This document will analyze a particular case study in an effort to bring out the roles and legal responsibilities of the various participants in a health case. Doctor Ivor Bolt, an orthopedic surgeon at the Bones and Bumps Orthopedic Private Hospital in Brisburg, was approached by a one Mr. Jasper Johnson. Doctor Bolt specializes in knee surgery in a department under the support at the hospital. Jasper, a retiree of 75 years old, visits Doctor Bolt and confides to him about his terrible knee. Doctor Bolt undertakes Jasper through a series of expensive tests so as to ascertain the cause of the pain. At this point, it’s not well known if there were cheaper alternatives that could have served the same purpose.
After the tests, Doctor Bolt books Jasper in for a knee replacement with state of the art prosthesis at a cost of $12,500. Jasper, in a show of good faith, pays an initial deposit of $7,500 to Doctor Bolt. The developed prosthesis is the brainchild of Creative Whizkid, a chief biomedical engineer at the hospital, who takes up a patent of the product at the Commonwealth Governmental intellectual property office in Australia.
Greedy Cousin, Jasper’s relative and beneficiary, looks for more information about his cousin’s prosthesis but does not find it registered in the Australian Register of Therapeutic Goods (ARTG), on the Therapeutic Goods Administration website. Reacting on this, Greedy confronts Doctor Bolt with this information but the doctor reassures him that the procedure will be successful, thereby disregarding the ramifications of using a non-registered prosthesis.
During surgery, Doctor Bolt utilizes the skills of his registered nurses as medical assistants at the private hospital, which is known to run efficiently. Upon completion of the procedure, Doctor Bolt decides to charge a premium to the bill because the surgery was a success, and also invoices Jasper with a bill for the cost of the prosthesis. Both Jasper and Cousin Greedy complain to the doctor about the excessive charges only to receive threat of action should they fail to settle the amount owing. Greedy, seeking to help save his cousin’s money reports the matter to the police and later, the Brisburg Medical Board.
Key legal disputes arise in this case study from the moment Doctor Bolt takes on Mr. Jasper Johnson as a patient. Bolt decides to arrange a series of expensive examinations so as to ascertain the cause of Jasper’s terrible knee at the Bones and Bumps Orthopedic Private Hospital. At this point there is no documentation that confirms that the process was necessary. As per the Regulation of Health Practitioners (lecture 2), unprofessional conduct may arise from provision of excessive or unreasonably required services to a patient. Bolt in this instance should have informed jasper on possible alternatives as well as consequences of the options, both positive and negative. The doctor should act in an advisory capacity in such circumstances, allowing the patients to make the final decision.
Jasper was not in a state to make an informed decision due to the disparity of information between him, his cousin and the doctor. Both Greedy and Bolt had an obligation to inform Jasper that the prosthesis he was about to receive had not yet been registered. The doctor had also not informed Jasper about the full financial implications of the procedure. Doctor Bolt only informed Mr. Johnson on the gross cost of the procedure, before the patient could claim any health fund benefits.
Jasper confirmed the contract by giving Doctor Bolt more than half the money as deposit. Doctor Bolt did not disclose the cost of the prosthesis at this point; therefore Jasper could have assumed that the total cost of the operation was all inclusive. By not providing this financial information, Doctor Bold created a wrong impression and therefore misled his patient into making a financial consent. Misleading conduct also includes being silent on important information, especially where the party in question is obligated to share such information.
Unconscionable conduct is likely to occur between a patient and his doctor where there is an imbalance of the bargaining power between the two parties (lecture 6). Doctor Bolt is in a much better position to bargain due to his expertise in medical costs. As a result, Doctor Bolt may be deemed to have taken an unconscionable advantage due to his superior position by deciding to charge a premium on the successful operation. Jasper could not possibly have predicted this situation in advance, and a court ruling will most probably be in his favor. Part V of the Trade Practices Act guarantees consumer protection in such instances, whereby civil or criminal proceedings may ensue. The Freedom of Information Act 1989 allows patients to access their records at public health establishments (lecture 9).
Greedy Cousin is not in a position to act as Jasper Johnson’s guardian, and therefore he cannot make decisions for his relative. In the Guardianship Act 1987 (NSW), a person can only be regarded as a guardian if the patient suffers from an intellectual disability, is of an advanced age, or has a mental illness (lecture 5). Otherwise, a guardian can be a patient’s ‘primary carer’, parent in case the patient is a child, spouse of the patient, or a close friend or relative (lecture 11).
Jasper cannot be deemed to be of old age since he voluntarily admitted himself to the hospital, and was also in a position to make his own decisions. Greedy is a third cousin, therefore not a close relative of Jasper. Greedy, as a beneficiary, had a right to get information on Jasper’s state of health, even though he had his own interests. Greedy should have told Jasper that the prosthesis was not included in the Australian Register for Therapeutic Goods. Greedy is not in a position to bargain the terms of Jasper’s hefty bill and, unless clearly stipulated, could not lodge a complaint on behalf of his cousin.
Since the prosthesis was not registered in the Australian Register for Therapeutic Goods (ARTG), Doctor Bolt was not authorized to use it on patients. A general registration is often awarded to practitioners who satisfy the requirements and qualifications in sections of the National Law, as well as standards established by the National Boards. According to the Poisons and Therapeutic Goods Act 7966 (lecture 8), only a holder of a license, supplier’s authority or authority under the Act may possess the right to use or supply the item concerned. Consequently, Doctor Bolt should have waited until the prosthesis was registered before he could implement it on a patient.
Doctor Bolt neglected his duties as a professional practitioner by disregarding this fact and instead basing judgment on the trust he had for his fellow doctor at the Bones and Bumps Orthopedic Private Hospital.
While complaining on issues to deal with misconduct of health practitioners, complaints should be directed to the HCCC (Health Care Complaints Commission) or a relevant State Council (lecture 10). Greedy Cousin followed the appropriate channels, where he first expressed his frustration to Doctor Bolt. Doctor Bolt used coercion to try and manipulate the cousin duo to pay up. Disgruntled, Greedy reported the matter to the State police who seemed not to take him seriously. Greedy then took the case to the Medical Board of Brisburg, who claimed that he had expressed unprofessionalism. The first step that the Medical Board of Brisburg should have done is alerted the appropriate professional council about the complaint.
Doctor Bolt is clearly at fault for the way he handled his patients in a fraudulent manner. Greedy was right to report the matter to the appropriate authorities, which cannot be said to have responded accordingly. Doctor Bolt is not in a position to ask for a premium just because the procedure exceeded his expectations. All doctors are under an obligation to serve their patients with utmost care, and cannot therefore demand for a reward for performing their duties.
Moreover, the biometric engineering department was under the support of the Bones and Bumps Orthopedic Private Hospital, so Doctor Bolt could only bill Jasper Johnson the relevant hospital expenses, and not his own personal valuations. The HCCC could bring up several charges against Doctor Bolt, which could end up penalties, suspension of his license to practice or even imprisonment (lecture 7).
References
University of Technology Sydney (2010). Lecture 2: The Constitution and Federal/State Health Regulatory Responsibilities in the Health Sector. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 5: Guardianship, end of Life Decision-Making, Wrongful Life and Death, and Reproductive Technology. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 6: Business Law. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 7: Employment and Workplace Law. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 8: Laws on Pharmaceutical and Therapeutic Goods. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 9: Public Health Regulations, Documents and Research. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 10: Complaint Management and Administrative Law. Sydney, NSW: UTS: Center for Health Services Management.
University of Technology Sydney (2010). Lecture 11: Mental Health. Sydney, NSW: UTS: Center for Health Services Management.