Healthcare is a primary industry around the globe. The astronomical factors surrounding the healthcare system can be a lot to take in. Thus, it is naturally challenging to regulate.
As the fastest-growing industry and not to mention the largest in the world, it’s only right to impose healthcare compliance.
This protects patients and healthcare providers from many harmful scenarios within the healthcare industry.
What Is Healthcare Compliance?
As the name suggests, healthcare compliance is adhering to laws and regulations surrounding healthcare procedures.
Like all federal laws, it is implemented to safeguard people’s rights and regulate power. Furthermore, it sets ethical standards for patient treatment and medical practice. The patient-physician relationship is no exception.
Laws and statutes vary from state to nation, but one thing is certain. It primarily sets a seal to quality healthcare and standard procedures. Moreover, it ensures everyone has equal access to healthcare services regardless of their economic status.
It’s safe to say that healthcare compliance regulates quality assurance in the industry. However, common problems arise when one’s profession may be at risk.
There are circumstances when physicians are left with tough choices that lead to lawsuits. While health professionals try to work as diligently and ethically as possible, lawyers for physicians suggest “absolute candidness.”
These cases require real-world experience and a multifaceted approach, which they are experts in.
In times like this, you may find yourself asking: “What is the fine line between rules and ethics?” You’ll never know until you experience it first-hand.
Who Is Involved?
Healthcare compliance concerns everyone in the healthcare system, including every staff member of an organization.
However, the larger responsibilities lie with the compliance officer or those with similar roles. Generally, enforcing compliance can be done with the appropriate system of rules.
Regardless of state or organization, compliance starts with creating an educational program that:
- Cultivates transparency and accountability
- Sets ethical behavior and promotes professional values
- Develops a culture of responsibility
A solid and efficient healthcare system starts with a program that maintains compliance properly.
Why Is It Important?
The healthcare industry is high-risk in nature, so it’s only reasonable that it is heavily regulated. It cannot stand solely without ethical workplace regulations, as with any other industry.
With the evolving regulatory issues over time, compliance issues are also arising for many healthcare professionals. This only strengthens the notion that healthcare compliance needs further attention.
Compliance allows both healthcare providers and patients to:
- Set proper expectations.
- Understand the appropriate and standard procedures.
- Deliver high-quality care without risk of injury.
- Avoid fraud or abuse.
- Protect patient privacy, safety, and valuable information.
- Bill patients reasonably.
- Prevent possible data breaches.
Consequently, ticking all these boxes can make your organization credible and reputable. Anything else that happens beyond your control, you can refer or consult with lawyers for physicians.
Legal Implications of Healthcare Compliance
Healthcare compliance (or non-compliance) has profound legal implications for your medical practice depending on the path you take.
The law’s complex nature and constant changes make implementing it more challenging. You can always build your foundation one step after another with a clear plan.
A clear plan constitutes clear directives and laid-out policies. As much as you want to simplify the rules, regulations will always be extensive and more than you can imagine. You miss one thing, and you can face a life-changing lawsuit!
Here’s how you can enforce compliance in your medical practice.
1. Physician-Patient Confidentiality
Always put patient privacy on top of your responsibilities as a healthcare professional. Failing to do so can ripple many adverse effects, including scams, fraud issues, and identity theft.
As a physician, you also create a business relationship with your patient. Laws such as the Health Insurance Portability and Accountability Act (HIPAA) require consent when sharing patients’ private information. Otherwise, it must be strictly kept confidential between the two of you.
2. Open Communication
Encourage open communication throughout the organization, including potential compliance violations.
To be human is to err; healthcare organizations are not immune to this. Communicating these concerns properly and in a timely manner may lessen the negative impact of non-compliance. It also opens the door to education and learning throughout the organization.
To avoid significant legal repercussions, communicate non-compliance to the designated officer immediately. Likewise, leaders must make it a valuable lesson that everybody can learn from and apply in the future.
3. Healthcare Compliance Evaluation
A healthcare compliance audit is as essential as compliance per se. It helps identify what elements need to be retained, improved, or removed entirely. It also determines future risks before they happen or mitigates uncontrollable factors affecting compliance.
In short, a healthcare compliance evaluation allows you to identify the strengths and weaknesses of your program. Hence, you can make proper changes accordingly before compliance issues occur.
Why Does It Matters?
Before physicians even obtain their professional license, they know the major concern there is for healthcare compliance. In fact, they are recognized as compliance drivers themselves.
This is rooted in the presumption that physicians can determine not only compliance but when there is none. Physicians are expected to provide care professionally and prospectively from the moment it is delivered until it concludes.
Doing so will prevent malpractice lawsuits over the course of your medical career. Although it’s only a surface of damages (and future ones) incurred, this permanent record won’t look good on your credentials.
Healthcare compliance remains a concept if not realized through an efficient program and implemented by diligent officers. Proper education on healthcare compliance helps physicians become:
- Attentive to details
- Critical thinkers and futuristic
- Individually and socially responsible
- Driven to do the right thing
- Reverent and dutiful to facts and data
One thing that can help physicians comply with standard and quality care procedures is focusing on areas they deal with daily.
Healthcare compliance will continue to be a challenge considering the complexity of laws relevant to medical practice. Moreover, creating an effective compliance plan will have its setbacks.
Incorporating a standard educational program for healthcare professionals is key to achieving successful healthcare compliance. Likewise, being proactive about the potential consequences of non-compliance gets you steps ahead.
At the end of the day, being able to provide high-quality care and avoid medical malpractice are what matters.