1.) There is indeed an imbalance between the public’s capacity to pay for the runaway costs of health care and physicians’ and health institutions’ desire to maintain their profession and business. The public and the physicians have duties and obligations to each other. It is the duty of physicians to provide competent and reliable health care services to the public, while the latter has the obligation to pay for the services rendered.
In most capitalist societies, it is not possible to rein in the costs of health care and give the public the healthcare freedoms it seems to prefer, since there is also a need to look at the interests of physicians and other healthcare providers. To do this will certainly jeopardize healthcare institutions and reduce the job of physicians to social services provider without any right to receive just compensation. One of the possible remedies to solve this problem is for the government to monitor any abuse or neglect on the part of physicians and healthcare institutions that deliberately increase the price of their healthcare services beyond what is generally accepted.
2.) There are a lot of factors that bring tension to hospitals’ four important influence— governance, medical staff, board of trustees and administration. On the aspect of governance, tension exists if a particular health institution does not a clear and functional organizational structure. A logical and well-designed organizational structure is important to prevent redundancy of works and positions, more expenditures, undefined and unimportant functions and offices, vague organizational culture, miscommunication, among others.
Medical staff should be well trained and be clearly and efficiently acquainted with their jobs and functions in order to prevent any disaster or problem. The existence of poorly trained and incompetent staff is dangerous to the health and lives of hospital patients, as well as to the reputation of the institution. The board of trustees, on the other hand, must have well defined governance, culture and ethical standards to be observed by all hospital staff. Tensions sprout of board of trustees are remiss in their duties. Meanwhile, poor work ethics may jeopardize the administration of a healthcare institution. Hospital administrators need to be very competent and be very aware of the nature of their jobs.
3.) There are negative implications of the practice of substituting non-nurses for professional nurses to perform all but technical tasks. First, it affects professional nurses as a whole. It may be seen by hospitals to cut cost and hire non-nurses to perform functions usually performed by professional nurses. Secondly, it will encourage the proliferation of non-nurses in the field to perform non-technical healthcare jobs. Third, this practice will put the health and life of public patients in grave danger, since a number of nursing jobs are being performed by non-nurses.
4.) The shift in utilization from inpatient hospitalization to ambulatory care services has been advertised as a safe and efficient means of cost control. It was found out that procedures carried out in ambulatory surgical units normally involve fewer professional resources and healthcare facilities than that done on an inpatient basis (Roos & Freeman, 1989). Despite this shift in utilization, health experts said that quality of services if not compromised with the use of ambulatory care services. The impact of this method on hospitals is less expenditures in hospital resources. Consumers also have to pay cheaper hospital bills. On the other hand, there is tremendous impact of this system on the health care delivery system as a whole since the use of ambulatory care services is safer than the use of inpatient hospitalization.
5.) The reason why more than half of surgical procedures are now performed in ambulatory surgery facilities is because it is proven to be safer and advantageous to both the healthcare institution and patients. The quality of ambulatory surgery remains safe and good and that it prevents patients from exposure to potential iatrogenic risks of hospitalization.
6.) Medical reality proves that private healthcare institutions are better and more competent than public healthcare institutions. In most developed countries like United States, Great Britain, France, Canada and Germany, the best healthcare institutions are those privately run hospitals. The reason for this is that private hospitals have the financial capacity to acquire state-of-the-art medical and healthcare technology and to recruit the best and the most experienced physicians, nurses and healthcare providers in the field. Private hospitals are better managed than their public counterparts because of competition. In order to survive competition with other private hospitals, they have to adopt the best governance and administration and recruit competent healthcare staff.
7.) It is important for healthcare professionals to integrate their work and training together when they practice. There are advantages, as well as disadvantages of this approach to professional education. In terms of costs, other professionals fail to integrate training and work because of poor educational training. This situation brings more cost to both the professional and the healthcare institution. In terms of educational efficiency, schools need to adopt industry-based programs in order to update their curricula and help their students to adjust when they graduate. In terms of patient care quality, schools with industry-based approach tend to produce competent and professionally trained graduates.
8.) It should be an individual choice of every professional healthcare provider whether or not to repay taxpayers for his/her publicly subsidized education. This situation involves a question of ethics, and cannot be indiscriminately applied to all members of the healthcare profession. In the first place, taxpayers’ money is not supposed to subsidize the education of future professionals, unless a particular profession is extremely needed for the benefit of the nation. However, one of the best means to repay taxpayers’ money is for healthcare professionals to provide competent and reliable healthcare services to the public.
9.) Cross-training of personnel has both negative and positive implications. In terms of quality care, those competently cross-trained are expected to deliver quality and reliable services, while those poorly trained may put the life and health of their patients in grave danger. In terms of cost, cost-training is advantageous to healthcare institutions; however, there is no assurance whether it may also impact patients’ hospital bills. In terms of efficiency, cross-training may produce professional who can perform multiple tasks. But efficiency should be measure by the quality of a particular task without compromising the integrity of the healthcare profession as a whole.
Roos, N.P. & Freeman, J.L. (1989). “Potential for inpatient-outpatient substitution with
diagnosis-related groups.” Healthcare Financing Review. Retrieved February 21, 2009, from http://findarticles.com/p/articles/mi_m0795/is_n4_v10/ai_8134863