Class,
Respond collectively and thoughtfully to the questions at the end of Case 9, p. 700. Comment on the case in light of recent changes in the U.S. law regarding health care (to the best of your ability).
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1. I feel that it is unethical for the doctor to consider their own financial interests when it conflicts with the patient's best interest.
ReplyDelete2. I also feel that it is also unethical to have such strong financial incentives for physcians to withhold medical servies because patients are more likely to not receive the care they need because withhold expensive tests means that the physician will recevie more money.
3. Dr. W should refer to the patient to the cardiologist because if something were to happen to the patient then Dr. W could be charged with neglect for not refering the patient to the care that he needs.
1) I think that it would be extremely unethical for a doctor to put their financial interests in front of the patients best interest. If a patient is in need of care, then the physician should treat them regardless of their financial loss.
ReplyDelete2) Yes, it's unethical for managed care organizations to connect financial benefits with medical treatment. By doing this, they may be affecting the doctor's ability to make an ethical decision.
3) Dr. W should give him the test incase something is wrong. It would be unethical for her to risk his life in order to make a few extra bucks.
First, let me say that this is completely irrational to run a hospital/care facility this way. Medicine would be run completely on greed! I hope that there are few of these hospitals in our country.
ReplyDelete1.) I believe it is completely unethical for doctors to consider their own financial interests in conflict with patient's best interest. I hope that my doctor doesn't run her office like this just as I would any other profession. I don't want my McDonald's burger flipper to give me Grade C meat just to save himself a couple bucks. Medicine is medicine and this completely violates the medical oath of patient care first.
2.) I do believe it is unethical. The whole premise behind this facility is immoral! How can you hire doctors that are not money driven? And knowing the incentive for the doctors as a patient, why would patients attend this facility, knowing that their visit is only adding to the doctor's greed. However, I do believe that finding the right doctor to fill the position could make all of the difference. Perhaps there is a doctor that would thrive in a situation like this; none come to my mind, not even myself. I think this is an unethical business plan that leads to immoral decisions by doctors.
3.) I think Dr. W should definitely give the test. Yes, the test will cost her more money, but what if she is wrong in her assessment that the problem is being blown out of proportion? This is completely relevant to my job (which I am at right now!). In the ER, a doctor missed a STEMI on a EKG because the test was not assessed quickly enough. Now they have put a new rule into effect - all EKGs are to be handed directly to the doctor. If the doctor is busy, we are to wait or hand the EKG to the NP or RN on staff. Anything in the body can change for the worse at any given moment. Especially with the heart, these conditions are not something to be overlooked. How would Dr. W feel if her patient did have a serious condition and died? She would, and should, feel completely to blame for the lack of treatment to put more money in her pocket.
1. I think it is always unethical for a doctor to consider their own financial interests when the conflict with a patients health and best interest, a patient's health should always be put ahead of the financial interest of the physician
ReplyDelete2.Yes, it is unethical for managed care to create situations in which doctors and health professionals would be tempted to skimp on testing for those that may need it to save themselves a few dollars. The financial aspect of this is clouding the doctors ethical decisions.
3. Dr. W should order the consult, in case something is actually wrong. Ethically she has a duty to her patient.
1. Yes, although it may be difficult, the doctor should put the needs of her patients ahead of her own financial interests. She will be doing her job and probably still making enough money to live comfortably.
ReplyDelete2. Yes, I believe this creates a conflict of interest for the doctors. They still have to make a living just like any other worker. However, they carry the extra responsibility of caring for people as well. They should not have to choose one or the other.
3. Dr. W should refer the patient to a cardiologist. In this case it is much better to be safe than sorry. The doctor may think she is saving money by not refering the patient, however if something is wrong and he dies, the lawsuit will be much more than a few hundred dollars the tes would have cost.
1) I do think it is unethical for a doctor to put their financial interests before the care of a patient. The patient's needs should always come first, despite the fact he may be an anxious person.
ReplyDelete2)By creating the financial incentives the managed care organizations are holding back treatments that would otherwise be ordered right away with no thought. It puts barriers on a doctors decision to treat the patient accordingly.
3) It is unethical for Dr. W to not treat Tom D. She should run the tests to check for a problem and worry about money later, the patients health is at risk, and by ignoring the problem now it might get worse as time goes on.
1. I feel that it is unethical for doctors to look at their own income when deciding treatment for patients. I think that it goes against all moral codes for physicians and they are supposed to be concerned with helping patients and not worried about their own money.
ReplyDelete2. I think that in a managed care facility, the doctors should get paid a base salary and not depend on what is going on with the patients. It is wrong to decide what Dr. W income will be if she decides to withold services from her patients. I think that it is wrong for her to determine what to do with her patient based on money.
3. Dr. W should run the necessary tests on the patient to make sure there isn't anything major going on. It would cost her less to do this than to have a lawsuit when her patient dies because she was too cheap to run the necessary tests.
1. It is unethical for doctors to consider their own financial interests when they conflict with a patient's best interest. They should have become a doctor to help people, not to make a lot of money. Their best interest should be whatever the patient's best interest is.
ReplyDelete2. It is unethical for managed care organizations to create such strong financial incentives for physicians to withhold medical services. They should be more concerned with the patient's health rather than the money. This could greatly affect the quality of care a person recieves, especially if they are in need of an expensive test or treatment.
3. Dr. W should give him the test just to be safe. Dr. W would be sorry if something was wrong and he didn't do anything about it, especially because he would most likely be sewed and ending up having to pay more. Dr. W should be worried about his patient's health, not money. Maybe in the future with the new health care bill, Dr. W won't have to worry about this and the government will help more with funding.
It is unethical for Dr.W to consider her own financial interests when it comes to the health of a patient. Dr.W does seem like she wants to do what is best for the patient, because she mentions "can I accept a slight risk" therefore, she knows the right thing to do is put the patients health first and any financial issues second.
ReplyDeleteIt is unethical for managed care organizations to create such strong financial incentives for physicians. the main reason why is exactly what could occur in this case. Certainly, Dr. W wants to take care of her patients with the best care possible, but the organizations make it very hard when her own income can be changed by how many patients she sees.
Dr. W should call in the cardiologist.There may be nothing wrong with Tom D, but at least she will know for sure when he receives the test.
Like everyone else so far, I agree it is very unethical for a doctor to consider their own financial interest first. If there was not an incentive for Dr. W I believe she would have immediately had a cardiology consult in this case.
ReplyDeleteIf Dr. W was not offered an incentive from the MCO she would not have to make such tough ethical decisions. The MCO is ethically wrong for offering these incentives to doctors. Dr. W should obviously do the cardiology consult.
yes, i do think it is unethical for a doctor to consider their own financial benefits when it is conflicted with the patient's best interest. doctors are obligated to give care to the patient, that is their duty.
ReplyDeleteyes, i think it is unethical for managed care organziations to create financial incentives for withholding treatment. that goes against everything doctors are supposed to stand for.
I think that dr. w should be a patient advocate and give tom d a sensitive test he needs. if something is seriously wrong with this patient and nothing is done about it, there could be serious consequences later on if something were to happen. if i were dr. d, i would get a new job at a different facility!
1.) The idea of how Dr. W is running her practice is not a good practice. Dr. W could have started her practice like this to initially save her patients money by paying for their treatment out of her own money. However, overtime it could turn into a case like this where she has become more about her money than the patient. In general the way she has her practice set up is terrible.
ReplyDelete2.) No, it is not ethical for businesses to have such financial rewards for not advising treatment
3.) I do not necessarily agree that Dr. W should immediately advise tests for the patient. Considering his past it is highly likely that he is over reacting and that the tests are not needed.
1) It would be incredibly unethical for the doctor to consider her own financial benefit let alone put it ahead of the needs of her patients. However, this situation is one in which a doctor should never be placed. i don't think anyone could honestly say that the thought of their own bank account would not cross their mind in this situation, especially if you had a family to support, whether you believe it to be ethical or not.
ReplyDelete2) It is extremely unethical for the managed care facilities to be run this way. If there are any financial incentives for the doctor they should be directly related to the health of their patients not inversely related to the degree of treatment.
3) In this situation Dr. W should put the needs of the patient ahead of her own financial needs. The patient should be referred to a cardiologist and given the best care possible. As soon as Dr. W begins putting her own needs ahead of those of her patients she stops being a doctor and should no longer practice.
1. Yes, I think it is unethical for doctors to consider their own financial interest when they conflict with the pts. best interest.
ReplyDelete2. Yes, i think that it is unethical for managed care organizations to create such strong financial incentives for doctors to withhold medical services. I do not believe that doctors should be paid incentive for doing or withholding treatment. I think that they should be paid just for being a doctor. Not on the basis of certain procedures.
3. I think that in this situation Dr. W should order a cardiology consult even if the cardiologiost orders extra testing. This was Dr. W. would for sure know that there is nothing wrong with him. And if something shows up then she will feel better knowing she did her job looking out for the pts. best interest.