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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:1.What are the potential ethical and legal implications for each of the following practice members? oMedical assistant oNurse Practitioner oMedical Director oPractice 2.What strategies would you implement to prevent further episodes of potentially illegal behavior? 3.What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice. Dr. Sibel and fellow classmates, Having someone call in a prescription without it being prescribed by an authorized provider is a very serious offense involving illegal actions by the medical assistant. Stephanie’s action not only affected her future as a medical assistant, but her actions also have an impact on the patient, nurse practitioner, medical director, and the primary care practice. Given that Stephanie does not have prescriptive privileges, she could have wrongly called in a medication that the patient was allergic to, interacted with medicines taken daily by the patient, or prescribed a medication that could produce long term side effects.Amoxicillin is not a cough suppressant, so Mrs. Smith did not receive the appropriate medication needed, and given that prescribing medication is out of Stephanie’s scope of practice, she should have never takenit upon herself to call in medicine for a patient without consulting with a medical provider and having them prescribe the desired medicine. While Stephanie appears to have previously been a wonderful medical assistant, this one action could result in her losing her job, losing her license to practice as a medical assistant (if she chose to be certified) and could result in legal action and disciplinary measures.