Health care administrators probably face difficult ethical decisions more frequently than just about any other type of professional. To resolve conflicting ethical considerations in patient care, cost control and relationships with pharmaceutical companies and other suppliers, they must have both a solid understanding of the issues involved and a commitment to do the right thing even when it isn't easy.
Cost vs Care
Some of the most cutting-edge medical technology available is also among the most expensive, and the extra cost doesn't always result in dramatically better outcomes. A TIME magazine article from 2012 gives the example of a treatment that gives the patient a 5 percent chance of living for a few extra months. Considering that the treatment will most likely not work and will only give the patient a few months even if it does work, can the expense really be justified? However, if an administrator decides not to approve the procedure, the patient's loved ones may accuse her of putting cost ahead of patient care. There is no simple answer for this type of situation, but it's better to have a clear and transparent policy rather than waiting until a situation like this occurs to make a decision.
Another dilemma commonly faced by health care administrators is how to handle business relationships between doctors and outside providers. For instance, if a doctor has an arrangement with a pharmaceutical company so that she receives a bonus or consideration of some kind for prescribing its products, she might be inclined to prescribe that medication more often than she really should. Because these types of relationships can create the appearance of impropriety, many health care administrators ban them completely.
Administrators sometimes have to make tough decisions about the doctors or other staff employed by the facility. If the administrator has reason to believe a doctor is behaving inappropriately toward subordinates or patients, it may be necessary to take action before the facility has to deal with a lawsuit. If the doctor is popular or influential, this can be a difficult call to make. However, the potential consequences of failing to do the right thing can be even worse.
Health care administrators are sometimes reluctant to admit fault when a mistake was made for fear the admission could be used against the facility in court. However, many situations that end up in court could have been resolved much more easily with a sincere apology and a procedure change designed to prevent a similar mistake in the future. This is another situation where the more ethical course of action also can end up being the less costly approach in the long run.
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