Discuss standard of care and statute of limitations. 3.7

5. Compare and contrast implied consent and informed consent. 3.7

6. Define and recognize negligence. 4.0

7. Define anti-kick back and Stark Law. 3.7

8. Define and recognize HIPAA violation. 4.1

9. Provide examples of things that might result in disciplinary action by a professional

licensing board. 3.9

10. Describe the contract arrangement between doctor and patient.

11. Define and recognize unprofessional conduct. 4.0

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12. Define and recognize investigative procedure, deposition, and discovery as they relate to

medical malpractice. 3.4

13. Define power of attorney. 3.4

14. Recognize the legal ramifications and requirements associated with mandatory reporting of

child abuse and neglect. 3.7

15. Define and recognize a breach of contract. 3.6

16. Differentiate between a mission statement and a vision statement. 2.6

17. Explain the Health Care Quality Improvement Act. 2.4

18. Explain inurement laws and the impact on physician practice. 2.9

19. Describe the purpose and reporting requirements of the National Practitioner Data Bank.

2.9 20. Explain the ethical requirement of confidentiality of patient information. 3.4

21. Describe the legal requirements for the prescription of a controlled substance. 3.7

22. Explain the importance of timely and accurate charting with respect to medical

malpractice. 3.7

Epidemiology

1. Define epidemiology. 3.7

2. Define descriptive epidemiology. 3.6

3. Define analytical epidemiology. 3.6

4. Differentiate between incidence and prevalence. 4.0

5. Differentiate between sensitivity and specificity and discuss the relationship to false

positives and false negatives. 4.1

6. Differentiate between positive and negative predictive values of a diagnostic test.

3.7 7. Explain crude rates. 3.3

8. Construct a 2x2 contingency table and demonstrate its use in calculating sensitivity,

specificity, relative risk, and odds ratios. 3.1

9. Describe receiver operating characteristic (ROC) curves. 3.0

10. Define and interpret the likelihood ratio. 3.0

11. Define relative risk, odds ratio, and hazard ratio. 3.3

12. Differentiate between internal and external validity. 3.1

13. Recognize threats to internal validity. 3.6

14. Differentiate between observational and experimental studies. 3.6

15. Identify sources of and means to control bias, including randomization, blinding, matching,

inclusion criteria, exclusion criteria. 3.7

16. Discuss the hierarchical levels of evidence of a study based on study design. 3.6

17. Discuss the relative values of summary investigations including Systematic reviews, Meta-

analyses, Clinical Practice Guidelines (CPG) Decision analyses and Economic evaluative

studies. 3.4

18. Calculate and interpret the numbers needed to treat (NNT), numbers needed to prevent

(NNP), and numbers needed to harm (NNH) with respect to a specific medical condition.

3.6 19. Describe the role of the IRB. 2.9

20. Differentiate between practice informed consent and research informed consent. 3.6

21. Interpret the ethical issues in clinical research. 2.9