Although I have only worked in the health care industry for a short period of time, I have encountered many incidents of disrespect among staff. It is understandable that this behavior is not demonstrated in all aspects of health care but it is important that it is addressed. Employees should feel as if they are appreciated and respected by their fellow co-workers and supervisors. Sometimes supervisors do not see their employees as equals and this is not true. Without the assistance of the employees, health care organizations would not run smoothly. Employers need their employees and employees should not be viewed as inferiors.
Workers should not be looked down upon or treated inhumanely. When constructive criticism is needed, it should be presented to employees professionally. Yelling or disrespected employees when errors are made is unnecessary and employees may be less likely to cooperate with supervisor.
This blog has been written because there have been many displays of disrespect in an industry that is supposed to show compassion. If employees are not able to respect each other, this may reflect in the behaviors demonstrated to patients. Therefore it is essential that health care providers and staff are able to work in an environment in which respect is given.
Additionally, the health care industry is an industry where teamwork is vital. If team members are not working together, this could also affect the care given to patients. The lack of teamwork could result in the lack of communication, which could lead to errors, and ultimately affect patient quality.
Although this blog did not address a particular case, I felt that it was necessary to address an issue that is seen frequently in the workplace. Health care administrators should stress the importance of team morale and respecting co-workers. The workplace is an environment in which people spend many hours and it is important that employees feel comfortable. Since disrespect and lack of compassion are not viewed as ethical. The ACHE Code of Ethics states that health care professionals should provide a work environment that displays and encourages ethical conduct by employees (Pozgar, 2005). Therefore, these are ethical concerns should be addressed by health care administrators.
Reference
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
Thursday, July 15, 2010
Wednesday, July 14, 2010
Timely Responses
Patients have the right to have their health care providers respond to them in a timely manner Pozgar, 2005). It is understandable that health care professionals have many patients to care for and they are often busy, but there should be standards in place to ensure health care professionals are not ignoring the concerns of patients. This is important to remember when reading the following case.
There was a case in which a patient expressed frustration with how she was treated during a visit with a new physician. She consulted with this physician because she thought they would have an answer to the questions she had regarding her illness (Pozgar, 2005). She expressed that she was initially seen by a medical student who wrote her history down on a sticky pad and the physician only consulted with her for about 10 minutes. After the consultation, the doctor was supposed to follow up with her which he never did. She wrote him a letter stating this information which he never responded to.
The physician in this case did not respect the rights of the patient. He did not provide a timely response and did not provide compassionate care. Ignoring the patient demonstrated the physician did not care about the needs of the patient. The patients want to feel as if their needs are taken care of and because this patient was going to this physician because she had extreme medical conditions, the physician’s help was needed.
If the physician did not know that was wrong with the patient or understand the patient’s condition, this should have been expressed. Therefore the patient could have consulted with another physician versus waiting for a response from this doctor.
The doctor did not commit themselves to the patient which is an ethical principle health care providers must always remember to do. Additionally, they did not respect the needs of the patient. These are a couple of the ethical issues that were demonstrated in this case.
As a health care administrator it is always important to ensure health care providers are following up with patients. If the physician was not able to promptly respond to the patient, they could have had another clinician follow up with the patient. The health care administrator could have addressed the patient in this case and apologized for how the patient was treated, even if the doctor still chose not to respond, it would have made the patient feel more comfortable that someone respond to their needs. Not responding could have also put the patient’s health in jeopardy, which could have created more issues for the health care provider and administration.
Reference
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
There was a case in which a patient expressed frustration with how she was treated during a visit with a new physician. She consulted with this physician because she thought they would have an answer to the questions she had regarding her illness (Pozgar, 2005). She expressed that she was initially seen by a medical student who wrote her history down on a sticky pad and the physician only consulted with her for about 10 minutes. After the consultation, the doctor was supposed to follow up with her which he never did. She wrote him a letter stating this information which he never responded to.
The physician in this case did not respect the rights of the patient. He did not provide a timely response and did not provide compassionate care. Ignoring the patient demonstrated the physician did not care about the needs of the patient. The patients want to feel as if their needs are taken care of and because this patient was going to this physician because she had extreme medical conditions, the physician’s help was needed.
If the physician did not know that was wrong with the patient or understand the patient’s condition, this should have been expressed. Therefore the patient could have consulted with another physician versus waiting for a response from this doctor.
The doctor did not commit themselves to the patient which is an ethical principle health care providers must always remember to do. Additionally, they did not respect the needs of the patient. These are a couple of the ethical issues that were demonstrated in this case.
As a health care administrator it is always important to ensure health care providers are following up with patients. If the physician was not able to promptly respond to the patient, they could have had another clinician follow up with the patient. The health care administrator could have addressed the patient in this case and apologized for how the patient was treated, even if the doctor still chose not to respond, it would have made the patient feel more comfortable that someone respond to their needs. Not responding could have also put the patient’s health in jeopardy, which could have created more issues for the health care provider and administration.
Reference
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
Saturday, July 10, 2010
Quality Blog #4: Quality and Reduction in Patient-Provider Contact
There is one aspect of quality I find very important to mention. Over the past years, the amount of time doctors spend with their patients has decreased. This includes outpatient and inpatient settings. Physicians used to spend more time assessing and treating patients. Standards in the health care industry have changed over time. Patients are spending less time in hospitals and receiving more outpatient treatment. Patients are also limited to the amount of time they are able to visit with their doctor.
This could be for several reasons. Physicians reduce time spent with patients in order to see more patients throughout the day. They also reduce patient visit times to reduce waiting times. Although reducing the amount of time physicians spend with patients seems beneficial, this practice could affect quality.
Additionally, managed care organizations have contributed to the reduction in time patients are able to spend with physicians, especially in inpatient settings. In 2008the average length of stay (LOS) in an inpatient setting was 4.6 days (HHS, 2009). The average length of stay for managed care patients was 3.8. Managed care organizations have played a huge role in the standards we have set for health care professionals. There is a maximum length of stay that is placed on hospitals. If patients are in the health care facility over the maximum length of stay, facilities are not paid for the costs accrued those additional days (Kongstvedt, 2007). Other payers like Medicare and Medicaid have adopted similar practices as a method of reducing costs. These methods of reducing costs could negatively affect quality.
I have had experiences in which I have felt rushed by physicians. During these experiences I did not feel that I received the quality of care I needed. I felt as if I walked out of the office with more questions than what I entered with.
Patients want to feel that clinicians care about their needs (Pozgar, 2005). This is a right of the patient. The patient has the right to receive compassionate care and often when patients are rushed this may not be the indication. When physicians do not spend an adequate amount of time with patients, quality is jeopardized. This issue could also increase the amount of errors in the health care industry. With the pressure to discharge a patient quickly, employees are prone to make more mistakes. Also, if providers are able to increase the amount of time with patients, errors can be corrected in a timely manner and more problems with the patient’s health may be found. If reducing the amount of time we spend with physicians will reduce quality, it is important to reevaluate some of the standards we have set for our health care system and find alternatives to reducing costs while not jeopardizing quality.
References
Kongstvedt, Peter. (2007). Essentials of managed health care. Jones & Bartlett Learning.
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
U.S Department of Health and Human Services, Agency for Healthcare Research and Quality. (2009). 2008 national statistics:outcomes for all discharges
This could be for several reasons. Physicians reduce time spent with patients in order to see more patients throughout the day. They also reduce patient visit times to reduce waiting times. Although reducing the amount of time physicians spend with patients seems beneficial, this practice could affect quality.
Additionally, managed care organizations have contributed to the reduction in time patients are able to spend with physicians, especially in inpatient settings. In 2008the average length of stay (LOS) in an inpatient setting was 4.6 days (HHS, 2009). The average length of stay for managed care patients was 3.8. Managed care organizations have played a huge role in the standards we have set for health care professionals. There is a maximum length of stay that is placed on hospitals. If patients are in the health care facility over the maximum length of stay, facilities are not paid for the costs accrued those additional days (Kongstvedt, 2007). Other payers like Medicare and Medicaid have adopted similar practices as a method of reducing costs. These methods of reducing costs could negatively affect quality.
I have had experiences in which I have felt rushed by physicians. During these experiences I did not feel that I received the quality of care I needed. I felt as if I walked out of the office with more questions than what I entered with.
Patients want to feel that clinicians care about their needs (Pozgar, 2005). This is a right of the patient. The patient has the right to receive compassionate care and often when patients are rushed this may not be the indication. When physicians do not spend an adequate amount of time with patients, quality is jeopardized. This issue could also increase the amount of errors in the health care industry. With the pressure to discharge a patient quickly, employees are prone to make more mistakes. Also, if providers are able to increase the amount of time with patients, errors can be corrected in a timely manner and more problems with the patient’s health may be found. If reducing the amount of time we spend with physicians will reduce quality, it is important to reevaluate some of the standards we have set for our health care system and find alternatives to reducing costs while not jeopardizing quality.
References
Kongstvedt, Peter. (2007). Essentials of managed health care. Jones & Bartlett Learning.
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
U.S Department of Health and Human Services, Agency for Healthcare Research and Quality. (2009). 2008 national statistics:outcomes for all discharges
Tuesday, June 29, 2010
Quality Blog #3: Patient Perspective and Adverse Effects
Adverse effects are also called side effects and can result from a reaction to a drug or surgery. They are considered events that cause harm to the patient. The patient’s perspective is a very significant aspect when discussing adverse events. This is true particularly because patients are the party most affected by the event. If the patient does not offer insight, the physician may not be aware that anything has occurred. Therefore this makes the patient’s perspective the most important determinant in perspectives on adverse effects.
A patient’s viewpoint also gives health care professionals an idea of how certain drugs or surgeries are affecting certain patient populations. For example, if health care professionals are noticing that diabetic patients are experiencing nausea from a certain medication, one could assume that this is an adverse effect for these patients. If this information had not been communicated by the patient, the clinician may not have been aware of the effect.
Adverse events can vary from mild to severe, including death. If these events can result in the death of a patient, the patient’s perspective is vital. If I needed to inform my physician about trouble I have been experiencing with a drug, I would expect the physician or other health care professional to take my concern seriously. If the physician chooses to research the side effect, it could lead to others classifying my problem as an adverse effect which could prevent harm to other patients who are given the same medication in the future. This is another example of how a patient’s insight could lead to determining whether an adverse event has occurred.
Health care professionals should also try to use the patient’s perspective as much as possible because it allows for more efficient and effective care for the patient. Without insight and feedback from patients, the affects of a drug may go unnoticed, which could create problems for the patient and health care professional in the future; which could reduce the quality of care given to patients. Reports from patients also allow health care professionals to make improvements in care (Ransom, Joshi, & Ransom, 2008). It is important for health care professionals to understand how these events affect their patients. If they have a better understanding of this, they are able to provide better care to patients as well.
Reference
Ransom, Elizabeth, Joshi, Maulik, & Ransom, Scott. (2008). The Healthcare quality book. Health Administration Pr.
A patient’s viewpoint also gives health care professionals an idea of how certain drugs or surgeries are affecting certain patient populations. For example, if health care professionals are noticing that diabetic patients are experiencing nausea from a certain medication, one could assume that this is an adverse effect for these patients. If this information had not been communicated by the patient, the clinician may not have been aware of the effect.
Adverse events can vary from mild to severe, including death. If these events can result in the death of a patient, the patient’s perspective is vital. If I needed to inform my physician about trouble I have been experiencing with a drug, I would expect the physician or other health care professional to take my concern seriously. If the physician chooses to research the side effect, it could lead to others classifying my problem as an adverse effect which could prevent harm to other patients who are given the same medication in the future. This is another example of how a patient’s insight could lead to determining whether an adverse event has occurred.
Health care professionals should also try to use the patient’s perspective as much as possible because it allows for more efficient and effective care for the patient. Without insight and feedback from patients, the affects of a drug may go unnoticed, which could create problems for the patient and health care professional in the future; which could reduce the quality of care given to patients. Reports from patients also allow health care professionals to make improvements in care (Ransom, Joshi, & Ransom, 2008). It is important for health care professionals to understand how these events affect their patients. If they have a better understanding of this, they are able to provide better care to patients as well.
Reference
Ransom, Elizabeth, Joshi, Maulik, & Ransom, Scott. (2008). The Healthcare quality book. Health Administration Pr.
Monday, June 28, 2010
Ethics and Honesty
Honesty is one ethical principle that is violated every day. People violate this principle in their personal lives as well as in their working environment. People often do not realize the severity of dishonesty and how it could affect someone else. In health care dishonesty can turn into a serious event. For instance, if a physician chooses not to disclose a patient’s true condition to them and the patient goes untreated. This case of dishonesty can turn into negligence on the health care professional’s part.
I was reading a case in which a physician neglected to tell a patient that she had cancer because the husband asked the doctor not to (Pozgar, 2005). The doctor and the husband thought the wife’s condition would get better. The patient turned out fine for awhile but had to be admitted into the hospital again. The doctor told the husband that the patient only had a few days to live, while the patient thought she would be leaving the hospital soon. She died shortly after. The couple had kids as well. The doctor should have looked out for the rights of the patient. If I have a condition, I would like to be informed of it, especially if there are measures I need to take to improve my condition. The doctor and the husband did not give the patient a chance to put her health in her own hands.
Those who are responsible for the care of patients must understand the importance of honesty. It is better to be honest than to allow a patient’s health to be jeopardized, especially if a mistake has been made. Employees should feel comfortable informing their supervisors about the mistakes they have made. Employees should not feel that they have to cover up a mistake. Many times the mistakes can be corrected. Although in the case previously mentioned, the doctor did not make a mistake in not disclosing the patient’s condition, he had opportunities to inform the patient.
Autonomy was an ethical principle that was not recognized in this case. The patient was not given the opportunity to make her own decisions regarding her health because she was not aware of it. As mentioned previously the doctor was not honest with the patient regarding her condition. This made his acts unethical and immoral.
Health care administrators should demonstrate the behavior they expect of their employees. If they expect their employees to be honest, they should be honest as well. Employees should also have someone they can confide if they have displayed dishonesty, so that the problem can be corrected. Health care administrators must also educate employees on what could be considered dishonesty, even if it is a small case because ultimately the health care facility is responsible. Employees should also feel assured to report any acts of dishonesty that may be witnessed. If these messages are reiterated to employees, they will understand the seriousness of dishonesty and how it can affect the care given to patients.
Reference
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
I was reading a case in which a physician neglected to tell a patient that she had cancer because the husband asked the doctor not to (Pozgar, 2005). The doctor and the husband thought the wife’s condition would get better. The patient turned out fine for awhile but had to be admitted into the hospital again. The doctor told the husband that the patient only had a few days to live, while the patient thought she would be leaving the hospital soon. She died shortly after. The couple had kids as well. The doctor should have looked out for the rights of the patient. If I have a condition, I would like to be informed of it, especially if there are measures I need to take to improve my condition. The doctor and the husband did not give the patient a chance to put her health in her own hands.
Those who are responsible for the care of patients must understand the importance of honesty. It is better to be honest than to allow a patient’s health to be jeopardized, especially if a mistake has been made. Employees should feel comfortable informing their supervisors about the mistakes they have made. Employees should not feel that they have to cover up a mistake. Many times the mistakes can be corrected. Although in the case previously mentioned, the doctor did not make a mistake in not disclosing the patient’s condition, he had opportunities to inform the patient.
Autonomy was an ethical principle that was not recognized in this case. The patient was not given the opportunity to make her own decisions regarding her health because she was not aware of it. As mentioned previously the doctor was not honest with the patient regarding her condition. This made his acts unethical and immoral.
Health care administrators should demonstrate the behavior they expect of their employees. If they expect their employees to be honest, they should be honest as well. Employees should also have someone they can confide if they have displayed dishonesty, so that the problem can be corrected. Health care administrators must also educate employees on what could be considered dishonesty, even if it is a small case because ultimately the health care facility is responsible. Employees should also feel assured to report any acts of dishonesty that may be witnessed. If these messages are reiterated to employees, they will understand the seriousness of dishonesty and how it can affect the care given to patients.
Reference
Pozgar, George. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Pub.
Tuesday, June 22, 2010
Unethical Behavior by Doctors
As I was browsing the internet, I stumbled across this article about medical students who felt they were pressured into acting unethically ("Study shows unethical," 2010). Researchers gathered information from Canadian medical students for the study. Some of the students saw their professors acting unethically and felt they should do the same. More than half of the students surveyed either felt pressured into acting unethically or saw their professors acting in this manner ("Study shows unethical," 2010). Students also stated that they did not feel comfortable approaching professors about ethical issues.
I found this article very disturbing. Physicians are viewed as leaders in the health care industry and it is sad when they are taught in medical school unethical behaviors. Although this study was conducted in Canada, there could be many other medical students who feel the same throughout the world. If physicians see this unethical behavior repeatedly, it may become a habit. They could also begin to think that this behavior is acceptable, especially if those they respect and learn from are displaying this behavior.
This is a very difficult situation for health care administrators. Physicians are a very critical part of our health care system and the information we receive from them is often considered valuable. Some of the unethical behaviors of physicians may be ignored if they are displaying it on a regular basis. Over time, these ethical dilemmas may be viewed as normal, especially if they are seeing this in medical school. For example, if a physician learned an unethical behavior during medical school and has been practicing medicine for 35 years, this behavior may have become a habit. If the physician is confronted, they may not think that they did nothing wrong.
As health care administrators, it is important that employees are frequently reminded of ethical standards and Code of Ethics. This can assist the administrators in educating the staff on what behaviors are considered unethical. It would also be appropriate to reeducate new physicians on ethical standards so that they are aware of what is expected of them when they begin practicing. In health care, sometimes it seems that physicians are exempt from certain standards because of their positions, but with ethics no one should be exempt.
Employees, including physicians, should feel comfortable speaking with someone regarding ethical issues. If they are struggling with the understanding what the ethical standards are, someone should be available for them. Having someone available and reeducating employees on ethical standards may prevent ethical dilemmas in the future. It is imperative employees understand and adhere to the standards of the facility in which they work. They must also fully understand the Code of Ethics and administrators should take the initiative to ensure these codes and standards are effectively communicated. They are not adhering to ethical principles and morals when employees ignore ethical standards. They could potentially harm fellow employees and patients.
Reference:
Study shows unethical behavior by doctors. (2010, March 22). Retrieved from http://abcnews.go.com/Health/story?id=117549&page=1
I found this article very disturbing. Physicians are viewed as leaders in the health care industry and it is sad when they are taught in medical school unethical behaviors. Although this study was conducted in Canada, there could be many other medical students who feel the same throughout the world. If physicians see this unethical behavior repeatedly, it may become a habit. They could also begin to think that this behavior is acceptable, especially if those they respect and learn from are displaying this behavior.
This is a very difficult situation for health care administrators. Physicians are a very critical part of our health care system and the information we receive from them is often considered valuable. Some of the unethical behaviors of physicians may be ignored if they are displaying it on a regular basis. Over time, these ethical dilemmas may be viewed as normal, especially if they are seeing this in medical school. For example, if a physician learned an unethical behavior during medical school and has been practicing medicine for 35 years, this behavior may have become a habit. If the physician is confronted, they may not think that they did nothing wrong.
As health care administrators, it is important that employees are frequently reminded of ethical standards and Code of Ethics. This can assist the administrators in educating the staff on what behaviors are considered unethical. It would also be appropriate to reeducate new physicians on ethical standards so that they are aware of what is expected of them when they begin practicing. In health care, sometimes it seems that physicians are exempt from certain standards because of their positions, but with ethics no one should be exempt.
Employees, including physicians, should feel comfortable speaking with someone regarding ethical issues. If they are struggling with the understanding what the ethical standards are, someone should be available for them. Having someone available and reeducating employees on ethical standards may prevent ethical dilemmas in the future. It is imperative employees understand and adhere to the standards of the facility in which they work. They must also fully understand the Code of Ethics and administrators should take the initiative to ensure these codes and standards are effectively communicated. They are not adhering to ethical principles and morals when employees ignore ethical standards. They could potentially harm fellow employees and patients.
Reference:
Study shows unethical behavior by doctors. (2010, March 22). Retrieved from http://abcnews.go.com/Health/story?id=117549&page=1
Tuesday, June 15, 2010
Health Care Fraud
Fraud is an ethical topic that is very common these days. There are many stories pertaining to health care fraud, but there was one that caught my interest. I enjoy watching documentaries because they give me information about significant stories that happened when I was younger or did not understand when they were developing at the time. There was a documentary about a podiatrist practicing in Nassau County, New York. A couple of years ago, a doctor was accused of billing Medicaid and Medicare for patients who were dead ("DA arrests jericho," 2008). The doctor was also creating charges for patients who had only seen him once. He was reporting to Medicare and Medicaid that he had seen these patients on several occasions. He was even billing Medicaid and Medicare for patients he never seen before. The podiatrist got away with this for 18 months.
It seems that this has not been the only case in which health care providers are billing third party payers for patients who are no longer living. Not only is this behavior illegal, but it is also unethical. The activity these providers are participating in, affects many people. It affects the patients, the payers, and the families of the victims. If I found out that a health care professional was using a deceased relative’s information to gain profits, it would saddened and upset me. I would ensure that this was reported immediately.
As health care administrators must make every attempt to ensure employees are not participating in fraudulent behavior. This could come in various forms such as accepting bribes, double charging and others. Fraud does not benefit anyone and could pose harm to many people. Causing harm is not considered an ethical principle. One of the duties of the health care administrator is to reinforce ethical principles and standards to the employees. This expresses the seriousness of ethics to employees.
Additionally the administrators can explain the consequences behind participating in fraud which could hopefully decrease the likelihood that employees will partake in the behavior. The Nassau County podiatrist was able to bill Medicare and Medicaid himself and did not have an executive monitoring his actions, therefore he was able to get away with it until the government got involved. This is a step that health care administrators want to avoid. Therefore, educating employees is essential in terms of ethical dilemmas.
I enjoy expressing which ethical principles or morals that were violated in each case. Although it would seem that professionals should know why certain actions are unethical, sometimes it is hard to determine that. In the case of this podiatrist, autonomy was violated because patients were not able to make their own decisions regarding the billing because they were unaware that their information was being used. The podiatrist also did not demonstrate beneficence, he actions were not representative of “doing good”. The podiatrist was also not being conscientious or honest in this case.
Having “morals” is an aspect of life that people assume others have, but in cases like these, it is safe to assume that not everyone has the same morals and ethical principles.
References
Da arrests jericho doctor. (2008, March 21). Retrieved from http://www.antonnews.com/syossetjerichotribune/2008/03/21/news/
It seems that this has not been the only case in which health care providers are billing third party payers for patients who are no longer living. Not only is this behavior illegal, but it is also unethical. The activity these providers are participating in, affects many people. It affects the patients, the payers, and the families of the victims. If I found out that a health care professional was using a deceased relative’s information to gain profits, it would saddened and upset me. I would ensure that this was reported immediately.
As health care administrators must make every attempt to ensure employees are not participating in fraudulent behavior. This could come in various forms such as accepting bribes, double charging and others. Fraud does not benefit anyone and could pose harm to many people. Causing harm is not considered an ethical principle. One of the duties of the health care administrator is to reinforce ethical principles and standards to the employees. This expresses the seriousness of ethics to employees.
Additionally the administrators can explain the consequences behind participating in fraud which could hopefully decrease the likelihood that employees will partake in the behavior. The Nassau County podiatrist was able to bill Medicare and Medicaid himself and did not have an executive monitoring his actions, therefore he was able to get away with it until the government got involved. This is a step that health care administrators want to avoid. Therefore, educating employees is essential in terms of ethical dilemmas.
I enjoy expressing which ethical principles or morals that were violated in each case. Although it would seem that professionals should know why certain actions are unethical, sometimes it is hard to determine that. In the case of this podiatrist, autonomy was violated because patients were not able to make their own decisions regarding the billing because they were unaware that their information was being used. The podiatrist also did not demonstrate beneficence, he actions were not representative of “doing good”. The podiatrist was also not being conscientious or honest in this case.
Having “morals” is an aspect of life that people assume others have, but in cases like these, it is safe to assume that not everyone has the same morals and ethical principles.
References
Da arrests jericho doctor. (2008, March 21). Retrieved from http://www.antonnews.com/syossetjerichotribune/2008/03/21/news/
Monday, June 7, 2010
Quality Blog #2: Medical Errors
Medical errors cause many injuries and deaths each year. According to the Agency for Healthcare Research and Quality, nearly 1 in 25 hospital patients are subjected to injuries caused by medical errors each year (AHRQ, 2000). The agency also estimates that 48,000-98,000 die annually from medical errors. This topic is an important one in terms of health care quality. This is true because if medical professionals are making errors that increase the infection rate in health care facilities and these errors are causing deaths, this is definitely not an example of health care quality. These deaths are preventable and health care workers have to take additional measures to ensure the health of the patient is not jeopardized due to their error. Medical errors reduce the quality of care given to patients.
The safety of the patient is essential in health care facilities. Patients are trusting health care professionals to improve their health. It makes some health care workers appear untrustworthy and incompetent when patients are becoming sicker while in the care of medical staff due to error. Both clinical and administrative have the responsibility of ensuring patients are safe and to reduce medical error. According to the AHRQ, there are steps that health care organizations can to improve the quality of care given to patients.
Some of the steps that can assist with reducing errors include investing in computer systems like Electronic Medical Records, which helps to catch errors faster than the human eye1(AHRQ, 2000). AHRQ also suggests that sending reminders for follow up tests helps with quality and reduces error. Health care organization should also establish some type of protocol to reduce errors.
This topic is really important to me because these deaths and injuries are preventable. Health care organizations have to make more attempts to reduce medical errors in an effort to increase quality. If facilities can reduce the number of injuries and deaths associated with medical errors, they are able to improve care given to patients. It is saddening when patients are subjected to injuries in a facility that is supposed to improve their health. As a future health care administrator, it is important that I take the initiative to reduce medical errors and improve quality. This is an issue that I have realized is important to me.
Reference:
Reducing Errors in Health Care: Translating Research Into Practice. AHRQ Publication No. 00-PO58, April 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/errors.htm
The safety of the patient is essential in health care facilities. Patients are trusting health care professionals to improve their health. It makes some health care workers appear untrustworthy and incompetent when patients are becoming sicker while in the care of medical staff due to error. Both clinical and administrative have the responsibility of ensuring patients are safe and to reduce medical error. According to the AHRQ, there are steps that health care organizations can to improve the quality of care given to patients.
Some of the steps that can assist with reducing errors include investing in computer systems like Electronic Medical Records, which helps to catch errors faster than the human eye1(AHRQ, 2000). AHRQ also suggests that sending reminders for follow up tests helps with quality and reduces error. Health care organization should also establish some type of protocol to reduce errors.
This topic is really important to me because these deaths and injuries are preventable. Health care organizations have to make more attempts to reduce medical errors in an effort to increase quality. If facilities can reduce the number of injuries and deaths associated with medical errors, they are able to improve care given to patients. It is saddening when patients are subjected to injuries in a facility that is supposed to improve their health. As a future health care administrator, it is important that I take the initiative to reduce medical errors and improve quality. This is an issue that I have realized is important to me.
Reference:
Reducing Errors in Health Care: Translating Research Into Practice. AHRQ Publication No. 00-PO58, April 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/errors.htm
Saturday, June 5, 2010
Racial Discrimination in Washington's Physician Offices
Ethical dilemmas are plentiful in the health care industry. We are in an industry where decision making is critical because decisions can determine the outcome of someone’s health and life. Therefore, it is important to acknowledge the significance of ethical decisions in health care. Racial discrimination still occurs in every aspect of our society and in all industries. In terms of discrimination, it occurs in the health care industry as well. After reading an article about research conducted in the state of Washington about African American patients being discriminated against, I felt this would be an appropriate ethical topic for this blog.
In health care there have been allegations of racial discrimination against patients as well as staff. For instance in research conducted in Washington, many patients felt they were not receiving the same care as other patients and were treated differently because of their ethnicity. The study was based mostly on African American patients.
Discrimination is an ethical issue that health care administrators have to address, regardless of their own prejudice. Racial discrimination can easily become a legal issue depending on the case. Therefore it is important for staff and administration to understand the ethics behind discrimination. In the study conducted by the state of Washington many patients decided to keep quiet about the discrimination they were facing in fear of not receiving treatment from that physician's office.
Patients should not be discriminated against because of their race. Minority patients should feel that they are really fair and quality services like everyone else. They should not feel afraid to speak up about the discrimination they faced. The administrators in these health care facilities should teach their staff about the importance of equality and treating every patient with dignity and respect. As stated previously an administrator needs to be able to set aside their own prejudices to provide care to the patients.
If they are not able to convey this message properly, they can consult with an outside agency that can educate the staff on ethics and discrimination to improve the care given to these patients. Although ethics is a subject that can become debatable because not everyone considers the same principles as being ethical, one should be able to determine that discrimination is not an ethical practice. Justice is an ethical principle that has been greatly disregarded in this case because they are not treating all patients similarly. There are also moral values that have been compromised in which they are limiting their compassion, conscientiousness, fidelity, and fairness due to the race of the patient.
Overall, the employees who were involved in discriminating should be reintroduced to the facility’s ethics policy and ensure quality is given to each patient.
In health care there have been allegations of racial discrimination against patients as well as staff. For instance in research conducted in Washington, many patients felt they were not receiving the same care as other patients and were treated differently because of their ethnicity. The study was based mostly on African American patients.
Discrimination is an ethical issue that health care administrators have to address, regardless of their own prejudice. Racial discrimination can easily become a legal issue depending on the case. Therefore it is important for staff and administration to understand the ethics behind discrimination. In the study conducted by the state of Washington many patients decided to keep quiet about the discrimination they were facing in fear of not receiving treatment from that physician's office.
Patients should not be discriminated against because of their race. Minority patients should feel that they are really fair and quality services like everyone else. They should not feel afraid to speak up about the discrimination they faced. The administrators in these health care facilities should teach their staff about the importance of equality and treating every patient with dignity and respect. As stated previously an administrator needs to be able to set aside their own prejudices to provide care to the patients.
If they are not able to convey this message properly, they can consult with an outside agency that can educate the staff on ethics and discrimination to improve the care given to these patients. Although ethics is a subject that can become debatable because not everyone considers the same principles as being ethical, one should be able to determine that discrimination is not an ethical practice. Justice is an ethical principle that has been greatly disregarded in this case because they are not treating all patients similarly. There are also moral values that have been compromised in which they are limiting their compassion, conscientiousness, fidelity, and fairness due to the race of the patient.
Overall, the employees who were involved in discriminating should be reintroduced to the facility’s ethics policy and ensure quality is given to each patient.
Tuskegee Syphilis Study
The Tuskegee Syphilis Study is an ethical dilemma that happened decades ago, but it is still an issue that I find very disturbing. Over the span of 40 years, men in Tuskegee who had syphilis were told they would be given treatment by a group medical staff. The medical staff put them through a lot of painful and unnecessary treatments. They were never told that these were placebos and that these treatments would not help their syphilis. Many of the men died as their illness got progressively worse.
This practice was occurring amongst African American men who had syphilis. The researchers wanted to study the effects of this illness if it goes untreated. The patients were not told that there was currently a cure for syphilis. Yet the researchers put them through several harmful acts. One can assume they chose these men because they lived in rural areas and the chances of them finding out there was a cure for syphilis were lessened.
These acts and this study took place for 40 years before it was ended. It is hard to understand how this was allowed to happen for so long. Many of the patients died when their deaths could have been prevented with a simple procedure of receiving penicillin. It is unbelievable and unethical that this happened to these men. Most of the patients were African American and impoverished men in a rural community. As a result of this study, many African Americans have been afraid to participate in studies believing it will become a repeat of the Tuskegee Syphilis Study. Health care morass took place in the African American community in which they lost trust in the health care system.
There were several ethical principles that were not taken into account during this study. These principles include beneficence, nonmaleficence, and justice. The leaders in this study did not display any moral values as well. They did not have any compassion for the patients or conscientiousness. They were not fair or honest either. These are just a few of the ethical issues that occurred during this study and do not include any legal issues. It saddens me to know that health care leaders and researchers did not stop this and many men lost their lives for no reason.
This practice was occurring amongst African American men who had syphilis. The researchers wanted to study the effects of this illness if it goes untreated. The patients were not told that there was currently a cure for syphilis. Yet the researchers put them through several harmful acts. One can assume they chose these men because they lived in rural areas and the chances of them finding out there was a cure for syphilis were lessened.
These acts and this study took place for 40 years before it was ended. It is hard to understand how this was allowed to happen for so long. Many of the patients died when their deaths could have been prevented with a simple procedure of receiving penicillin. It is unbelievable and unethical that this happened to these men. Most of the patients were African American and impoverished men in a rural community. As a result of this study, many African Americans have been afraid to participate in studies believing it will become a repeat of the Tuskegee Syphilis Study. Health care morass took place in the African American community in which they lost trust in the health care system.
There were several ethical principles that were not taken into account during this study. These principles include beneficence, nonmaleficence, and justice. The leaders in this study did not display any moral values as well. They did not have any compassion for the patients or conscientiousness. They were not fair or honest either. These are just a few of the ethical issues that occurred during this study and do not include any legal issues. It saddens me to know that health care leaders and researchers did not stop this and many men lost their lives for no reason.
South Florida Nurse Cause Harm to Hundreds of Patients
Last year there was a nurse in South Florida who was accused of reusing IV bags on multiple patients. There were nearly 2,000 she exposed to several infectious diseases such as TB, HIV, hepatitis and other diseases. The nurse had been a nurse for multiple years, and it is unknown if she had done this in previous years. This case shows many ethical dilemmas because she put the health of the patients at risk. Health care providers are taught to give the best care to patients and in this case she did not.
If she was worried about the lack of supplies, this should have been an issue she could have addressed with her manager. She should not have taken into her own hands to manage the supplies. This jeopardized the health of her patients and her actions made it seem as if the hospital was not producing quality care.
In health care ethics, one of the principles is nonmaleficence which is to avoid causing harm to patients. Nonmaleficence is a standard in the health care industry. In this case, the caregiver caused harm to many patients and exposed them to many deadly infections. She did not “avoid” causing harm to patients. This principle is important is all aspects of the health care industry. The health care system is used by patients to help with the improvement of their health. Patients should not leave a facility feeling as if they have been harm in some kind of way. The patients were not informed of the nurse’s actions until several months later, because that’s when the hospital were informed of it.
Another ethical principle that was questioned is beneficence requires doing good and helping others. In this matter, the nurse did not help others and her behavior is not labeled as doing good. If there was an issue with supplies, this should have been noted and expressed to her superiors. She did not help the patients, coworkers and other hospital staff by not mentioning to them what she was doing.
The health care administrators ensured that the patients were exposed were informed and requested they return for testing of infectious diseases that they could have been exposed to. Administrators could also review the ethics policy with the employees to ensure that they are aware of what is expected of them. This case cost the hospital a lot and reviewing the principles and standards of the hospital could reduce the risk of this happening again.
If she was worried about the lack of supplies, this should have been an issue she could have addressed with her manager. She should not have taken into her own hands to manage the supplies. This jeopardized the health of her patients and her actions made it seem as if the hospital was not producing quality care.
In health care ethics, one of the principles is nonmaleficence which is to avoid causing harm to patients. Nonmaleficence is a standard in the health care industry. In this case, the caregiver caused harm to many patients and exposed them to many deadly infections. She did not “avoid” causing harm to patients. This principle is important is all aspects of the health care industry. The health care system is used by patients to help with the improvement of their health. Patients should not leave a facility feeling as if they have been harm in some kind of way. The patients were not informed of the nurse’s actions until several months later, because that’s when the hospital were informed of it.
Another ethical principle that was questioned is beneficence requires doing good and helping others. In this matter, the nurse did not help others and her behavior is not labeled as doing good. If there was an issue with supplies, this should have been noted and expressed to her superiors. She did not help the patients, coworkers and other hospital staff by not mentioning to them what she was doing.
The health care administrators ensured that the patients were exposed were informed and requested they return for testing of infectious diseases that they could have been exposed to. Administrators could also review the ethics policy with the employees to ensure that they are aware of what is expected of them. This case cost the hospital a lot and reviewing the principles and standards of the hospital could reduce the risk of this happening again.
Wednesday, May 26, 2010
What quality means to me?
Quality is a very important aspect of our health care system. When patients enter a facility they want to know that they are receiving the best care and they will receive care that is in their best interest. Quality is not only expected in health care, but it is an expectation people request in all aspects of life. People want quality homes, care, food, and clothing. For example, people would rather purchase a home that was built with quality material versus paying the same price for the home and the house is poorly made. This example also displays how increasing quality can affect costs. Although people expect quality services in their everyday lives, this expectation only increases when it comes to health care.
Quality health care means that health care professionals are not only meeting the standards, but they are exceeding them. Those organizations that are considered to have quality health care always exceed the expectations of the patients and others. How can a health care facility distinguish themselves from the competition if they are providing standard services?
Health care quality should be analyzed and shown throughout all areas of health care, clinical to administration. Those working in health care have to understand that quality must begin with team work. A patient may experience superb customer service from an employee assisting them in concierge and receive horrible care from one of the nurses caring for them. If the experience with the concierge staff does not correlate with the services received from the nurse, this could lead to the patient believing they did not receive quality care.
For example, a patient could go for a doctor’s visit where the customer service is very minimal. They are welcomed by the registration staff that appears very bland and uninviting. The registration staff successfully checks the patient in, but does not engage the patient, smile or may any direct eye contact. The patient goes to see the nurse and a similar experience occurs. When the patient sees the doctor, the patient feels as if the visit satisfies the IOM’s aims for improvement and quality[1]. The physician focused on the patient providing them with efficient, effective and timely services. Although the physician may have provided quality care, they patient did not receive quality service from other members of the staff. Therefore management must stress the importance of teamwork in order for patients to experience quality care and services when visiting their facility. Even though this is just an example, the scenario could be the total opposite in which the physician does not provide quality care but the nursing and registration staff does. This is an example of why teamwork is important in health care quality.
Quality standards can vary from person to person. This may be one of the reasons quality is a big topic in health care because not everyone can agree on what is considered quality care. In my opinion providing quality care means providing care that heals the patient in a safe manner. Quality care also means giving patients the care they need with compassion. If more health care professionals were more compassionate about the care given to patients it would increase the quality of care given to patients. Patients want to know that they are in good hands. Although the health care provider may be a stranger to the patient, treating each patient like care as you would care for a family member. Also, patients like to know that the provider is listening to them and trying to find a solution to whatever problem they are having. When patients feel mistreated and disrespected by a health care provider, this does not represent quality care. Gaining the patient’s trust and being honest are other key elements in providing quality care. If a provider is demonstrating dishonest and untrustworthy behaviors, this raises suspicion and could jeopardize the patient’s care.
Overall, quality care means providing patients with the best care possible from all aspects of health care.
[1] Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The Healthcare Quality Book (2nd Ed.). Washington, DC: Health Administration Press.
Quality health care means that health care professionals are not only meeting the standards, but they are exceeding them. Those organizations that are considered to have quality health care always exceed the expectations of the patients and others. How can a health care facility distinguish themselves from the competition if they are providing standard services?
Health care quality should be analyzed and shown throughout all areas of health care, clinical to administration. Those working in health care have to understand that quality must begin with team work. A patient may experience superb customer service from an employee assisting them in concierge and receive horrible care from one of the nurses caring for them. If the experience with the concierge staff does not correlate with the services received from the nurse, this could lead to the patient believing they did not receive quality care.
For example, a patient could go for a doctor’s visit where the customer service is very minimal. They are welcomed by the registration staff that appears very bland and uninviting. The registration staff successfully checks the patient in, but does not engage the patient, smile or may any direct eye contact. The patient goes to see the nurse and a similar experience occurs. When the patient sees the doctor, the patient feels as if the visit satisfies the IOM’s aims for improvement and quality[1]. The physician focused on the patient providing them with efficient, effective and timely services. Although the physician may have provided quality care, they patient did not receive quality service from other members of the staff. Therefore management must stress the importance of teamwork in order for patients to experience quality care and services when visiting their facility. Even though this is just an example, the scenario could be the total opposite in which the physician does not provide quality care but the nursing and registration staff does. This is an example of why teamwork is important in health care quality.
Quality standards can vary from person to person. This may be one of the reasons quality is a big topic in health care because not everyone can agree on what is considered quality care. In my opinion providing quality care means providing care that heals the patient in a safe manner. Quality care also means giving patients the care they need with compassion. If more health care professionals were more compassionate about the care given to patients it would increase the quality of care given to patients. Patients want to know that they are in good hands. Although the health care provider may be a stranger to the patient, treating each patient like care as you would care for a family member. Also, patients like to know that the provider is listening to them and trying to find a solution to whatever problem they are having. When patients feel mistreated and disrespected by a health care provider, this does not represent quality care. Gaining the patient’s trust and being honest are other key elements in providing quality care. If a provider is demonstrating dishonest and untrustworthy behaviors, this raises suspicion and could jeopardize the patient’s care.
Overall, quality care means providing patients with the best care possible from all aspects of health care.
[1] Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The Healthcare Quality Book (2nd Ed.). Washington, DC: Health Administration Press.
Monday, December 8, 2008
Managed Care Organizations
Managed care organizations provide health care to millions of people in the United States. Two private MCOs are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). These organizations have been around for decades and the HMO Act of 1973 allowed managed care to become more popular. Over the years more people have become dependent on managed care for health care needs. Although managed care has been helpful in some aspects, these organizations have been the topic of many debates.
MCOs have been stereotyped as having lower quality of care and focusing more on costs than the health care of patients. The accusation of lower quality of care could come from the idea that sometimes caregivers do not spend enough time with patients. This helps a facility see more patients throughout the day or not have enough staff to extend the amount of time with patients. Another accusation is that managed care organizations focus more on costs than helping patients. For example, there have been statements made that physicians who work in managed care organizations receive incentives for not performing certain procedures for patients. MCOs have also been known to deny claims for medically necessary treatments that could eventually lead to the further health complications or death. These are ways for MCOs to manage costs but this could cause concern for ethical issues.
It is important for MCOs to focus on the patient because these patients depend on them for health care. They want to feel that when they visit a facility they will receive good care, especially since they spend money to ensure they receive care. For those who have been treated unfairly by a MCO, these organizations have to remember their ethical practices. Patients have rights and the MCOs have keep their health the main focus. They should not put the patient's health in harm and give them the compassionate care they deserve. MCOs will be around in the future and there will be ethical issues in the future. Hopefully, they will be able to have a new approach to these issues and address them more appropriately.
MCOs have been stereotyped as having lower quality of care and focusing more on costs than the health care of patients. The accusation of lower quality of care could come from the idea that sometimes caregivers do not spend enough time with patients. This helps a facility see more patients throughout the day or not have enough staff to extend the amount of time with patients. Another accusation is that managed care organizations focus more on costs than helping patients. For example, there have been statements made that physicians who work in managed care organizations receive incentives for not performing certain procedures for patients. MCOs have also been known to deny claims for medically necessary treatments that could eventually lead to the further health complications or death. These are ways for MCOs to manage costs but this could cause concern for ethical issues.
It is important for MCOs to focus on the patient because these patients depend on them for health care. They want to feel that when they visit a facility they will receive good care, especially since they spend money to ensure they receive care. For those who have been treated unfairly by a MCO, these organizations have to remember their ethical practices. Patients have rights and the MCOs have keep their health the main focus. They should not put the patient's health in harm and give them the compassionate care they deserve. MCOs will be around in the future and there will be ethical issues in the future. Hopefully, they will be able to have a new approach to these issues and address them more appropriately.
And the Band Played On
HIV/AIDS began to affect our population in the 1980s and has been detrimental to our society. This illness has killed millions around the world and continues to infect individuals everyday. In a class on Community Health I watched a movie named "And the Band Played On". This movie discussed the HIV/AIDS epidemic from the beginning and gave a closer perspective to how HIV/AIDS affect individuals from a researcher, family member, infected person, and society viewpoint. One of the main issues in the movie discussed how many homosexual men were contracting the disease in bath houses. These were spa-like businesses that allowed men to have sexual intercourse.
There was one character in the movie who was a French-Canadian flight attendant. He was suspected of infecting several men with HIV. Since this was the beginning of the epidemic he was in denial that he was infected. Researchers from the CDC (Centers for Disease Control and Prevention) began to investigate him. They asked him how many sex partners did he have and he admitted to sleeping with thousands of men around the world. After conducting more research on him they found that there were at least 40 men in the United States who were infected with HIV as a result of this flight attendant.
Although this was person was not the main subject of the movie, his role was most devastating to me. It difficult to see him because there are characters like him in real life. These individuals are infecting others without any remorse. This behavior is unethical and those who knowingly infect others lack ethical moral, values, and principles. Nonmaleficence is the ethical principle that is especially disregarded because it discusses causing no harm. Infecting others with HIV is causing a lot of harm to the person who is infected. Those who participate in this behavior also violate the values of compassion, respect and honesty.
It is important that more people are educated on the topic of HIV/AIDS so that we can prevent incidents like these. Ethics can play an important role in certain individuals who contract HIV. Hopefully one day our society will be able to get some control over this epidemic. Until then preventing people from contracting the disease and helping those who are infected is imperative.
There was one character in the movie who was a French-Canadian flight attendant. He was suspected of infecting several men with HIV. Since this was the beginning of the epidemic he was in denial that he was infected. Researchers from the CDC (Centers for Disease Control and Prevention) began to investigate him. They asked him how many sex partners did he have and he admitted to sleeping with thousands of men around the world. After conducting more research on him they found that there were at least 40 men in the United States who were infected with HIV as a result of this flight attendant.
Although this was person was not the main subject of the movie, his role was most devastating to me. It difficult to see him because there are characters like him in real life. These individuals are infecting others without any remorse. This behavior is unethical and those who knowingly infect others lack ethical moral, values, and principles. Nonmaleficence is the ethical principle that is especially disregarded because it discusses causing no harm. Infecting others with HIV is causing a lot of harm to the person who is infected. Those who participate in this behavior also violate the values of compassion, respect and honesty.
It is important that more people are educated on the topic of HIV/AIDS so that we can prevent incidents like these. Ethics can play an important role in certain individuals who contract HIV. Hopefully one day our society will be able to get some control over this epidemic. Until then preventing people from contracting the disease and helping those who are infected is imperative.
Sunday, December 7, 2008
Patient Abuse
Patient abuse is an issue that is faced everyday in the United States. There have been extreme cases of patients abuse that has even resulted in death. Patient abuse is something that many people are working hard to improve. Although patient abuse affect patients in every aspect of health care, elder abuse has become a serious issue. Elder abuse can include emotional, financial, verbal, mental, sexual, or physical abuse. Many reports of elder abuse go unreported because some elders fear retaliation and the fear of no one believing them.
Elder abuse is an aspect in health care that seriously needs to be addressed. When the elderly turn to caregivers for care it is not always an easy decision. They have been used to caring for themselves and trusting others may be difficult for them. Caregivers that abuse the elderly could include employees working in the facility where the patient resides and even family members. In many cases the patients who are getting abused cannot defend themselves physically and verbally. This makes the patients more vulnerable to abuse and often prevents the patients from speaking up for themselves. It is a violation of patient rights because patients have the right to receive compassionate care from caregivers.
It is saddening that patients experience this treatment towards the end of their lives. This can also be hard for the family members who discover the abuse. Patients tend to be very trusting of those who provide care for them and abusing the patient could cause distrust. Abusing the patient could also cause more health problems and sometimes result in death which is why it is an important issue to discuss. This could eventually increase health care costs because we will have to treat patients for abuse. This problem in the United States does not seem to be improving. Hopefully more individuals will become more aware of the issues regarding patient abuse and will become more educated to prevent this in the future.
Elder abuse is an aspect in health care that seriously needs to be addressed. When the elderly turn to caregivers for care it is not always an easy decision. They have been used to caring for themselves and trusting others may be difficult for them. Caregivers that abuse the elderly could include employees working in the facility where the patient resides and even family members. In many cases the patients who are getting abused cannot defend themselves physically and verbally. This makes the patients more vulnerable to abuse and often prevents the patients from speaking up for themselves. It is a violation of patient rights because patients have the right to receive compassionate care from caregivers.
It is saddening that patients experience this treatment towards the end of their lives. This can also be hard for the family members who discover the abuse. Patients tend to be very trusting of those who provide care for them and abusing the patient could cause distrust. Abusing the patient could also cause more health problems and sometimes result in death which is why it is an important issue to discuss. This could eventually increase health care costs because we will have to treat patients for abuse. This problem in the United States does not seem to be improving. Hopefully more individuals will become more aware of the issues regarding patient abuse and will become more educated to prevent this in the future.
Euthanasia in the United States
Until this year, Oregon was the only state in the United States to legalize Euthansia. This pass November, Washington was the second state to make this procedure legal as well. This procedure allows patients to have a physician assist in suicide. Dr. Jack Kevorkian was a famous physician known for conducting physician-assisted suicide. He was convicted when he conducted one of his procedures on television. Prior to his conviction in 1999, Oregon legalized physician assisted suicide with its Death with Dignity Act.
Euthanasia has been a controversial topic in health care as well as ethics for years. Some support euthanasia arguing that it is the patient's choice and it could be good economically which could save on costs of keeping a patient alive. Physician assisted suicide has both pros and cons. Patients who are terminally ill may not want to continue to live in painful conditions and opt for physician assisted suicide. Patients have to go through a rigorous process to qualify for the procedure. Although it may be a hard process for patients to go through, patients may see this as the best option for them. Some also argue that if patients are now allowed to participate in physician assisted suicide, they may commit suicide on their own. This could relate to the ethical principle of autonomy which gives patients the right to make their own decisions as well as the right of self-determination.
Other issues concerning euthanasia includes that this act should not be legal and is not considered ethical for a physician to conduct this procedure. Physicians are expected to cause no harm to patients and assisting the the suicide could be considered as harm. Physicians have been stereotyped as the person that helps to keep people alive and not to cause their death. This is one reason people may have an issue with physicians participating in euthanasia. Others may disagree because they do not believe in any form of suicide.
The citizens of the United States do not have to accept euthanasia but the reality is there are two states where it is legal. The choice lies between the physician and the patient. Not to say that citizens do not have a voice but patients have the right to choose this procedure. It is available to truly believe this is something they want and negative interference could cause other issues with the patient and could lead to patients committing suicide alone. There may be other states who choose to legalize it in the future.This could cause more issues in regards to euthanasia or it could cause more people to become more accepting of the procedure.
Euthanasia has been a controversial topic in health care as well as ethics for years. Some support euthanasia arguing that it is the patient's choice and it could be good economically which could save on costs of keeping a patient alive. Physician assisted suicide has both pros and cons. Patients who are terminally ill may not want to continue to live in painful conditions and opt for physician assisted suicide. Patients have to go through a rigorous process to qualify for the procedure. Although it may be a hard process for patients to go through, patients may see this as the best option for them. Some also argue that if patients are now allowed to participate in physician assisted suicide, they may commit suicide on their own. This could relate to the ethical principle of autonomy which gives patients the right to make their own decisions as well as the right of self-determination.
Other issues concerning euthanasia includes that this act should not be legal and is not considered ethical for a physician to conduct this procedure. Physicians are expected to cause no harm to patients and assisting the the suicide could be considered as harm. Physicians have been stereotyped as the person that helps to keep people alive and not to cause their death. This is one reason people may have an issue with physicians participating in euthanasia. Others may disagree because they do not believe in any form of suicide.
The citizens of the United States do not have to accept euthanasia but the reality is there are two states where it is legal. The choice lies between the physician and the patient. Not to say that citizens do not have a voice but patients have the right to choose this procedure. It is available to truly believe this is something they want and negative interference could cause other issues with the patient and could lead to patients committing suicide alone. There may be other states who choose to legalize it in the future.This could cause more issues in regards to euthanasia or it could cause more people to become more accepting of the procedure.
Saturday, December 6, 2008
Doctor Holds Patient in Room
While watching the news one day I saw a story about a physician who refused to let a patient leave until payment was made. The patient said that she called her physician and asked how much a specific service would cost and he explained the costs to her. Once she went to the office he changed the price of the service. The patient informed him that she only had the amount he originally stated and he told her that she could not leave until she made that payment. The physician blocked the door to prevent patient from leaving. One of the assistants in his office assisted in restraining the patient as well.
This behavior was unethical in many situations not only health care. Holding a patient against their will due to nonpayment was not right. There are many individuals in the United States who cannot afford healthcare and they deserve the right to receive services without feeling that they will be harassed for not being able to make payments. In the book discussing Legal and Ethical Issues, it states that a patient has the right to discharge. Patients should not be detained because of the inability to pay for services rendered. This could be considered false imprisonment. This was evident in this particular case. The physician was reprimanded for his behavior which was deserved. Caregivers have the responsibility to exercise good judgment which was not used by the physician or his assistant at this particular clinic. It would have been extremely uncomfortable as a patient to have to experience this behavior by someone I trust.
It is important for physicians to remember the focus of their jobs which is to help the patient. False imprisonment is no form of helping the patient and does not demonstrate any positive ethical principles such as beneficence and nonmalficence. These principles are always important to remember when giving care to patients and in my opinion are two of the most important principles in health care ethics. Although this was an unfortunate event, there are similar cases that have occurred. If more patients are informed of their rights, maybe situations like these would happen less often.
This behavior was unethical in many situations not only health care. Holding a patient against their will due to nonpayment was not right. There are many individuals in the United States who cannot afford healthcare and they deserve the right to receive services without feeling that they will be harassed for not being able to make payments. In the book discussing Legal and Ethical Issues, it states that a patient has the right to discharge. Patients should not be detained because of the inability to pay for services rendered. This could be considered false imprisonment. This was evident in this particular case. The physician was reprimanded for his behavior which was deserved. Caregivers have the responsibility to exercise good judgment which was not used by the physician or his assistant at this particular clinic. It would have been extremely uncomfortable as a patient to have to experience this behavior by someone I trust.
It is important for physicians to remember the focus of their jobs which is to help the patient. False imprisonment is no form of helping the patient and does not demonstrate any positive ethical principles such as beneficence and nonmalficence. These principles are always important to remember when giving care to patients and in my opinion are two of the most important principles in health care ethics. Although this was an unfortunate event, there are similar cases that have occurred. If more patients are informed of their rights, maybe situations like these would happen less often.
Friday, October 24, 2008
Doctors giving Patients Placebos
This morning I read a survey online that over of the 679 physicians surveyed gave their patients placebos. These doctors were treating arthritis patients and 60 percent of the physicians felt that giving patients placebos were ethically permissable. Some of the physicians did not disclose to the patients that they were receiving placebos and sometimes the patients were given these medications 2 to 3 times per month. It is hard to understand how these physicians felt that this type of treatment was ethical.
In the article it states that under the standards of the American Medical Association, it is unethical which states that patients should have full knowledge of treatment they are receiving. It is not fair to give patients treatment that is not helping their condition. They are paying for and taking medication that is doing no good to their health. This could eventually cause financial hardship to a patient. It is similar to buying a car and not knowing that the motor is not included. The car will not work without the motor. These placebos are not working and helping the patient. I would be skeptical receiving care from a physician who thought this aspect of their practice was ethical. This is apparently unethical because it is a violation of patient's rights. Patients have the right to know the type of medications they are receiving especially if the are placebos. This issue is also a violation of the AMA Code of Ethics which states that physicians should be honest in all professional interactions and make relevant information available to patients.
Deontological Ethics involves telling the truth. These physicians cannot consider themselves honest if they are giving patients medications and the patients feel these medications will be used to help their conditions.The patients had arthritis and this is a very painful condition. Which makes the circumstances of this issue worse. Giving the patients the placebos 2 to 3 times per month does not seem to be conscientious behavior as well. Hopefully with this article patients will take a closer look at the behaviors of their caregivers and will encourage other physicians to not take on the practices of their fellow colleagues.
In the article it states that under the standards of the American Medical Association, it is unethical which states that patients should have full knowledge of treatment they are receiving. It is not fair to give patients treatment that is not helping their condition. They are paying for and taking medication that is doing no good to their health. This could eventually cause financial hardship to a patient. It is similar to buying a car and not knowing that the motor is not included. The car will not work without the motor. These placebos are not working and helping the patient. I would be skeptical receiving care from a physician who thought this aspect of their practice was ethical. This is apparently unethical because it is a violation of patient's rights. Patients have the right to know the type of medications they are receiving especially if the are placebos. This issue is also a violation of the AMA Code of Ethics which states that physicians should be honest in all professional interactions and make relevant information available to patients.
Deontological Ethics involves telling the truth. These physicians cannot consider themselves honest if they are giving patients medications and the patients feel these medications will be used to help their conditions.The patients had arthritis and this is a very painful condition. Which makes the circumstances of this issue worse. Giving the patients the placebos 2 to 3 times per month does not seem to be conscientious behavior as well. Hopefully with this article patients will take a closer look at the behaviors of their caregivers and will encourage other physicians to not take on the practices of their fellow colleagues.
Wednesday, October 22, 2008
University of Kentucky
During one of my classes, Health Care Needs of the Elderly, we had a guest speaker who was the CEO of Winter Park Memorial Hospital. He told us the story of a physician in Kentucky who branded "UK" for his alma mater (University of Kentucky) onto a patient. This seemed to be very unethical and inappropriate so I wanted to do more research on the topic. I found an article going into more detail about that the guest speaker told us. A woman went to the physician to have a hysterectomy and allowed the physician to videotape the surgery in 2002. The physician branded "UK" on the uterus of the patient during her surgical procedure. In the article I read, there was a picture of the brand which was very disturbing (picture is listed above). It is not understandable why a physician would act in this manner. He was aware that the procedure was being videotaped but continued to brand the patient. It is not understood if he felt that this would be amusing to the patient or if the patient would disregard this immature behavior.
When patients put their lives into the hands of a caregiver they expect to receive the best of their care and the physician who degraded his patient in this manner should have been heavily reprimanded. This was a violation of patient rights. Normative ethics relates to this story because this type of ethics is designed to determine what moral standards should be followed so that human behavior and conduct may be morally right. The physician also did not demonstrate what most would consider good moral judgment in this case. Branding a patient does not appear to be good moral judgment on the physician's behalf. This leads to a violation of Code of Medical Ethics. This code states that " A physician shall be dedicated to providing competent medical care with compassion and respect for human dignity and rights." The patient's human dignity was not treated with respect and there is no way to justify the behavior of this physician. Another Code of Medical Ethics that was violated was maintaining standards of professionalism and respecting the rights of the patient.
It is saddening that events such as this one occur in health care. Having a procedure that the patient had, was a very serious procedure and having the physician violate her rights was very depressing. If I am placing my care into the hands of a caregiver I was superior service and with a hysterectomy, this could also be a very difficult procedure for some women. Hopefully the patient feel as if justice has been served and the physician has learned his lesson in ethics.
Wednesday, October 8, 2008
John Q
I had to watch John Q for another class and saw that the movie embraced a huge ethical dilemma. For those who are not familiar with the movie. It is the story of a working class family (The Archibalds) whose life is about to change with an unexpected health tragedy. The son of the Archibalds is about 9 years old and while playing baseball one day he collapsed. He was taken to the hospital and the family was told that he needed a heart transplant but his insurance was not going to cover it. The heart transplant would cost $250,000 but in order to place the son on the list to receive a heart the family would have to pay $30,000 cash. The son did not have long to live and after coming up short on the deposit, the hospital decided to release the son.
Situations like this occur everyday in the United States. Families are not able to pay for health care and they are placed in situations such as this. Ethics is questioned when asking a family to make a cash payment to save the life of a child. This was a working class family who did not have the $30,000 to pay for the heart transplant deposit. They sold almost everything they had and still was not able to come up with the money. To add to the turmoil the hospital tried to release the child knowing he was not in good condition and would not live much longer without the transplant. The hospital should have had more alternatives for the family besides telling them to make a cash payment. I feel it is the responsibility of the hospital to help everyone especially those who need life saving treatment. One of the principles of ethics is beneficience which stands for the act of doing good. In this case, the hospital was not acting on this principle of ethics. In my opinion, asking a family to pay $30,000 and trying to release a dying child is not beneficience.
The principle of human dignity was also questioned in this dilemma. Human life is very significant and sending someone home to die does not constitute the right of human life. The hospital took away the child's right to live by refusing to place him on the list to receive a heart and trying to release him to go home. If the child only had a short time to live with the help of the hospital, imagine what would have happened if he would have went home without any medical treatment or support. The hospital did not consider this because receiving money seemed to be most important.
In the movie, the Archibalds had an HMO and one of the employees said that HMO receive incentives for not offering treatments to patients which raises another ethical dilemma. The father said that the child receives a check up every year and no doctor every said that he was healthy and had no conditions. The dilemma here is clear, if the doctors would have ran tests prior to the incident, they could have seen that the child did not have a healthy heart and could have possibly treated him. There have been many speculations that HMOs do not offer treatments and in return receive incentives at the end of the year. This is unethical because the job of the physician is to maintain the health of the patient. If the physician does not give all of the treatments they are reducing the quality of care as well as the health of the patient.
These were two ethical dilemmas in the movie John Q that I felt should be pointed out. It is important for health facilities to realize their responsibilites and react ethically and lawfully. It is unfortunate that these events do occur often. Which is why ethics and law play significant roles in regards to the care of patients and health care organizations.
Situations like this occur everyday in the United States. Families are not able to pay for health care and they are placed in situations such as this. Ethics is questioned when asking a family to make a cash payment to save the life of a child. This was a working class family who did not have the $30,000 to pay for the heart transplant deposit. They sold almost everything they had and still was not able to come up with the money. To add to the turmoil the hospital tried to release the child knowing he was not in good condition and would not live much longer without the transplant. The hospital should have had more alternatives for the family besides telling them to make a cash payment. I feel it is the responsibility of the hospital to help everyone especially those who need life saving treatment. One of the principles of ethics is beneficience which stands for the act of doing good. In this case, the hospital was not acting on this principle of ethics. In my opinion, asking a family to pay $30,000 and trying to release a dying child is not beneficience.
The principle of human dignity was also questioned in this dilemma. Human life is very significant and sending someone home to die does not constitute the right of human life. The hospital took away the child's right to live by refusing to place him on the list to receive a heart and trying to release him to go home. If the child only had a short time to live with the help of the hospital, imagine what would have happened if he would have went home without any medical treatment or support. The hospital did not consider this because receiving money seemed to be most important.
In the movie, the Archibalds had an HMO and one of the employees said that HMO receive incentives for not offering treatments to patients which raises another ethical dilemma. The father said that the child receives a check up every year and no doctor every said that he was healthy and had no conditions. The dilemma here is clear, if the doctors would have ran tests prior to the incident, they could have seen that the child did not have a healthy heart and could have possibly treated him. There have been many speculations that HMOs do not offer treatments and in return receive incentives at the end of the year. This is unethical because the job of the physician is to maintain the health of the patient. If the physician does not give all of the treatments they are reducing the quality of care as well as the health of the patient.
These were two ethical dilemmas in the movie John Q that I felt should be pointed out. It is important for health facilities to realize their responsibilites and react ethically and lawfully. It is unfortunate that these events do occur often. Which is why ethics and law play significant roles in regards to the care of patients and health care organizations.
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