Legal Aspects of U.S. Health Care System Administration: A report

Day by day, concerns regarding public health are increasing in the world. The USA is the top most economy of the world is most concerned with the well-being of its people. She articulates various laws from time to time to reinforce and increase the knowledge of public health and its administration in the country.


Wellcare hospital is a renowned hospital in the Happy Town. This Hospital has been acclaimed for giving its best services regarding all aspects to people around the globe. Recently some ethical issues regarding misconduct and inter-employee conduct occurred in the hospital. As a result, the hospital was under scrutiny for breach of medical compliance.


My position as a health administrator (legal and compliance) has always remained good with the hospital. Last year, a training session was undertaken by me in whom I had taken training in personnel conduct and inter-employee conduct. The roles and duties look into the actual palpability of a medical suit filed by any patient on to the hospital. If an act of negligence is noticed to be performed by the hospital staff, then I look into the matter, discuss it with concerned hospital staff, the victim and of course the hospital authorities who are senior to me.


The professional staff of the hospital sometimes compromised with the boundaries of ethics and medical conduct. The top reasons for this kind of activity can be listed below:


Competition: There are various challenges in the delivery of health care to people. There is not just one hospital which will provide a single service. Many hospitals hand over the same service at a given point of time. Under such circumstances, hospital staff, as an employee has to perform better for better promotions, salaries, and positions in the hospital. Naturally, where competition increases, there is a chance of a breach of faith to a certain extent.

Shortage of staff: There is always a deficit of staff in health care organizations; especially an inadequacy of nurses is always experienced. Suppose the hospital requires 50 nurses and only 30 are there. Naturally, it will be arduous for 30 to perform the task of 50 nurses in the best way. There is a hamstring of ethical concerns in such circumstances. Many surveys from time to time have reported that nurses suffer from job dissatisfaction and mental disturbances due to their profession as discussed above. Unethical acts are percolated by them which actually should not be done.

Excess legal procedures: Patience is lacking all around the globe. Slight negligence of professional staff may result in legal proceedings and complete spoilage of career. Therefore, professional staff performs all acts keeping the law in its mind. In such a case, sometimes compromise has to be done in acting during the emergency condition. Let’s take an example: A late night emergency occurred with an admitted patient, and this patient required administration of a rare drug. Sam (the nurse on duty), had to fill in a form, before giving this drug to the patient. Now, what to do. Keeping ethics on the backend, Sam filled up the form first and then gave the requisite medical care to the patient.

Elements required of a plaintiff to prove medical negligence 


Medical lawsuits have become very typical in the United States. Therefore, the state laws have made four obligatory elements to prove that a medical negligence has occurred.


A professional duty owed to a patient– First of all, the patient has to prove, that the concerned medical practitioner owned a medical duty towards him. The committal starts when the patient is introduced to the doctor first time. Proof of their discussion and medical advice prescribed will do the task.

Breach of such duty– Second, breach of duty by the doctor has to be proved by the patient. For this, the patient has to refer to “standard of care”. In this, the patient has to prove that if he/she had been referred to some other medical professional/doctor, then what difference would have been there in the service provided. Sometimes, this part of medical misconduct is easily perceivable by the court of law. And by looking at the visible damages, the court identifies that some medical mismanagement has occurred. In legal terms, it is called as “res ipsa loquitur”(Latin for “the thing itself speaks” but more often translated as “the thing speaks for itself”).

An injury caused by breach- This concept in medical words is known as “proximate causation”. Legally, breach of medical misconduct is meaningless, if it has not caused any injury to the patient. So, to prove this part, the patient has to validate the actual blemish caused to him by hospital misconduct.

Resulting damages- This part of the medical negligence, if verified, will finally certify the damage caused to the patient. In this part, calculation of damages is done. Most of the times, monetary damages are calculated.

It is important to note, that despite grounds of misconduct, if any harm did not take place, then the court may not punish the health care professional anyhow. In such a case, the petition of the patient remains underpass.


There are various duties set up by Well Care hospital governing board which can further mitigate the effects of medical negligence.


First of all, there is a jumbo time gap between the filing of the suit and actual trial. During this time interval, an out-of-litigation process can be accomplished. If any medical care can provide relief from the existing injuries, then that is provided by the Well Care hospital management system.  Hospital authorities also give expert testimony in this regard. If settlement through mutual understanding is possible, then preference is given to that. These types of discussions are conducted in doctors’ offices because physicians are most comfortable in their own capacity. It is important to note that legal procedures are always stretched out and time-consuming. In this extended period, a lot of money would be wasted in the court of law. If the victim wants to settle the case via monetary benefit, then it is preferred.


Academic Resources/References:


Simek J. (2016) “Specifics of nursing ethics” Konkakt 18 (2): e64-e68.

Pozgarr and Sanctucci (2015) “Legal Aspects of US Health Care Administration” Published by Jones and Bartlett Publishers, 12th

Pozgar, G.D (2013) “Legal and Ethical Essentials of Health Care Administration” Published by Jones and Barlett Learning, 2nd

Yoder (2013) “Patient Care Staffing levels and facility characteristics in US Hemodialysis Facilities” American Journal of Kidney Diseases, 62 (6):1130-1140.

Bal, S.B. (2009) “An Introduction to Medical Malpractice in the United States” Clinical Orthopaedics and Related Research 467(2):339-347.