Primary Care Ethical Dilemmas

Discharge planning is used to create a plan of care for a patient who is leaving a care setting. An evaluation is done to determine the patient’s continuing care needs once they have left the care facility. When patients are send back home or to a facility that does not require full time nursing care assistance, programs need to be put into place to ensure that the patient is receiving the proper continuation of care post discharge. Proper discharge planning can decrease the chances of a hospital readmit, help in recovery, ensure medications are prescribed and given correctly, and adequately prepare family or caregivers to assume proper post discharge care. According to the Family Caregiver Alliance, “It is important, not only for patients, but family

According to the U.S Department of Health and Human Services, the Affordable care Act from President Obama gives consumers more options and benefits when seeking coverage from insurance company. It offers lowering cost as well as gets more access to high quality of care. This law creates Patient’s Bill of Rights that is very effective to protect consumers from any abuses or fraud from insurance company. Some preventive services are available to many Americans especially Medicare recipients at no cost. Not just that, they also receive a special offer of 50 percent discount for any well-known drugs in the market place under Medicare named “donut hole.” The Affordable Care Act helps other organizations and programs to convince healthcare providers

a) Reflect on the journey of medical ethics and interpret how the principles of the Hippocratic Oath are applied within your organisation………………………………….…………

McCall Ethics Case Study Jerry is Dr. Williams’s office assistant. He has received professional training as both a medical assistant and an LPN. He is handling all the phone calls while the receptionist is at lunch. A patient calls and says he must have a prescription refill for Valium and that the provider, a friend, calls in the medication prior to any flights. This type of request happens often and in slightly different scenarios, but the outcome should remain the same to avoid ethical and legal issues. This paper will review the case study to help resolve the problem at hand, refilling a prescription without provider authorization. Qualified Medical Training Understanding the definitions of a licensed practical nurse, LPN, and a medical assistant, MA is the first step to making a factual conclusion for this case study. Support staff to the provider cannot make decisions about medication refills for patients without a direct order from the provider. This action is outside the scope of practice for an LPN or MA. Licensed Practical Nurse An LPN is a role in support of the nurse or RN, a registered Nurse usually in a skilled nursing setting such as a hospital or long-term care facility. As defined by the National Federation of Licensed Practical Nurses, NFLPN, an LPN “means the performance for compensation of authorized acts of nursing which utilize specialized knowledge and skills and which meet the health needs of people in a variety of settings under the direction

Managed Care is a system of health care in which patients agree to visit only certain doctor and hospitals, and in which the cost of treatment is monitored by a managing company. David, a clinical supervisor of one pad was responsible for the clinical supervision of eight clinical case managers. On typically day, he receives around 40 phone messages about clients that are in need of his services. His job is to field calls from mental health providers seeking authorization to provide treatment for clients. There are those who believe that managed care is simply another example of corporate America discovering a means to increase profits for shareholders of insurance companies, at the expense of individuals seeking mental health treatment. (pg.

Many mental health counselors work with managed care organizations (MCOs) to provide services to clients. While managed care guidelines determine how counselors deliver services and what they will be reimbursed for, many counselors are upset with how limiting the guidelines are. It is a challenge for counselors when insurance reimbursement is denied because the MCOs are not honoring DSM codes (Braun & Cox, 2005). Therefore, counselors tend to submit inaccurate diagnoses that are reimbursable for their clients can receive services and they can be paid. However, this can lead to ethical and legal dilemmas for counselors. Braun and Cox (2005) address this issue in their article “Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders.”

The training will includes healthcare codes of ethics for managed care and five ways to improve ethics in the managed care organization.

In addition, the article highlighted the issue of litigation and policy context under the Employee Retirement Income Security Act’s (ERISA’s) preemption provision. It stated that “when a law or legal action involves the administration of plan benefits, such as a state law mandating certain benefits or a patient’s challenge to the denial of a plan benefit, ERISA preemption is triggered” (Jacobson, 1999). Therefore, the states block the litigation against the managed care organizations. Lastly, the courts and public policy have been a challenge of the implementation of cost containment initiatives. Some prominent commentators have been arguing for years that health care delivery should be guided by market principles as determined through contractual

The growth of managed care in the United States has been paralleled by a rising tide of anti–managed care sentiment. The “managed care problem” is understood generally as the need to protect individuals against large companies that care more about their bottom line than about people. The premise of the BEST (Best Ethical Strategies for Managed Care) project is that the “managed care problem” is best understood as an ethical problem—a conflict of values that arises as the country changes from a patient-centered to a population-centered approach to health care. The BEST project team worked with nine managed care organizations to identify their most intractable problems. The team redefined these problems in terms of ethical dilemmas, and then

function of pediatric primary care that may be best delivered using a team approach. Coordination of care is a holistic health care approach that is often delivered by a team of practitioners such as a physician, advanced practice nurse, school nurse, social worker, pharmacist, nutritionist, respiratory therapist, and others. Coordination is defined as “the state of being harmonized in a common action or effort” (Stille & Antonelli, 2004). The cases of Dewey Jones, Martha Ames, and Spike Smith are examples of interdisciplinary coordinated care.

Many individuals come together to organized a care plan for a patient. The patient plays a role in the process, sharing his or her preferences and needs as they related to information sharing and health services. Family members and caregivers need to have a say in the care of the patient, as coordination failures frequently occur when care is transitioning from one party to another. Healthcare providers must be a part of the care coordination team, and this shouldn't be limited to only doctors.

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

There was a lot of literature on health care clinical ethics, considerably less literature on health care organizational and administrative ethics. Many times what is good for health care business may not be ethical, causing an "ethics gap." Ethics gaps can be identified and corrected by careful analysis of an institution's organizational culture. A true case study on how a nurse was able to change a tainted organization into a responsible one by ethics infrastructure changes. Finally, implications for health care were addressed.

Healthcare professionals will be faced with ethical dilemmas throughout their career, particularly in the hospital environment. Having an education regarding professional healthcare ethics will provide some direction in how to best address these dilemmas at a time when either the patient or their family is in need of making decisions for themselves or their family member. It can be difficult for healthcare professionals to weigh professional protocol against their own personal beliefs and ethical understandings when determining critical care for their patient.

Everyday, healthcare professionals are faced with ethical dilemmas in their workplace. These ethical dilemmas need to be addressed in order to provide the best care for the patient. Healthcare professionals have to weigh their own personal beliefs, professional beliefs, ethical understandings, and several other factors to decide what the best care for their patient might be. This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brains hemispheres which has left her unconscious. She only has some brain stem reflexes and requires a ventilator for support. She is unable to communicate how she wishes to proceed with her healthcare. Mrs. Smith’s children, Sara and Frank have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life, as Sara would like to do, or stop all treatments and care, as Frank feels his mother would want. In the healthcare field, there are situations similar to this case that happen daily where moral and ethical judgment is necessary to guide the decision that would be best for the patient. The purpose of this paper is to explore and discuss, compare and contrast the personal and professional values, ethical principles, and legal issues regarding Mrs. Smith’s quality of life and further plan of care.