Raising the Bar: Meeting Healthcare Law Contemporary Challenges for Healthcare Judge Advocates in the United States Army and Air Force

摘要

United States Army and Air Force Judge Advocates whose clients are healthcare organizations were chosen to identify the most pressing issues facing them and to identify the relative importance of sources from which legal knowledge is acquired. For this study, the investigators conducted two iterations of the Delphi technique separated by content analysis performed by an expert panel. In the first round, the investigators received responses from 13 of 27 respondents (48.2%) and identified 62 issues. After content analysis, these competencies were refined into 20 unique issues or problem areas that were categorized into six domains. The domains were contracting, quality management, compliance, human resource, medical ethics, and financial management. During the second round, 16 of 32 respondents (50%) utilized a 7-point bipolar Lickert scale to rate each domain and each competency contained within the domain for importance. They evaluated the importance of six sources from which legal knowledge is acquired. The two highest rated domains were compliance (5.50) and medical ethics (5.19), followed by quality management (5.13) and contracting (4. 56). The five highest rated competencies were the proper release of personal health information (6.75), medical malpractice defense (6.50), adverse actions process (6.19), medical research (6.06) and compliance with the joint ethics regulation (5.88). Notably, informal methods of acquiring legal knowledge dominated in importance, with 50 of the 60 highest ratings in the acquisition of legal knowledge attributed to experience/on-the-job training, personal study, and mentoring. Conversely, of the 50 lowest ratings in the acquisition of legal knowledge, 47 were attributed to formal methods of acquiring legal knowledge such as law school, judge advocate school, and continuing legal education.