The lack of standard procedures set in healthcare management especially those related to decision making have given numerous problems to the healthcare industry. This in turn affected not only the healthcare practioners but their patients and clients as well. The healthcare industry has been getting the bulk of funding from the government. Data from the Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group shows that the healthcare expenditures of the United States is more than $2 trillion dollars budget compared to the federal government’s budget of $3 trillion (HealthCareProgram.org, 2013). This should include facilities, trainings and health insurances.
However, despite the amount of financial attention given to the healthcare industry, numerous problems still arises specially those involving decision making. For instance, based on the results of a study conducted by Sergey Zakharov, Navratil Tomas, and Daniela Pelclova (2012) on the extent of medical errors, they found out that “the most common errors were: improper dosage (60.9%), wrong medication (19.3%), or erroneous route of administration (12.9%). The most frequent medication errors appeared using drugs affecting the nervous system (psycholeptics and antiepileptics), antibiotics, and drugs affecting the respiratory system. Nurses administering the drugs were responsible for 43.0%, physicians prescribing the drugs for 36.8%, and pharmacists dispensing the drugs for 20.2% of the errors.” This is one clear indication of the effects of the varied decisions-making of health practioners.
The healthcare industry entails decision making in all levels, where these decisions are very important as sometimes it dictates the lives of patients. Health Insurance problems had risen dramatically over the past years, about 51% of the total population are reportedly uninsured, leading to increasing number of “inefficiently cared” patients as the government lacks policies on what to do with people who lack such insurances (Collins et.al., 2006). This has likewise led to varying decisions of health care offices where some patients were well taken-cared of, and other not given services at all. For instance, findings saw that “nearly one-quarter (23%) of adults who reported spending any time uninsured in the past year said test results or medical records were not available at the time of a scheduled appointment, compared with 15 percent of continuously insured adults and nearly one of five (19%) adults with any time uninsured said he or she had been given a duplicate test, twice the rate of duplication reported by continuously insured adults.” (Collins et. al., 2006) People who usually belong to the group of uninsured are the ones greatly affected by this, however, the healthcare institutions is also indirectly affected.
Other contributory factors to the varied decisions in the healthcare industry involve ethical concerns. Given that ethics has no standards and the acceptance of an action depends on one’s personal point of view, it is hard to give standard procedures in decision making. This gave rise to numerous problems. Its negative consequences includes misunderstandings between and among health practitioners as they present various decisions but the management almost always has the final say. This has also caused possible conflict between the medical practioner and the patient or his family since the decision of the practioner might not be congruent with what the patient or his family likes (Casali, 2010). The lack of written rules on how these are treated gives them no options.
Although, specific health care institutions might have their own set of protocols in coming up with certain decisions, still these does not hold true to all health care institutions. The absence of could confuse them as well as their clients (Walshe, 2006). For example, doctors in a hospital give end-of-life choices to a specific patient but upon seeking 2nd opinion from other doctors or institutions, he ruled-out the formers decision. This could lead to confusion in addition to having the image of the healthcare institution in jeopardy. Likewise, the point of view of other doctors or the patients may differ to what has already be decided.
Health care problems especially those brought about by the varied decisions of healthcare practioners had been existing for hundreds of years, but until today, no specific rules or guidelines have been set to address them. Several studies have been made focused on how decision –making should be made in healthcare management especially when faced with crucial decisions but they remain to be theories as nothing has been officially adopted by the government or concerned organizations. Decision-making still lies on the personal judgment of each person involved.
References:
Casali, Gian (2010). Ethical Decision Making and Health Care Managers: Developing managerial profiles based in ethical frameworks and other influencing factors. Retrieved from http://eprints.qut.edu.au/47003/1/Gian_Casali_Thesis.pdf
HealthCareProblems.org (2013). Health Care Statistics. Retrieved from http://www.healthcareproblems.org/health-care-statistics.htm
S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren (2006). Gaps in Health Insurance: An All-American Problem, The Commonwealth Fund, April 2006. Retrieved from http://www.commonwealthfund.org/Publications/Fund-Reports/2006/Apr/Gaps-in-Health-Insurance--An-All-American-Problem.aspx
Walshe, Kieran (2006). Evidence-based Management: From Theory to Practice in Health Care. Retrieved from http://www.cebma.org/wp-content/uploads/Walshe-en-Rundall-Evidence-Management-From-Theory-to-Practice-in-Health-Care.pdf
Zakharov, Sergey, Tomas, Navratil, and Pelclova, Daniela (2012). Medication Errors – an eduring problem for children and elderly patients. Ups J Med Sci. 2012 August; 117(3): 309–317. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410291/
