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Organizational Change and Ethical-Legal Influences

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.

Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.

Case Study Questions:
What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

Sample Solution

in. In 2018, Statistica reported that retail e- commerce in the USA sales grew by 13% to $504 million. This sales figure is approximately 10 times larger than the total recorded by Statistica for Canada in 2018. While SMEs may not be entirely at fault they play a vital role in the economy and therefore are believed to contributes to the problem. Statistics Canada (2019) explain that SMEs account for 54.2% of the economic output of the business sector. The largest number of SMEs can be found in the retail and wholesale trade sectors. Therefore it can be argued that the failure of SMEs to adopt websites and new technologies can threaten e-commerce growth and even the economic growth of Canada. As it can result in missed opportunities that could contribute to the growth of e-commerce sales and success of Canadians businesses. These missed opportunities are another major implication. SMEs could be left behind in favour of other businesses that have websites. Websites are not only an important e-commerce tool, but it can be a useful source of information for consumers. Therefore SMEs that choose to not create a website could find it difficult to compete or differentiate themselves in a market where their competitors have websites. Research by the Canadian Internet Registration Authority (CIRCA) found that consumers tend to view SMEs without websites less favourably. A CIRCA (2016) Internet Tracking Study found that Canadian consumers are less likely to trust businesses without a website. The study also found that consumers thought SMEs without a website looked less credible (CIRA, 2016). By not having a website, most SMEs in Canada are missing a large opportunity for e- commerce sales in the B2B sector. Laudon and Traver (2017) explains that business to business (B2B) sales is the largest form of e-commerce in the U.S. with over $6.7 trillion USD in transactions in 2016. In Canada, e-commerce has become an important part of the B2B retail landscape. A study by Forrester Consulting commissioned by Purolator (2016) found “B2B online selling is already a major part of doing business in Canada” today. Of the 400 retailers surveyed by Forrester Consulting, half of B2B sellers indicated that over 25% of their sales took place online. Purolator (2016) warned that “firms that avoid online selling risk falling behind” in favour of other sellers that embrace e-commerce and changing consumer behaviour (1). The third implication of these findings is related to the risk of falling behind. Canada Post (2016) estimates that e-commerce sales in Canada will continue to grow by doubl
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