Practice of Medicine

MEDICAL JURISPRUDENCE: THE PRACTICE OF MEDICINE Sergio P. Paguio, MD., LL.B., FPSP, FPSO Quiz Recap

1. What is Medical Jurisprudence? - Medical jurisprudence is a set of laws that govern the practice of 062111

medicine.

2. What do you call the law that is not enforced by the state? - Non-jural law 3. Who is responsible for administering the Physician’s Licensure Exam, the PRC or the Board of Medicine?

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Board of Medicine

4. Under what power of the state is health included? - Police power 5. What is the goal of the profession of medicine? - Service to humanity

2. Who shall by means of signs, cards, advertisement, written or printed

matter, or through the radio, television or any other means of communication, either offer or undertake by any means or method to diagnose, treat, operate, or prescribe any remedy for any human disease, injury, deformity, physical mental or psychical condition.

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The purpose of this 2nd provision is to protect the people who through deceptive advertisement or machination may be able to induce them to be under the medical service of one who is not in a capacity to do so.

*What to place in your prescription pad:

1. Name 2. Field of Practice 3. Clinic hours in various hospitals you are affiliated with 4. Initials of the degrees you achieved as a physician

Example: What is the practice of medicine? ➪ Is a privilege or franchise granted by the state to any person to perform medical acts upon compliance with law. ➪ The law referred to is the Medical Act of 1959. ♥ The practice of medicine consists of judging the nature, character and symptoms of a disease, in determining the proper remedy to the disease. ♥ The practice of medicine means the diagnosis and application and the use of medicine and drugs for curing, mitigating or relieving bodily disease or conditions. *Any form of treatment (i.e. traditional or non-traditional) can be considered as practice of medicine as long as these procedures are done by a duly licensed physician, ACTS CONSITITUTING THE PRACTICE OF MEDICINE

1. Who shall, For compensation fee, salary or reward in any form paid to him directly or indirectly or through another, or even without the same, physically examine any person and diagnose, treat, operate or prescribe any remedy for human disease, injury, deformity, mental or physical condition or any ailment, real or imaginary, regardless of the nature of remedy or treatment administered, prescribed or recommended.

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From the first provision: Physically examine a person and diagnose Physically examine a person and treat Physically examine a person and operate Physically examine a person and prescribe any remedy.

♥ Provided that the above mentioned acts are performed, the following do not affect the act as to the practice of medicine: ➪ Whether or not the act was done with or without compensation. ➪ Regardless of the nature of the remedy or treatment administered. DEFINITION OF TERMS: ➪ MEDICAL DIAGNOSIS - is the art of balancing probabilities. ➪ DIAGNOSIS - is a mental process whereby one or more persons appraise a situation and make a decision based on their judgment that may or may not lead to action. ➪ TREATMENT – all steps taken to effect a cure of an injury or disease. ➪ OPERATION - is an act or succession of acts performed upon the body of a patient for his relief or restoration of normal condition. Either by manipulation or the use of surgical instruments or both. ➪ PRESCRIPTION – is a direction of remedy or remedies for a disease and the manner of using them; a formula for the preparation of a drug and a medicine. Transcribed by: KC

*NEVER place the name of the institution where you trained in because it is considered unethical. See paragraph above for the reason why. *It is NOT unethical to place your diploma in your clinic.

3. Who shall use the title of M.D after his name. *Post Graduate Interns (PGI) are NOT allowed to affix M.D. after their names because of the premise that they haven’t passed the Physician’s Licensure exam yet. *The title Doctor can be added to their names during internship. 3 Medical Schools granted with CHED Deregulated Status

1. UPCM 2. UST-FMS 3. PLM-CM

WHO ARE QUALIFIED TO PRACTICE MEDICINE IN THE PHILIPPINES?

1. Those who complied with the prerequisites to the practice of medicine in accordance with the medical act.

2. Those

who can have limited practice without any certificate of registration. ➪ Ex. Foreign doctors doing medical missions for Operation Smile. They are allowed to operate on patients with cleft palate but they are not allowed to prescribe medications as their permit is limited

3. Balikbayan physicians – P.D 541 allowing former Filipino Professionals to practice their respective professions in the Philippines. ➪ Possible if the physician is board certified in the Philippines. If the physician ever comes back, he/she will just go to PRC and present a certification that he/she practiced abroad.

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4. Those

foreign physicians qualified to practice by reciprocity or by endorsement. ➪ Applicable to the Reciprocity Clause

5. Limited practitioners of healing art. ➪ Ex. Physicians who practice acupuncture 6. Medical Students – renders service under the direct supervision and control of registered physician without any compensation. ➪ Sometimes, the patients give gifts if you have established rapport with them. Some see it as a form of compensation but if the purpose of the patient is not to reward you for your service, it is not unethical to receive gifts.

♥ Only NATURAL person can practice medicine. (starts at birth and ends at death). CLASSIFICATION OF MEDICAL PRATICE

1. As to the scope of practice: a. General b. Specialist 2. As to the venue of practice: a. Clinic b. Hospital 3. As to number: a. individual b. group

*If the hospital you trained in isn’t accredited by a medical organization, you are still considered to have earned your residency training but you are not entitled to work in tertiary hospital. *Group practice is beneficial due to referral system. PHYSICIAN

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Licensed Physician License to practice medicine One who has received a degree from an institution and one that is lawfully engaged in the practice of medicine. ➪ WHO definition: ➪ is a person who after completing his secondary education follows a prescribed course of medicine at a recognized university or medical school. PENALTIES OF ILLEGAL PRACTICE:

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CIVIL LIABILITIES : There is a wrongful act of a physician. A civil suit is filed against physicians and/or hospitals are premised on recovery of damages for their wrongful act or of the employees. *related to money

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*related to moral trepidation HIPPOCRATIC OATH ➪ I swear to fulfill, to the best of my ability and judgment, this covenant: ➪ I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. ➪ I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of over-treatment and therapeutic nihilism. ➪ I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. ➪ I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. ➪ I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. ➪ I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. ➪ I will prevent disease whenever I can, for prevention is preferable to cure. ➪ I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. ➪ If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. Those who cannot practice medicine anymore are the following:

1. Those with revoked license 2. Those with extreme physical disability 3. Those of unsound mental status 4. Those with highly infectious disease. References ➪ Dr. Paguio’s Power Point ➪ KC’s notes

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B.

CRIMINAL LIABILITIES: When the act or omission of a physician constitute a crime, which may be done with deliberate intent or on account of imprudence, negligence, lack of foresight or lack of skills. ➪ ”Proof beyond reasonable doubt”. *No doctor in the Philippines has been charged of criminal liabilities yet *Criminal liabilities are considered if the act is done deliberately or on account of imprudence *if you have done everything in your power to help the patient, it doesn’t make you liable; starts with a complete history and physical exam and proper record keeping. * The patient’s chart is for your eyes only. *The clinical abstract is given to the court in lieu of the medical record.

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C.ADMINISTRATIVE LIABILITIES Penalty imposable is reprimand or suspension or revocation of

license

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File at Professional Regulations Commission

Transcribed by: KC

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