MEDICAL OFFICE

PROCEDURES
OFAD 40013

OFAD 40013 - MEDICAL OFFICE PROCEDURES

ETHICS AND LAW FOR
THE MEDICAL
ASSISTANTS

OFAD 40013 - MEDICAL OFFICE PROCEDURES

THE MEDICAL ASSISTANT’S
ETHICAL RESPONSIBILITY
▪ The medical assistants, in their role and within the boundaries of their job
responsibilities, are also required to treat patients, with respect to maintain
confidentiality, to improve knowledge and skills, and to contribute to the
community. In addition, they are advised to merit the respect of the public and of
the medical profession.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

THE MEDICAL ASSISTANT’S
ETHICAL RESPONSIBILITY
▪ In the Philippines, the Philippine Medical Association (PMA), Code of Ethics of
Medical Profession, has stated the fundamental principles in Article I, Section 1, to
guide the physicians in the practice of their profession. In this respect, medical
administrative assistant must be familiar and give importance to the principles as
personnel in the practice of the medical profession.

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ARTICLE 1, SECTION 1
THE FUNDAMENTAL PRINCIPLES TO GUIDE THE PHYSICIANS IN THE
PRACTICE OF THEIR PROFESSION.

1.1. Principle of Respect for Life. The right to life is inviolable. Life is a necessary
condition for all other human goods. It must be protected and fostered at all its stages
beginning from conception to its natural end.
1.2. Principle of Respect for Person. Every person has an intrinsic worth and dignity. Trust
shall be central to the physician-patient relationship. Physicians shall respect patient
autonomy.
1.3. Principle of social justice. All patients have a right to basic healthcare and a just
process in the allocation of resources.
1.4. Principle of Beneficence. The interest of the patient shall be placed above those of the
physician. Societal pressures, financial gains and administrative exigencies shall not
compromise this principle.
1.5. Primum Non Nocere. The foremost responsibility of the physician is to do no harm to
the patient.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

AAMA CODE OF ETHICS FOR
MEDICAL ASSISTANTS
The AAMA Code of Ethics for medical assistants sets forth principles of ethical and moral
conduct as they relate to the medical profession and the particular practice of medical
assisting.
Members of the AAMA dedicated to the conscientious pursuit of their profession, and thus
desiring to merit the high regard of the entire medical profession and the respect of the
general public which they serve, do pledge themselves to strive always to:
A. Render service with full respect for the dignity of humanity.
B. Respect confidential information obtained through employment unless legally
authorized or required by responsible performance of duty to divulge such information.
C. Uphold the honor and high principles of the profession and accept its disciplines.
D. Seek to continually improve the knowledge and skills of medical assistants for the
benefit of patients and professional colleagues.
E. Participate in additional service activities aimed toward improving the health and well-
being of the community.
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MEDICAL ASSISTING CREED
The Medical Assisting Creed of the AAMA sets forth medical assisting statements of
belief:
• I believe in the principles and purposes of the profession of medical assisting.
• I endeavor to be more effective.
• I aspire to render greater service.
• I protect the confidence entrusted to me.
• I am dedicated to the care and well-being of all people.
• I am loyal to my employer.
• I am true to the ethics of my profession.
• I am strengthened by compassion, courage, and faith.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
AMERICAN MEDICAL ASSOCIATION
PRINCIPLES OF MEDICAL ETHICS
Preamble
The medical profession has long subscribed to a body of ethical statements
developed primarily for the benefit of the patient. As a member of this profession, a
physician must recognize responsibility to patients first and foremost, as well as to
society, to other health professionals, and to self. The following Principles adopted
by the American Medical Association are not laws, but standards of conduct that
define the essentials of honorable behavior for the physician.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

AMERICAN MEDICAL ASSOCIATION
PRINCIPLES OF MEDICAL ETHICS
Principles of Medical Ethics
I. A physician shall be dedicated to providing competent medical care, with compassion and
respect for human dignity and rights.
II. A physician shall uphold the standards of professionalism, be honest in all professional
interactions, strive to report physicians deficient in character or competence, or engaging in fraud
or deception, to appropriate entities.
III. A physician shall respect the law and also recognize a responsibility to seek changes in those
requirements which are contrary to the best interests of the patient.
IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and
shall safeguard patient confidences and privacy within the constraints of the law.
V. A physician shall continue to study, apply, and advance scientific knowledge, maintain
commitment to medical education, make relevant information available to patients, colleagues, and
the public, obtain consultation, and use the talents of other health professionals when indicated.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

AMERICAN MEDICAL ASSOCIATION
PRINCIPLES OF MEDICAL ETHICS
Principles of Medical Ethics
VI. A physician shall, in the provision of appropriate patient care, except in
emergencies, be free to choose whom to serve, with whom to associate, and the
environment in which to provide medical care.
VII. A physician shall recognize a responsibility to participate in activities
contributing to the improvement of the community and the betterment of public
health.
VIII. A physician shall, while caring for a patient, regard responsibility to the patient
as paramount.
IX. A physician shall support access to medical care for all people.

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ARTICLE II: DUTIES OF
PHYSICIANS TO THEIR PATIENTS
Section 1. A physician should be dedicated to provide competent
medical care with full professional skill in accordance with the current
standards of care, compassion, independence and respect for human
dignity.
Section 2. A physician should be free to choose patients.
Section 3. In an emergency, provided there is no risk to his or her
safety, a physician should administer at least first aid treatment and
then refer the patient to the primary physician and/or to a more
competent health provider and appropriate facility if necessary.
Section 4. In serious/difficult cases, or when the circumstances of the
patient or the family so demand or justify, the attending physician
should seek the assistance of the appropriate specialist.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

ARTICLE II: DUTIES OF
PHYSICIANS TO THEIR PATIENTS
Section 5. A physician should exercise good faith and honesty in expressing
opinion/s as to the diagnosis, prognosis, and treatment of a case under
his/her care. A physician shall respect the right of the patient to refuse
medical treatment. Timely notice of the worsening of the disease should be
given to the patient and/or family. A physician shall not conceal nor
exaggerate the patient’s condition except when it is to the latter’s best
interest. A physician shall obtain from the patient a voluntary informed
consent. In case of unconsciousness or in a state of mental deficiency the
informed consent may be given by a spouse or immediate relatives and in
the absence of both, by the party authorized by an advanced directive of the
patient. Informed consent in the case of minor should be given by the parents
or guardian, members of the immediate family that are of legal age.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

ARTICLE II: DUTIES OF
PHYSICIANS TO THEIR PATIENTS
Section 6. The physician should hold as sacred and highly confidential
whatever may be discovered or learned pertinent to the patient even
after death, except when required in the promotion of justice, safety
and public health.
Section 7. Professional fees should be commensurate to the services
rendered with due consideration to the patient’s financial status, nature
of the case, time consumed and the professional standing and skill of
the physician in the community.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

MEDICAL LAW
Law is a set of rules made and enforced by a recognized authority. Law
protects citizens and helps society to work smoothly. Physicians and
other health care professionals may be affected by the law both
criminal and civil status. The law, then as it applies to standards of
acceptable care, is known as medical jurisprudence, or medical law.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

LAW AND THE RIGHTS TO
PRACTICE
Medical law regulates the right to practice and the granting of various
licenses and certifications. Each state governs the practice of medicine within
its borders through laws know as medical practice acts.
Medical practice acts also protects users of health care services. To do this,
the acts set forth the penalties for practicing medicine without a valid license.
The acts also define misconduct, including conviction of a felony, such as
insurance fraud; unprofessional conduct, such as sexual behavior with a
patient; personal or professional incapacity, such as mental illness;
inappropriate use, or overprescribing, of drugs. The penalty for such acts
may be the suspension or revoking of a license.
The license to practice medicine, called licensure, is granted by a board
established in each state. Licenses are issued to applicants once they have
completed the educational requirements and have successfully passed
examination.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
THE PHYSICIANS PRACTICE
In today’s complex health care environment, the physician’s practice
has many elements of both a health service and a business, such as
providing good patient care, scheduling, performing billing and
insurance procedures, hiring and training staff, and maintaining the
physical resources of the office, such as equipment and the office
premises. Every part of the practice is affected by legal and ethical
considerations.
Because of the physician's primary responsibility is to practice
acceptable standard of patient case, the laws, responsibilities, and
ethical considerations that surround the physician-patient relationship
are of great importance.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
INTERACTING WITH PATIENTS /
PHYSICIAN-PATIENT RELATIONSHIP
The relationship between the physician and the patient starts when the
patient comes to the physician for care. The contract is implied; it is not
expressed in either words or writing. The physician does not say “I am
here to offer you care.” The patient does not say “I am requesting
care.” The patient usually comes with a complaint, and the physician
treats it. The physician’s behavior, in having a practice open to
patients, and the patient’s behavior, in coming to the physician’s office,
together establish an implied contract. At times a written, or express
contract is provided, and both physician and patient sign a document.
The physician may provide a standard written contract to allow a
patient to pay for services over an extended period of time.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

INTERACTING WITH PATIENTS /
PHYSICIAN-PATIENT RELATIONSHIP
Once the physician-patient relationship is established, the physician is legally
required to:
• Possess the ordinary skill and learning commonly held by a reputable physician in
a similar society. The patient has the right to believe that the physician is so
qualified. Accordingly, the physician’s license should be displayed in the office.
• Use his or her learning, skill and the best judgment for the benefit of the patient.
• Preserve confidentiality.
• Act in good faith.
• Perform to the best of his or her ability.
• Advise against needless or unwise treatment.
• Inform and advise the patient when the physician knows a condition is beyond his
or her scope of competency.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
INTERACTING WITH PATIENTS /
PHYSICIAN-PATIENT RELATIONSHIP
The physician is not legally required to:
• Accept as patients all those who seek his or her services.
• Restore a patient to the same condition that existed before illness occurred.
• Obtain recovery for every patient.
• Guarantee successful results from an operation or a treatment.
• Be familiar with all possible reactions of patients to various medicines.
• Be free from errors in complex cases.
• Possess the maximum amount of education possible.
• Continue care after a patient discharges himself or herself from a hospital,
even if harm could come to the patient.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
INTERACTING WITH PATIENTS /
PHYSICIAN-PATIENT RELATIONSHIP
In the physician-patient relationship, the patient also has certain
responsibilities. The patient must give the information necessary for the
physician to make a correct diagnosis; follow the physician’s instructions and
any orders for treatment, provided that these are within the bounds of similar
standards of care for physicians who practice in the area of medicine; be, in
general, cooperative; and pay for all services rendered.
When a patient comes to a physician’s office for treatment, that patient’s
consent to treatment, like the contract itself, is not stated outright. This implied
consent applies to routine treatment only. For more complicated procedures,
especially surgery, diagnostic tests, and x-ray treatments, it is important to have
express consent. The patient may express consent either in writing or orally. It
is standard practice for the patient to give written consent by signing a special
consent form before any special procedure is performed. An exception to this
practice is the patient who is incapable of giving consent when an emergency
requires immediate action. Express consent is important to avoid lawsuits or,
even more seriously, criminal accusations.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
INTERACTING WITH PATIENTS /
PHYSICIAN-PATIENT RELATIONSHIP
When oral consent is acceptable, it may be given in a telephone
conversation provided that the call is a three-way conversation
involving the patient and two office personnel. Both office employees
then must sign as witnesses to the conversation in which the patient
expressed consent.
There is another aspect of patient consent, whether implied or
express. The patient must give informed consent. Informed consent
means that the patient has had the illness or problem explained by the
physician in simple, understandable language. The patient has also
been given options for treatment, with the individual benefits and risk
of each, along with the physician’s prognosis. In other words, the
patient has been given enough information to make a knowledgeable
decision.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
INTERACTING WITH PATIENTS /
PHYSICIAN-PATIENT RELATIONSHIP
Adults who are legally competent are able to give informed consent.
The law requires that in order to be competent, a person must have
attained legal majority (adult age as define by law) and must be of
sound mind. When a patient is not able to give consent, that consent
must be given by the next of kin, the legal guardian, or a court-
appointed guardian.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

THE ADMINISTRATIVE MEDICAL ASSISTANT’S
ROLE IN COMPLIANCE MEDICAL
Medical practices must take steps to reduce risk of accusations of fraud
and abuse when submitting claims to insurance companies and federal
agencies such as Medicare. The process involved in coding and billing
are complicated, and there is much room for error. Although many
errors are not intentional, medical practices are required to show their
resolve to behave with compliance, or adherence, to rules and
regulations.
The potential for accusations of fraud is always present in the complex
areas of patient care, billing and coding, and documentation. If fraud is
detected and not reported or corrected, the reputation and legal
standing of the practice is put at grave risk. The assistant has job
responsibilities related to all of these areas and plays a central role in
helping to ensure that the practice is in compliance.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
THE ADMINISTRATIVE MEDICAL ASSISTANT’S
ROLE IN COMPLIANCE MEDICAL
The assistant who is working efficiently and effectively is key to the success
of a compliance plan. In the following areas of responsibility, the assistant
helps the practice stay in compliance:
• Accurate data entry. Accurate work speeds the correct payment of claims
and lessens the chances of federal audit.
• Accurate documentation. Good documentation reduces the chances for
mistakes and provides an excellent trail of proof of corrective action is
required.
• Timely filing and storing of records. Keeping records in good order and for
an appropriate length of time can show the physician’s good faith efforts to
apply the principles of compliance.
• Prompt reporting of errors or instances of fraudulent conduct. The assistant
has the ethical and professional responsibility to help the physician correct
mistakes and investigate instances of unlawful behavior.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
SAFEGUARD AGAINST
LITIGATION
The assistant needs to be aware that liability for negligence is
recognized by law to include not only the physician’s actions but also
the actions of the physician’s employees. An assistant who is
performing tasks within the job description and as a proper
assignment is considered to be the agent of the physician. It is the
physician’s responsibility to define the assistant’s job properly, to state
and regulate office policies and procedures are implemented. It is the
assistant’s responsibility to understand thoroughly his or her job
description and the office policies. The assistant must act responsibly
within the scope of his/her job and according to office policies.

OFAD 40013 - MEDICAL OFFICE PROCEDURES

SAFEGUARD AGAINST
LITIGATION
Assistants who maintain good interpersonal relationships with patients and
other staff members help reduce the likelihood of litigation. In particular, the
following guidelines are useful:
• Keep everything that you hear, see, and read about patients completely
confidential.
• Never criticize a physician to a patient.
• Do not discuss a patient’s condition, diagnosis, or treatment with the patient,
with other patients, or with staff members. What the physician tells the
assistant about a patient is to be kept confidential, even from the patient.
• Do not diagnose or prescribe, even though you feel sure you know what the
physician would prescribe. There are often circumstances in the case of
which you are unaware. Prescribing constitutes the practice of medicine and
is unlawful unless you are licensed.
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SAFEGUARD AGAINST
LITIGATION
• Notify the physician if you learn that a patient is under treatment by another
physician for the same condition.
• Inform the physician of all information given by the patient, as when the patient has
questions, appears confused, or seems not to understand directions or instructions
given.
• Also inform the physician any unpleasant incident that may have occurred between
the patient and any staff member. In this case, the assistant writes a notation to the
physician, which does not become part of the patient’s record.
• Notify the physician if the patient mentions that he or she has no intention of
returning to the office or complying with the treatment plan.
• Keep complete and accurate records, including notations about a patient’s failure to
keep an appointment, cancellation of an appointment, or failure to follow treatment
instructions.
• Be selective in giving information over the telephone. Many practices accept
requests for information only when they are written.
OFAD 40013 - MEDICAL OFFICE PROCEDURES
SAFEGUARD AGAINST
LITIGATION
• Observe the confidentiality of computerized records by shielding
computer screens from the view of patients or other staff members,
protecting passwords, and following practice security guidelines when
using e-mail for transmitting information.
• Keep prescription pads and medications in a secure place.
• Be safety conscious. See that all equipment is in safe working
condition and be alert to potential safety hazards.

OFAD 40013 - MEDICAL OFFICE PROCEDURES