• Morality=character

• Ethics= moral philosophy (Application of

morality)
• Etiquette- code that governs social behavior
(behavior in a certain setting)
REFERRAL SYSTEM
• Sending the patient to another specialist or
rehabilitation team member or hospital for
the ongoing management of the problem
• Referral does not mean TRANSFERRING
responsibility but SHARING of the
responsibility in patient care
 When to refer
• In need of specific investigation or advice
• When the primary consultant is not satisfied
with the progress of the patient
• Unsure of the diagnosis
• Medical legal concerens by the physician or
patient or both
 Factors affecting referrals
• Availability of qualified professionals
• Length of training
• Uncertainty of diagnosis
• Patient characteristics
• Reimbursement plan
 Referral process-8 steps
• 1.Establish good relationship with the patient
• 2.Establish need for the referral
• 3.Set objectives for the referral
• 4.Explore resources available
• 5.Patient decides to use or nonuse
• 6.Make pre referral treatment
• 7.Co ordinate referral
• 8.Evaluate and follow up
 Benefits of the referral
• For the patient
• For the physician
• For the consultant
 1.For the patient
• Prompt diagnosis and management
• Save time,money and effort
• Better outcome
 2.For the physician
• Learning and training
• Gaining confidence
• Increases communication among the health
care staff
 For the consultant
• Improves the quality of the patient care
• Improves communication among the health
care staff
 Referral letter outline
• Demographic data- name,age,sex,location
• Referring professional details
• Reasons to refer
• Degree of urgency of appointment
• Clinical problem
• Any investigations,medication
• Ongoing treatment
 Types of Referral
• According to the case
• 1.Mandatory-Likely to
suffer if not referred
• 2.Elective-Unlikely to
suffer if not referred
CONFIDENTIALITY IN HEALTH CARE
• What is confidentiality
• Confidentiality breach
• Tips for maintaining confidentiality
• Disciplinary Actions
• The ethical principle that a physician or a
health professional will hold secret all
information related to the patient,unless the
patient gives the consent to disclose
• All nformation not only include- health
situation but also living situation,family and
finances
Health Insurance Portability and
Accountability Act (1996)
 Confidentiality breach
• Disclose of private information to a third party
without the consent of the patient
• Disclosure can be oral,written,e
mail,telephone
• Accessing medical records of a patient without
a legitimate reason
 Tips
• Think before you speak
• Don’t discuss in the public places
• View information of the patients whom you
are directicly caring for
• After viewing confidential information log off
• Documents should not be disposed
• Donot use patient’s full name
 When to reveal patient’s personal health
information (PHI)
• 1.Court process
• 2.Criminal investigation
 Disciplinary actions
• Extend from fines to termination depending
on the extent of the breach
• Hold liable even if you have leaked by mistake
• Legal right to Sue
• Confidentiality not only protects patients but
also ourselves