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Contractual Limitations

Medical care providers such as hospitals and managed care plans may never authorize the delegation of more authority than is permitted by state law, but they may impose limitations on the delegation of authority that are more restrictive than the state laws. These limitations are generally covered in the employee policies and procedures and the medical staff rules. Typically nurses and technicians may accept orders only from physician members of the medical staff. Those in the employ of a physician may work in the hospital only after an independent review of credentials and with a specific scope of practice. The penalty for violating these policies is loss of the job for those who are hospital employees or loss of staff privileges for the physicians. These policies also may be admissible in a medical malpractice lawsuit as evidence of the proper standard of care.


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