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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 2nd floor faculty suite
CPM-Independence campus
- Office phone number: 216-916-7474
- rpetrozz@kent.edu
-Office Hours: Monday (PM), Wed (PM), Thurs (AM)

Ken Slenkovich, MA

- Assistant Dean and Senior Instructor


- Department of Health Policy and Management
- kslenkov@kent.edu
- Office phone number: 330-672-6504

Jeff Hallam, PhD

- Professor and Chair


- Department of Social and Behavorial Sciences
- jhallam1@kent.edu
- Office phone number: 330-672-0679

Mark James, PhD, MS

- Professor and Chair


- Department of Biostatistics, Environmental Health
Sciences, and Epidemiology
-mjames22@kent.edu

Lynette Phillips, PhD, MSPH

- Associate Professor
- Department of Biostatistics, Environmental Health,
Sciences and Epidemiology
-lphill20@kent.edu
- Office phone number: 330-672-6324

Jonathan VanGeest, PhD

- Professor and Chair


- Department of Health Policy and Management
- jvangees@kent.edu
- Office phone number: 330-672-6514

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 todays medical-legal environment

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 nations 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. DAddato 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.

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): 15431548.
3. Mercer, S.L. et al. Guiding the way to public health improvement: Exploring the connections
between the community guides evidence-based interventions and health department accreditation
standards. J Public Health Management Practice 2014; 20(1): 104110.

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.

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
B
C
F

90-100%
80-89%
70-79%
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.

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.

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 todays 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 tnovak7@kent.edu (KSUCPM) or visit www.kent.edu/sas for more information on
registration procedures.

XI. PLAGIARISM and CHEATING


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 students 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 medicines 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. Chebyshevs 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. Maslows hierarchy of needs
5. Herzbergs two factor theory
6. Victor Vrooms expectancy theory
7. Lockes 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 doctors 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 doctors
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 todays
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

12

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.

13

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, workers 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.

14

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.
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.
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.
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
16

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, Metaanalyses, 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

17