Tenet Healthcare Scandal

Authors Note: This paper is being submitted on the 18th of March 2013 for the winter semester of Medical Law and Ethics section 05.

As healthcare cost, rapidly increase, healthcare professionals are finding innovative ways to contain cost. Occasionally, the healthcare organization may find themselves entombed in an ethical decision and find it difficult to take the appropriate action. In this paper, I will analyze the case study of Dr. S. and Dr. V.; and deliberate how the actions of Dr. S. and Dr. V. violated the Stark Law.

In mid-April 2000, Sherri Worth was faced with some very unsettling news about Pate Memorial Clinic’s future with a competitor potentially moving into the area. Worth was the assistant administrator at Pate Memorial Hospital (PMH) and was also responsible for the Pate Health Clinic (PHC). A study by the competitor was being done to see whether sufficient demand existed to establish a clinic 5 blocks north of PHC. The two biggest concerns in regards to the new competition were:

In many ways, the hospital system in America is set up mirroring our government. They are similar in the way that checks and balances have been set in place to ensure the best possible care is delivered to patients. With these checks and balances there are three main bodies; the governing board, medical staff, and executive management (Showalter, 2017). The duties and responsibilities of each body many times is to oversee and continually check the others. A prime example of this system can be seen through the case of Moore v. The Board of Trustees of Carson-Tahoe Hospital, which took place in Nevada and was heard before the Supreme Court of the state in 1972 (Moore v. Board of Trustees of Carson-Tahoe Hospital, 1972). Specifically, in this case, the duty of the governing board to “exercise reasonable care in selecting and retaining medical staff” is questioned in contrast with the right of the physician to have “due process… when disciplinary action is taken” (Showalter, 2017). In hopes of changing a decision by the governing board, and attempting to reverse the decision of a lower court, the appellant, Dr. Moore, brought the case against Carson-Tahoe Hospital (Moore v. Board of Trustees of Carson-Tahoe Hospital, 1972).

As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.

"Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error…" (John Hopkins Medicine). This soaring number has caused medical errors to become the third leading cause of death in the United States. For many people, medicine seems foreign and unknown. People who have lost loved ones due to medical error desperately look for a reason, and many times that blame falls upon doctors. Media has put a negative connotation on doctors as well, causing their reputation to plummet whenever a hospital procedure turns badly. A renown surgeon and author, Atul Gawande, uses his knowledge and experience to give people a new perspective on medicine. In the article "When Doctors Make Mistakes," Gawande uses rhetorical appeals: ethos, pathos, and logos to prove the need for a change in the medical systems and procedures. He analyzes how the public looks at doctors, giving a new perspective to enlighten the reader that even the best doctors can make mistakes.

In Creela Belle Howard’s article “Legal settlements at Veterans Affairs more than tripled since 2011, many due to medical malpractice,” she argues that VA hospitals, known for having a history of scandals and malpractice, should start terminating staff members for malpractice. Howard presents credible evidence, as well as implementing emotion through heartbreaking examples of veterans who passed away at the hands of shiftless staff at VA hospitals throughout the country. The author also presents no bias by stating facts without opinions about her own personal views.

Competition between providers has caused physicians and hospitals to offer the most current healthcare technologies and modern, eye-catching settings has contributed to increasing healthcare costs, as well as providing unwarranted highly technical services (Shi & Singh, 2015). Renovations of the physical settings and the acquisition of expensive technologies elevated healthcare services prices to cover the additional costs of providing high technical services and attracting clients.

The men believed they were receiving medical care from the government, not participation in an experimental research study. The doctors and nurse Evers failed to explain important information such as the purpose, the risks and benefits, alternative procedures, and a statement that offered the individuals opportunity to ask questions of concern and their ability to withdraw at any time during the experiment. Comprehension and understanding of the words of the procedures were changed (spinal taps --- back shots) to make the therapies they were receiving seem less harmful, but instead more

HealthSouth Corporation was one of the largest publicly traded owners of rehabilitative hospitals within the Untied States and paved the way for its industry. However, prior to 2003 the company had a very dark secret: fraud. In 2003 HealthSouth was accused of making $2.7 billion in false journal entries in the company’s system (Helios, 2013). These false entries allowed the corporation to inflate its earnings and revenue. While the corporation was dabbling in a fraudulent, aggressive account system, auditors were unable to detect the extent of the fraud occurring. If not for Michael Vines and Weston Smith, HealthSouth Corporation might have continued its false entries and continued deceiving shareholders and even Wall Street itself. HealthSouth serves as a historical example of how corporate culture can use fraud and deception schemes to not only rationalize what it is doing, which is an element of the fraud triangle, but also encourage fraudulent financial statements.

The American College of Healthcare Executives (ACHE), has a strong impact on ethical decision making because they focus on the “entire being” of the healthcare professional. For example, in ACHE’s preamble of The Code of Ethics it states, “In fulfilling their commitments and obligations to patients or others served, healthcare executives function as moral advocates and models.” Imagine, when a healthcare administrator recites these few words, he cannot help but acknowledge the depth of his commitment and the high level of morality that is expected from him. Because of the vast number of complex ethical dilemmas that arise, ACHE further promotes the value and importance of strong ethical decision making in ACHE’s Ethics Toolkit. “When the ethical guidelines are not enough, when there is uncertainty about the proper ethical approach, and when there is a need to develop additional

“If you don’t have integrity, you have nothing. You can’t buy it. You can have all the money in the world, but if you are not a moral and ethical person, you really have nothing”. –Henry Kravis - The American healthcare system delivers some of the finest care in the world. However, despite the high level of achievement delivered from the American healthcare system, it is afflicted with problems. Ethical issues that occur in the healthcare delivery system are indeed common. Almost every decision that is made in a healthcare organization has ethical implications. These ethical implications are towards the patient, provider and the leader of the organization. Ethics tend to determine which actions will contribute to an individual fulfillment of happiness. Ethics are very powerful and tend to presuppose freedom and responsibility in the organization. In my current place of employment the care of patients is integrated with medical research, which in return allows for the healthcare practices to continuously be studied and improved. As a healthcare leader or worker, decisions will be made when the common good of both the patients and organization must be taken into consideration. As an effective healthcare leader one must practice adhering to the ethical standards and codes of conduct for his or her individual place of employment. According to Rae (2009), there are 7 steps in making moral decisions. The seven

It was a creative idea taken too far and the wrong way. Elisabeth Robert, the firm’s CEO, was on the board of Vermont’s largest hospital. After the incident, however, Robert decided it was best to resign. This demonstrates that she does have regard for those who are ill and she showed this by participating in the decision-making process of a large hospital.

The creditability of our profession is undermined when we face the temptation to ignore our ethical responsibilities. The author of “Ethics & Critical Thinking” asserts the most common ethical fallacies rely on poor judgments, enormous stress, and conflict. Patient violations are committed everyday when our thoughts maintain “it’s not unethical even if our acts have caused harm as long as the person we harmed had it coming, provoked us, deserved it, was really asking for it, or practically forced us to do it—or, failing that, has not behaved perfectly, is in some way unlikable, or is acting unreasonably.” Integrity and values guide our behaviors and ethical commitment

Professionals in every field are always confronted with some kind of ethical issues. It has however been noted that these ethical issues become high in magnitude and extent when public officials are involved. Due to the involvement of human life, an industry like healthcare holds ethics in highest regard. Even though these healthcare practitioners are highly trained to deal with issues of these kinds, their decisions can sometimes have a lasting impact on their professional and personal lives (Edwards 2009).