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Ethical Moral Perspectives
Published in Michael van Manen, The Birth of Ethics, 2020
When a clinician reduces moral actions to a deductive rationalization of duties or harms, the ethical relatedness of patient, family, and clinicians partaking in decision making may quite simply fail to be seen. This is concerning if we believe that the ethics of neonatal-perinatal medicine are ultimately founded in the face-to-face encounters between healthcare practitioners, families, and the infants.
Medical Insurance Fraud by Doctors
Published in Thaddeus L. Johnson, Natasha N. Johnson, Christina Policastro, Deviance Among Physicians, 2019
Thaddeus L. Johnson, Natasha N. Johnson, Christina Policastro
Lastly, the technique of appealing to higher loyalties is commonly utilized by deviant physicians (DuBois et al., 2012; Hoffmann, 2009). Centered on the hierarchy of loyalty, offenders sacrifice the demands of greater society for the demands of their own subgroup and clients (Sykes & Matza, 1957). Examples of this type of rationalization in health care was observed in Wynia, Cummins, VanGeest, and Wilson’s (2000) study of 720 practicing physicians. Because of health care coverage limitations, some respondents “gamed” the reimbursement system as a form of patient advocacy. For instance, while some physicians falsely billed providers for a covered procedure or treatment, other clinicians embellished or misrepresented the severity of patients’ conditions to help them secure coverage (Wynia et al., 2000). Though neutralizations may not fully shield the individual from the force of his own internalized values and the reactions of conforming others (Sykes & Matza, 1957), such rationalizations provide episodic relief from moral quandaries that constrain deviant behavior. Since white-collar physicians otherwise tend to be law-abiding, highly trusted pillars of the community (Presser, 2009), neutralization theory provides a viable framework for examining physician deviance.
Rational prescribing in primary health care
Published in Christopher Riley, Morton Warner, Carolyn Semple Piggot, Amanda Pullen, John Wyn Owen, Releasing Resources to Achieve Health Gain, 2018
Rationalization of prescribing in primary care should provide an opportunity to release resources, both financial and other. However, it is vital that this process of rationalization is based on a holistic approach and includes consideration of the effects on secondary care, the primary health care team and the patient.
Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis
Published in Behavioral Sleep Medicine, 2020
Sergio Garbarino, Wayne A. Bardwell, Ottavia Guglielmi, Carlo Chiorri, Enrica Bonanni, Nicola Magnavita
An indirect result of our study is the observation that depression and anxiety are associated with OSA, but they are overlooked in common practice. Diagnosis and treatment of depression and anxiety in OSA patients has room for important improvement. A physician focusing on symptoms and treatment of the physical illness, to the exclusion of any associated mental illness, results in incomplete care of the patient. In a disease like OSA, which has such a high percentage of comorbidity of psychiatric disorders, this is unfortunate. This is contrary to the principles of person-centered medicine and of rationalization of health care. Significant effort should be made to personalize care for OSA patients, including early diagnosis and treatment of mental illnesses (Lim, Sutherland, Cistulli, Pack, 2017; Sutherland, Almeida, de Chazal, & Cistulli, 2018). Interdisciplinary cooperation is recommended for both OSA patients with symptoms of anxiety or depression and depressed or anxious patients with treatment resistance. Future research direction could address overlapping of OSA and mood disorders, because, on the one hand, OSA may complicate diagnosis of depression and make treatment challenging, and treatment of OSA can improve the response to standard therapy of depression or anxiety. Understanding the mechanisms connecting OSA and psychiatric disorders may improve the choice of personalized treatment. This is a new prospective that is in accordance with Personalized Medicine.
Implementation of technology in healthcare entities – barriers and success factors
Published in Journal of Medical Economics, 2023
Teresa Pakulska, Urszula Religioni
The functioning of medical facilities on the health care market is a major challenge for managers. On the one hand, the aim of these entities is to provide health services by using effective and safe methods of therapy and thus maximizing utility for patients. On the other hand, medical facilities are subject to market laws to a similar extent as entities operating in other areas of the economy1. The task of the managers of medical entities is therefore to ensure the effective functioning of medical entities, also in economic terms. In view of the first and overriding objective of the functioning of medical entities (protection of patients’ health), attention to rationalization of costs, profitability and the pursuit of profitability become a real challenge.
Recovery-Oriented Reflective Practice Groups: Conceptual Framework and Group Structure
Published in Issues in Mental Health Nursing, 2019
Sebastian Gabrielsson, Git-Marie E. Looi
Im and Meleis (1999) proposed that a nursing perspective should encompass a focus on health, caring, holism, the subjectivity of clients, a dialoged approach, and lived experiences. Meleis (2007) presented the following four characteristics that, when integrated, define the nursing perspective: the nature of nursing science as a human service; the practice aspects of nursing; caring relationships that nurses and service users develop; and a health and wellness perspective. RORPGs are based on an understanding of nursing that aligns with Thorne and Hayes’s (1997) description of nursing as a highly individualized, reflective, and contextual phenomenon. How nursing practice is characterized and understood is of vital importance for its further development as a profession and for building nursing knowledge. It has been argued that the emotional understanding of nursing, “to care for,” has been devalued in modern society and that the discipline of nursing itself contributes to this development in its striving for professional and academic status (Herdman, 2004). This rationalization of nursing would be evident in conceptualizations such as “evidence-based nursing” and “the nursing process.” The emotional, caring aspect of nursing is proposed to have been made subordinate to the cognitive and instrumental aspects and the linkage between feeling and action to have been broken. There is also concern that a focus on safety and risk management fails to meet service users’ needs and hinders individualized, flexible, and recovery-oriented psychiatric care (Higgins et al., 2016; Morrissey, Doyle, & Higgins, 2018; Slemon, Jenkins, & Bungay, 2017). RORPGs are, therefore, informed by an understanding of nursing practice as a dynamic process of care focused on reflection, relationships, needs, and interventions (Looi, Sävenstedt, & Engström, 2016).