• Create Activities

    Create educational activities for ethical dilemmas in delegation and comanagement using these presentations, case studies, and pre and post-test questions.


    After completing this educational activity in Delegation and Comanagement, you should be able to:

    • Identify what federal statutes pertain to appropriate delegation of care and comanagement of patients
    • Define “remuneration”. 
    • Identify whether delegation of authority equals delegation of responsibility.

    Pre- and Post-Test Questions

    1. When is it acceptable okay to give a portion of your postoperative fee to the person with whom you are postoperatively managing a patient?
    a. Only once, at the first referral, to establish the referral relationship.
    b. After 30 days into the postoperative period.
    c. Never

    2. If you know and trust the health care provider who routinely refers patients to you for cataract and refractive surgery, it is acceptable to meet the patient for the first time at the OR door.
    True or False

    3. Which laws come into play in a delegation of ophthalmic care situation: state or federal?
    a. State
    b. Federal
    c. Both

    4. Anti-kickback laws do not apply unless there is a third-party payor in a designated “Federal Health Care Program”.
    True or False

    5. The following raise concerns about inappropriate comanagement:
    a. Arrangements are occult to the patient
    b. Arrangements are primarily financially driven
    c. Arrangements are offered as a reward for referrals
    d. All of the above

    6. In the “staged competence” scheme of Case 1, an independently licensed optometrist who works in Dr. McDonagh’s office as a full time employee fails to identify a defect in a child’s red reflex, and a retinoblastoma is missed. For schedule reasons, the subsequent “ophthalmologist” exam stage is scheduled for three months later. The best response is:
    a. Never delegate authority.
    b. Delegate only to those of known competence to perform the task.
    c. Continue “staged competence” but review every optometrist’s decisions.
    d. Fire the optometrist for incompetence

    See also: Code of Ethics – Delegation and Comanagement