The Abandonment Of Professional Autonomy

One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).

The main objective of healthcare professionals is to provide the best quality of patient care and the highest level of patient safety. To achieve that objective, there are many organizations that help improve the quality of care. One of the best examples is the Joint Commission. Unfortunately, the healthcare system is not free from total risks. In healthcare activities, there are possible errors, mistakes, near miss and adverse events. All of those negative events are preventable. But, it is clear that errors caused in healthcare result in thousands of deaths in the United States.

"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.

When assessing whether a no fault regime is better than a negligence rule in dealing with the causes and consequences of medical error, it would seem prudent to first understand the meaning of the term “medical error”. Liang defines medical error as ‘a mistake, inadvertent occurrence, or unintended event in health-care delivery which may, or may not, result in patient injury’ (2000, p.542). The consequence of these errors (or adverse events) that lead to patient injury, and the method by which we determine and administer compensation for such injuries, has been the source of heated debate amongst scholars in recent

Hospitals have organizational structures that allows them to carry out their duties efficiently and successfully. What separates the organizational structure of a healthcare organization from a business, essentially that the hospital 's organization is chiefly founded on the amalgamation of medical and administrative staff (Carayon, et al., 2014). The organizational structure of the twenty-first century solutions in health care hospitals involves, both divisional and hierarchical structure. In the of the chain of command hierarchy, there are various levels of professional’s that fall under other levels within the facility, and each staff member is organized in regards to departments that are related to their (KSA’s) skills, attributes and job duties (Carayon, et al., 2014). Hospital organization philosophies is based on development of values and ethics, with the understanding on moral principles relating to human conduct. These systems are comprised with the processes in decision making and determining the best actions to consider between the difficult alternatives when pertaining to patient care.

A second issue is malpractice. Malpractice issues are always present in an unstable environment where patients will seek to remedy an incident if they feel they have been harmed (Hamric, 2009). It is important to always act in a reasonable way as a health care clinician but unfortunately there are always those who are negligent in their actions as practitioners.

Tort reform has intense arguments to both sides and creates a myriad of concerns. On one side of the tort reform movement, defendants such as corporations and medical professionals want limits on the damages awarded to the plaintiff. The benefit of tort reform for defendant is the financial savings. However, a cap placed on medical malpractice cases and other cases that are of negligence would standardize the monetary compensation regardless of the damage. In my opinion, Medical malpractice tort reform is a gray area, for each breach of the standard of care involves a different story and person, therefore the damages vary and should be evaluated fairly. In this essay, both sides of the argument are discussed, with a focus on medical malpractice tort reform.

In Joint Commission, the stated out the standards needed for an organization to be compliance with patient care and safety criterion for accreditation. In Nightingale Community Hospital, some of this policies and procedures are not rightly observed in all the units, example is the policy that clearly stated that verbal orders has to be verified within 48 hours is not being practiced in many units. Above all, the second quarter compliance was steady and of all quarters rated the best, but the compliance result for the third quarter were quite poor. Most of the policy needs revision and the standard needs improvement in other for the hospital to be in compliance. One of the policies that need to be implemented is the form the nurse that collects the order, the form has to signed, dated and placed outside of the patient's chart, bringing it to the knowledge of the physician that an action is requested from him in regards to the patient.

This article was selected as it explained and discussed the probable standardized procedure that health care organizations may have to follow for improvements in patient safety. This article explains how the inter-personal and professional relationship of different health care providers need to be maintained for better health care as explained in one of the chapters of health care management.

Hospitals are one of the many organizations that must comply with regulations to keep patients and staff safe and as well as maintain the quality of care. Ideally, a good care system for patients includes medical professionals as well as friends and family to compliment each other in providing for patient needs. Because patients require care from medical professions in hospitals, there are provisions that the hospital must follow.

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

It is human nature to make mistakes; however, mistakes that cause harm to someone else could be considered negligence. In the case with Mr. Benson in the Neighborhood Newspaper article, a mistake was made that was irreversible. He went into the hospital to have his leg amputated, and the doctor amputated the wrong leg. The question is was the doctor negligent in his practice? Is the amputation of the wrong leg considered to be malpractice on the doctor’s part? This paper will differentiate between negligence, gross negligence, and malpractice. After differentiating between these terms, it will be determined if the doctor operating on Mr. Benson was considered to be negligent, gross negligent or was this mistake malpractice.

My article selection is based on miscommunition and patient safety in a healthcare setting. The model that the author implemented to help better understand the significance of this issue is the Swiss Cheese Accident Causation Model. What this model represents is how a domino effect of miscommunication throughout different stages in corresponding with patients and medical staff can ulyimatly leads to the possibility of delayed healthcare, accidents, or even death . The holes in the model concept represent a breakdown in safety errors that can trigger deficiencies due to latent errors with such as organizational errors, environment, miscommunication, reliability. When these holes in the defensive layers align, then certain hazards can lead to an accident . In the healthcare setting each year miscommunication is said to contribute to estimate costing $1.7 billion dollars, which is then distributed to medical malpractice cases which in turns effects roughly 1,700 lives(Spoke,2017)

Boyd: BUREAUCRATIC AUTHORITY IN THE "COMPANY OF EQUALS": THE INTERACTIONAL MANAGEMENT OF MEDICAL PEER REVIEW.

The concepts discussed within the article regarding professionalization, medical autonomy and medical dominance served to be new knowledge for me as the article discussed the significance of autonomy and professionalization from a sociological aspect as witnessed within the field of medicine. Furthermore, the article within Key Concepts of Medical Sociology addresses the differences between how certain occupations fall within the category of professions while not every occupation is deemed as a profession (Gabe et al. 163). I found this concept to be extremely interesting as I have never studied the idea behind occupation and professions from a sociological perspective as in how not every occupation is considered to hold a title of a profession