Kathy Smith, RHIT, CCS, is the outpatient coder at Doctors Phillips, Sullivan, and Franks office. Dr. Phillips, the chairman of the group practice, enters Kathy s office accompanied by Sally Jones, the practices risk manager. Sally requests records of all patients in the past two years who have had gastric bypass surgery by Dr. Franks and states that they will be back for them in 20 minutes. Kathy reminds Sally that the department policy for study requests is 24 hours, but Sally tells her that this is an urgent matter. Sally and Kathy are close friends and have both worked at the physician s practice for 15 years. Sally confides in Kathy that Dr. Phillips needs the records in response to a patient death after surgery, with the family threatening a lawsuit against the surgeon practice group.
Kathy lets Sally know that she will pull the records immediately and thanks her for sharing the information with her. Kathy s mother is scheduled to have bypass surgery by Dr. Franks next week, so naturally she is concerned. As Kathy pulls the files, she notes that 23 of the 75 patients expired due to complications from the surgery.
Kathy calls her mother to please reconsider her surgery and to get a second opinion from another surgeon. When Kathy gets off the phone, Sally confronts her about the discussion she has overheard between Kathy and her mother.
Kathy responds, I couldn t help but notice a trend in the outcomes of the surgeries, and I couldn t help but be considered about my mother. Wouldn t you do the same thing if your mother were scheduled to have gastric bypass surgery with Dr. Frank.
Please submit your answers to the following questions on a Word document in the appropriate drop box.

1. What internal and external forces impact Sally s concerns in this case?

2. What internal and external forces impact Kathy s concerns in this case?

3. What ethical concerns are presented in this case?

4. Discuss the issues presented in this case as they relate to the American Health Information Management Association (AHIMA) Code of Ethics?

5. Identify what you consider to be the greatest legal or ethical dilemma in this case and determine the best option for resolution.