Within some managed care systems, physicians who perform more procedures and spend more time with patients than is deemed necessary are penalized or physicians are simply paid based upon their number of patients, rather than the extent of the care they give to patients (Jecker 1998).
Managed care was designed to reduce the tendency of physicians to please patients with 'good' health insurance by allowing them to take drugs (such as brand-name medications or antibiotics) when they were not strictly necessary or have tests for which there was little indication that they would be beneficial for the patient. One of the most controversial aspects of managed care was the insistence that patients obtain referrals for specialists and the need to remain 'in network' for treatments. This was despite the fact that medical opinion might vary widely in terms of the best way to treat an illness. A patient with cancer might receive a recommendation for surgery from one specialist and for radiation from another and the insurance company's policy about what specialist was in 'the plan' and what procedures were deemed medically necessary would prejudice this highly personal decision on the part of the patient.
The hospital where I work, like all medical institutions, has little...
Ideally, I would like a shift to a more comprehensive system of national care, as practiced in other nations such as Canada and the United Kingdom. The levels of bureaucracy created by the managed care system often result in more administrative costs rather than savings, and clearly result in poorer and less comprehensive patient care. Policies often encourage patients not to obtain care because of high copays or fear that procedures will not be covered. This results in higher costs later on when treatment is not provided in a timely fashion. Doctors and nurses should be the ultimate arbitrators of care, not insurance agents.
Enhancing Postoperative Patient Safety: A Quality Improvement Initiative on Monitored Anesthesia Care (MAC)Introduction and BackgroundHealthcare quality and safety are critical components of postoperative care, particularly for patients undergoing procedures that involve Monitored Anesthesia Care (MAC). Recent studies indicate a significant risk for adverse events related to MAC, including hypotension, hypoxia, and delayed recovery (Alzanbagi et al., 2022). These complications can lead to extended hospital stays, readmissions, and higher healthcare costs.
conflict can have many negative implications for an organization if it is mismanaged, some conflict is necessary for an organization to move forward. Conflict must be managed in an effective way so it generates positive policies rather than personal animosity and in-fighting between staff members. Pinpointing the sources of conflict is essential: is the conflict due to the fact that nurses are understaffed? Are unpleasant shift times being unfairly allocated?
Nurses in executive roles like Chief Nursing Officers (CNOs) build bridges between various members of the healthcare team, between healthcare team members and patients, and also between the legislative environment and organizational practices. In a position of leadership, the CNO also sets the tone for organizational culture. An interview with CNO Oakes reveals some of the most pressing trends and issues impacting the role of CNO and also the healthcare
Policy Recommendation for Collaboration and TSA Privatization The objective of this study is to evaluate the benefits of collaboration between the federal government and non-profit organizations. The study cites different examples of collaborations across the world and their achievements. Moreover, the paper investigates whether it is beneficial to privatize the TSA (Transportation Security Administration) since the organization has performed below the international standards in the last few years. Finally, the study
Clinical narratives are used for the articulation and sharing of knowledge and experience which has been acquired over time and through experiential learning and is a way of enabling nurses to "tap into the thought processes and best practices of expert clinicians" through sharing of stories based on experience. Professional conferences involve the attending of conferences, which expose nurses to ideas that are new and best practices of other
Pharmacology for Nurses Pharmacology, the study of drugs and their effects on the human body, is a critical component of nursing education and practice. Nurses must have a sound understanding of pharmacology to safely administer medications and monitor their effects on patients. This foundation allows nurses to play a pivotal role in medication management and patient education (Burchum & Rosenthal, 2021). Knowledge of pharmacology enables nurses to understand why certain medications