Thursday, October 14, 2010

Case 10: Economic Incentives in Health Care CLOSED

Recall our discussion about doctor-patient relationships and appropriate roles for health care professionals.

18 comments:

  1. I do believe that Dr. G is acting in an unethical way by referring her patients to a RASA hosptial, but only because I believe she is doing so due to her financial cut from the hospital. I think if Dr. G did not have a financial part in the hospital and was referring patients to RASA due to their excellent services this would be morally acceptable because the doctor would be referring the patients to the hosptial based on general knowledge and expereince rather than outside obligations. As I have said before, any time there is money involved an individual's decision will be swayed toward the influencing factor. I believe of course that surgeons and hospital staff deserve to be paid, however I do not believe that profits should be shared for using an operating room. This is essentially the same as being paid for a doctor to use a doctors office, it is not a legimit reason to receive profit. The doctor is not performing a better job simply because they are in a doctors office rather than in any other room in the hospital. It is only a matter of location, it does not mean anything. Doctors and hospital staff should be paid based on their practice they do, not the location they are in. I believe the RASA policy only works to the detriment of the patient if the hosptial is a poor one, but if the hospital is providing adequate care to their patients I do not believe the hosptial is a detriment.

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  2. I think that medicine has become a business, and as such money is a huge player. It is not morally unethical for Dr. G to refer her patients to a RASA hospital if it is not costing the patient more. Why shouldn't the doctor get the most for her services. If the patient care and outcomes are the same and/or better I see no problem with Dr. G and the hospital benefiting. The profits that the hospital makes might lead to the recruitment of highly specialized and talented doctors or new high tech machinery that can greatly improve healthcare. On the other hand if it is costing the patient more it is unethical. Why charge hardworking people extra for something that they are reaping no extra benefits for.

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  3. I 100% agree with Christy. Since the issue of money is constant on people's minds now, I believe it has the potential to really effect a person's moral thinking. If the doctor would have referred all patients to this hospital prior to it ever being a place where she could get financial benefits, then I say it is not a decision that could be unmorally. Money has no business in the health care fields. It has the potential to have drastic consequences on a person's decisions, especially those within the health care field. I do not think it is ethical for doctors to ever receive any benefit for using a certain facility or drug because it takes focus away from their main goal: to provide the best care for their patients. It may or may not affect their decision making, but the temptation of money to persuade someone's decision would always be on my mind if I was a patient of this doctor.

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  4. I agree with both Lindsay and Christy in that provided the RASA hospital is providing the same level of care for a patient as any other, and are the same price, then there is no issue with a doctor referring a patient to these institutions. Once it becomes a negative for the patient though, then the doctor is unethical for referring the patient to a hospital merely because the doctor will see benefit. It seems to me that the profit sharing policy is morally acceptable, provided it does not get in the way of providing the best possible care for the patient. As long as the hospital is the best place for the patient, then this policy does not work to the detriment of the patient.

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  5. I think it is not morally wrong for Dr. G to refer her patients to the RASA hospital since they offer great services as the other hospitals around the area. To some it may seem as a gimmick or that Dr. G will be profiting from it somehow. If the RASA hospital cares and treats the patients really well and carefully without looking at it as a business, then i think the RASA's profit-sharing policy is morally acceptable. I don't think the RASA's policy work to the detriment of the patient so long as they put the benefit and care of the patient first!!

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  6. I agree with most people in this blog saying that the medical field has become all about money. By Dr. G referring patients to a RASA hospital she is knowing she is going to be paid more. There may be better hospitals for that same patient but not a RASA hospital. I think the RASA should not have the profit-sharing policy. I feel it just creates more problems than there already are in the health care field. I do believe that sometimes the RASA policy could work against the patient. The doctors could be looking in their own best intrest, rather than the patients.

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  7. I believe Dr. G is acting in a morally acceptable way by referring her patients to the RASA hospital because the hospital is equally equipped as the other hospitals. RASA's profit-sharing policy is also morally acceptable. I also believe RASA's policy does not work to the detriment of the patient as long as they put the patient before the money.

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  8. Along with others, I beleive that it is not morally unethical for her to refer her patients to this type of hospital because if it is not going to cost the patient any more than another then why is it a problem. Some patients look for the cheapest route and even though the DR. is getting something more out of it then who cares. Money is used for what a patient is getting. If the Dr. is going to put the patient before the money then i don't see a problem with going to these types of hospitals.

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  9. I personally agree with that as long as the patient care outcomes are the same as they would be at any other hospital in the area then Dr. G is not acting morally unethical. The only problem I would see with this scenario is if the patient care differed as a result of the referral to RASA in some way because our first interests are always best possible patient care outcomes. I agree with many of the previous bloggers who say that the practice of medicine is mainly about money in today’s society as most as the hospitals are for-profit and have to stay competitive, like with profit-sharing, in order to have the best doctors. I do not believe the policy in place by RASA is to the patient’s detriment as long as patient outcomes are equivalent to the care the patient would receive at other hospitals the surgeon could operate.

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  10. If the treatment at the RASA hospital would be better for the patient then yes. That would take away the money only aspect that the doctor may be after. In this case it sounds as though the doctor is just referring patients there so she can get more money for treating them. I don't think that RASA should share profit they earn with doctors. This just spells out bad for doctors to treat patients for other reasons other than health. I do believe that it is detrimental to the patients. They will get treated, but they may only receive the treatment that is most costly to them so that the most profit can be made by the doctors.

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  11. I may be crude in saying this but I think the surgeon should send his patient's to the RASA hospitals. If the patient is paying the same amount at either hospital the surgeron should send them to the RASA hospital. The patient is getting the same care, same procedure, and at the same price why wouldn't the surgeon want to bennifit twice from it.It's almost like a tip to a waitress at a resturaunt. I mean we son't know what the doctor is doing with the extra money, he could be donating it. Now if the RASA's surgery costs more for the patient because of the profit sharing then yes it is morally unacceptable because the patient is paying more money, that they didn't agree on, to the surgeon.

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  12. I believe there are a few missing factors to this situation. How does Dr. G's referral to RASA affect the patient? Do they get better or less care? Do they pay more or less for those services? Are the outcomes of surgery at that affiliation the same as they are for other non-profit organizations? If the patient does not pay more, they get the same or better care, with equal or better outcomes then I do not see the problem with Dr. G's referral, because no one is at loss because of that situation. However, if the patient has to pay more, they do not get great care, or the outcomes of surgery are not as adequate as other hospitals, I believe it would be unethical for Dr. G to refer her patients here. In this situation, Dr. G would be putting her financial situation above the best interest of her patients.

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  13. I have the same opinions as most of the people do on here saying that if the doctor is referring the patients to the RASA just for the benefit of making money, I believe its morally wrong. Then again, you would have to take in the question if the patients are getting the equal treatment as they would any other place, and if so, is paying more better in the end for a treatment. The problem that I see is if the doctor is making more of a profit from the RASA, then they shouldn’t be in partnership because the doctor would be making the money in the situation. I feel that the patients health should be the first thing doctors want to help other than dipping into our pockets and seeing how much we are willing to give for certain treatment, especially if there are alternatives.

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  14. Brittany Buechel: I believe that Dr. G is acting in a morally acceptable way. If the hospital can offer great patient services and the doctor can benefit from the services, I believe it is a win-win situation. I think money can be an incentive for some doctors. The better they do, their patients will refer them to their friends, the more money they will make. I know if I was working in a for-profit hospital, I would want to be the best that I could be to build a patient quota. I believe that RASA's profit-sharig is acceptable as well. Doctors should be paid for their work of operating on patients and receiving a share of the hospitals profit is the benefits for working at a for-profit organization. I do not believe that RASA's policy work to the detriment of the patient. If the patient is receiving great care from the doctors and other health care staff, and the patient's wants and needs come first, than there is no harm to the patient of going to a for-profit hospital.

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  15. I believe that Dr. G is acting morally acceptible if the hospital is offering great services although I also believe that if Dr. G only has his own incentives in mind then I think it is not morally acceptible. Again I think that RASA's policy is morally acceptible and not detrimental to patients if they are offering great services.

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  16. I do not think it is wrong for Dr. G to be referring her patients to the RASA hospital because no matter what the patient is going to get the same kind of care from either hospital. Dr. G is just doing what she thinks is right because she is benefiting from the patient's surgery if they did have it at the RASA hospital. What's the difference between someone picking a job that offers them better benefits and pays more. As long as the patient is getting good care, then nothing else really matters.

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  17. I think it is ethical for Dr. G to refer the patients to the RASA hospital. They are getting equal care at both places. However, if Dr. G is doing so for personal benefits I think it is wrong. A doctor should not have personal intentions behind any of his or her actions. As Jaime said, I think as long as a patient gets taken care of, nothing else should matter.

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  18. I believe it is morally unacceptable. It is like what we talked about in class last week. If doctors got the same pay as everyone else, we would weed out the bad ones and have only people who truly care about the patients. By referring patients to this hospital, she is gaining a bigger cut which seems to be her only motive. This hospital is not any better than the others.

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