Health Care Professionals and Administrative Roles towards Preventative Care Goals - Research Paper Example

?Running Head: HEALTH CARE PROFESSINALS Health Care Professionals and Administrative Roles towards Preventative Care Goals Health Care Professionals and Administrative Roles towards Preventative Care Goals Introduction Since the year 2000 the medical field has experienced rapid changes in relationship to the demanding expectations for professional medical personnel to take on deeper and more integral roles in administration (Williams & Torrens, 2008). Dual roles have meant that health care professionals have had to assume the duties of administration while continuing to treat patients. This means expertise in both administrative roles and the role of health care provider must be gained to be an effective part of the medical field. The argument that has come to light in relationship to this dual role assumption has been whether or not effective treatment can be given by those who are assuming administrative rolls and whether or not administrative roles are being properly attended when the needs of patients are also the responsibility of the care giver (Williams & Torrens, 2008). In addition, medical professionals are also becoming a part of healthcare policy decisions which brings into question if there is a conflict of interest between the needs of the medical profession with the needs of the public where policy is concerned (Williams & Torrens, 2008). At the same time, politicians and those who are strictly administrators do not have adequate knowledge that would be equitable in creating decisions concerning medical policy as those who have been trained in the medical profession. The following paper will investigate the nature of the administrative role and how it is affected through dual role commitments by medical professionals who take on those duties. In examining the dual roles of medical and administrator in the medical field, the nature of focus and the interests of the patients are being compromised when policy and decision making capacities are the role of the same physicians who should be attending to the medical needs of those in their care. Topic Description Medical professionals are assuming administrative roles because they possess adequate knowledge in regard to specialization and experience that reflects on section over which they are exercising administrative duties. This gives them the freedom within a clinical setting to create and implement policies that have come from their knowledge and experience within their field. They tend to have a quicker response because they understand the problem more quickly than a non-medical administrator. Policy and the social construction of the medical profession frame the experience of being ill in society. Medicine has developed into more of a profession than a service industry, the nature of illness created through the structures that are designed by administrators. Having medical professionals in these roles provides contextual knowledge that frames the overall experience of being ill (Freidson, Lorber, & Freidson, 2008). When administrators are non-medically trained individuals with the power to create policy and make changes, often the changes are irrelevant and are not in alignment with the essential needs that should be addressed (Holmes, 2010). The most affected field is that of service delivery which adversely affects the level of patient care (Williams & Torrens, 2008). Health care professionals have the capacity to understand how different decisions will affect patient care. Without the input or direct administration by health care professionals, the decision making process is burdened with misunderstandings that affect both the medical professionals and the patients. A medical professional will understand the connections between suppliers, patient needs, and how to marry the two in order to have sufficient means with which to create service (Williams & Torrens, 2008). Medical professionals have a much higher capacity to serve in the administrative capacity because they have exclusive knowledge about the medical profession and the needs of patients. The following paper will examine the role of the hospital CEO. The hospital CEO oversees a variety of different operations with the core purpose of ensuring a smooth running healthcare facility (Burns, 2006). This will include supporting a variety of programs to meet specific goals as well as undertaking roles that are exclusively administrative. The work of the hospital CEO is to utilize expertise and specialized knowledge in order to run the institution with innovative and constructive policies which serve both patients and shareholders. Problem Statement The issue of medical professionals involving themselves in administrative functions is supported by the well-informed outcomes of knowledgeable decisions, but restricts the direct patient care that a medical professional can give and takes talented doctors out of the medical practice. As the future of medicine becomes focused on preventative care and early intervention, the nature of the position of hospital CEO will increase to include policy development that will need medical professionals in order to create efficient systems that are still competitive. Background of the Problem In trying to provide administrative assistance in a system, a health care professional is then restricted to the amount of time he or she can spend with patients, if they continue to see patients. Mufti (2000) discusses the issue of medical professionals as they move into the administrative side of medical practice. When a medical professional takes on the administrative duties, they will decrease or eliminate their involvement in medical practice. This can result in talented doctors no longer servicing in medical practice. If they are involved in both sides of medical practice, their attention is limited in both areas. One of the ways that medical professionals are changing in their capacities is through creating hybrid expertise. Kuranmaki (2004) writes that in Finland the trend in the 1990s was to have medical professionals that were both educated in medical practice and in management accounting techniques in order to serve the New Public Management reforms that had been passed in the country. In contrast, the UK medical professionals resist the idea of crossing business with their medical practice, their focus remaining on the idea of the purity of the calling into the field of healing. This contrast is symbolic of the issues that should be discussed as more and more administrators are being recruited from the medical profession rather than from the business field. The development of administrative capacities by medical professionals shows a trend towards a combination of disciplines between medical expertise and business frameworks of control that requires expertise in administrative structures and policy building. The medical field is a field of business. While the act of care is considered a service, the setting and environment of medicine is competitive and profit based. Jones and McCullough (2011) discuss the nature of the business of medicine. The discussion of medicine is divorced from the nature of care, placing the business in perspective with profit and supporting the concept that without profit the business of medicine would fail and then not have the capacity to serve any patients. Despite how cold it may seem to discuss profit in relationship to patient care, the bottom line is important in creating continuous support for those who are ill and in need. The problem with divorcing care from compassion and empathy is that it becomes difficult to temper policy making with the needs of patients and the ways in which to best provide them with service. Therefore the market and environment of business as a competitive business are relevant to the decision making process. Everything from the type of care available to the type of equipment used is based upon both care needs and the attractiveness to consumers of medical care. Decisions are made with the market and the needs of patients under consideration. The supply side of medical care is divided between generalists and specialists, the needs of specialists supported by the referral alliances that are formed with generalists. This economic relationship is a part of the reason that administrative medical professionals support the system through their understanding of these types of economic connections (Nam, Gruca, & Tracy, 2009). Over the course of the next five years some of the dynamics of the medical professional to business or administrative roles will be changed in relationship to the new frameworks of medical care as it becomes available to more Americans with different sets of insurance structures that are becoming available under the Patient Protection and Affordable Care Act. Manchikanti (2011) writes that the focus of medical care as changes in policies will increase the number of people who have accessibility to health care will be focused on prevention. This is a crucial state in which the medical professional will be needed for policy changes so that health care is optimized through cultural changes that focus on prevention through both patient awareness and lifestyle changes and medical interventions earlier in the progress of illness. This kind of proactive and interactive relationships with medical professionals, administrators, and patients will change the course of medical culture within the next five years. `Leadership Role A healthcare professional has the responsibility to continue their understanding of patient care after taking on the role of an administrator. Hojat (2009) writes that “empathy is defined as a predominately cognitive attribute that involves an understanding of experiences, concerns and perspectives of another person” (p. 412). As a medical professional, it is essential that empathy be a part of the care that is given to a patient. In becoming a leader in a clinical setting, the burdens of leadership include making choices that might compromise care in favor of saving costs if the essence of empathy is not maintained. This will also affect the overall sense of care if a non-medical administrator is given charge of the decision making process. Hojat (2009) comes to the conclusions that through empathy, medical professional in and outside of administrative roles have a better chance of higher levels of delivery service. When creating administrative functions, understanding the needs of patients is a large step towards creating effective leadership within the clinical setting. The problem with leadership from medical professionals in administrative roles as they are taken out of the pool of talented physicians is one that might not need a solution. Although the loss of medical professionals to the administrative side of medical practice does constitute a loss, the need for quality policy decisions provides for the hope that in losing medical professionals to administration, the overall profession will thrive. In creating solutions for the future collaboration between hospital CEOs in creating creative solutions for the increases in patient care should include programs that are cross departmental and cross facility in order to work together towards meaningful prevention. Quality Indicators for Performance Improvement Preventative care is not without its controversies. There is a concern that opportunistic preventative care crosses the line for quality care. Lai and Pon (2012) discuss the idea of opportunistic preventative care as a way of both making money and being too invasive so that it represents a possible corruption in the system. Opportunistic preventative care can be seen in the example of removal of breast tissue to prevent breast cancer before there is an indication of any cancerous tissue. While the point is not to debate whether or not doing this kind of preventative care is applied correctly, but to hope that corruption would not be used to find ways to have a monetary interest in preventative treatments. One of the ways to create quality preventative care systems is through quality indicators for performance improvement. Rantz and Popejoy (2004) write that “Quality indicators are markers that may indicate the presence or absence of potentially poor care practices” (p. ix). QIs were created by the Center for Health Systems Research and Analysis for the University of Wisconsin. The purpose of QIs is to assess the overall performance of a medical facility towards improvement where necessary can be achieved (Rantz and Popejoy, 2004). The AHRQ Healthcare Cost and Utilization Project provides software that can examine the costs involved in a project in comparison to other factors, including quality of care, in order to see if it is meeting goals based on a variety of data that will either support or conflict with the nature of the care that is being provided. It will assess the financial benefits in relationship to care so that an administrator can competently assess the full breadth of how a project is meeting goals. In creating quality prevention programs, a CEO will want to have a comparative study on quality in both the profitability of the project and the quality of care that is being generated (McLaughlin & Kaluzny, 2006). Scorecards would be a wonderful way in which to judge quality of care from the patient perspective. Scorecards allow for a patient to assess their experience so that data can be generated for the QI assessments. Through scorecard theory, a set of data can be allowed to influence the decision making process through a more quantifiable process (Rantz and Popejoy, 2004). Strategies for Improvement Action Plan One of the ways that preventative methods can be encouraged is through rewarding physicians with financial incentives. This strategy makes the effort personal with personal financial rewards for service in creating good preventative efforts. This method has not been proven to have a high level of impact, however, and the use of reporting instruments have been proven to be as efficient. In a study of clinics where financial rewards were used to create incentives for preventative methods of treatment, it was discovered that there was no clinical differences in the approaches taken by physicians with incentives as without them (Gavagan, 2010). The use of money as a way to create clinical control does not seem to be an effective method or strategy for an administrator in a hospital. Another strategy for the CEO who is a medical professional is to continue to have a hands on policy in which he or she integrally participates in patient care to keep in touch with his or her abilities in a medical capacity. This will provide an incentive to continue meaningful interactions that encourage continued empathy. Through quantifiable data the CEO can make cold decisions on policy, but through continuing empathy the CEO is creating policy through the effect of relationships on his decision making process. While making fiscal decisions should be against data, the issue of health care is not defined by statistics, but through the needs of the patients. Conclusion The CEO of a hospital is a position that should be filled by a medical professional who can use their expertise to influence decisions of policy and patient care. While the distance that is created by fulfilling an administrative position may sever empathy, an effort to continue connecting to patients can help to create good decision making experiences. In addition, finding incentives for physicians to be proactive with preventative care without taking advantage of opportunities simply for the benefit of creating cash flow must be found in order to support effective preventative care. The future of medicine is preventative care and CEOs of hospitals should work together to gain the most benefit of programs in order to create quality care. Resources Burns, J. B. (2006). Career opportunities in the nonprofit sector. New York: Ferguson. Freidson, E., Lorber, J., & Freidson, E. (2008). Medical professionals and the organization of knowledge. New Brunswick: AldineTransaction. Gavagan, T. F. et al (2010). Effect of financial incentives on improvement in medical quality indicators for primary care. Journal of American Board of Family Medicine. 23(5), 622- 631. Holmes, E. (2010). Character, leadership, and the healthcare professions. Journal of Research Administration, 41(2), 47-54, 6-7. Hojat, M. (2009). Ten approaches for enhancing empathy in health and human service cultures. Journal of Health and Human Services Cultures. 31(4) 412-450. Jones, J. W. & McCullough, L. B. (March 2011). Business dealings with a patient: Money never sleeps. Journal of Vascular Surgery. 53(3), 856-857. Kuranmaki, L. (April-May2004). A hybrid profession – the acquisition of management accounting expertise by medical professionals. Accounting, Organizations, and Society. 29(3-4), 327-427. Lai, M. & Pon, J. (2012). The evolving practice of preventative medicine. UBC Medical Journal. 3(2). Manchikanti, L. et al (2011). The impact of comparative effectiveness research on interventional pain management: Evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient Centered Outcomes Research Institute. Pain Physician. 14, 249-282. McLaughlin, C. P., & Kaluzny, A. D. (2006). Continuous quality improvement in health care. Sudbury, Mass: Jones and Bartlett. Mufti, M. H. (2000). Healthcare development strategies in the Kingdom of Saudi Arabia. New York: Kluwer Academic/Plenum. Nam, I, Gruca, T. S., & Tracy, R. (July 2009). The effects of competition on referral alliances of professional service firms. Organization Science. 21 (1), 216-231. Rantz, M. J., & Popejoy, L. L. (1998). Using MDS quality indicators to improve outcomes. Gaithersburg, Md: Aspen Publishers. Williams, S. J., & Torrens, P. R. (2008). Introduction to health services. New York: Thomson Delmar Learning. Read More