Ethical Dilemmas in the Office

Ethical Issues in an office setting is nothing out of the ordinary. There are many situations that could cause problems between employees and management or employees with other employees. One that I would like to address is an outside issue between an employee and office manager that was brought into the work setting.

I personally know someone that has worked in a medical office as the Office Manager for 13 years. She had become very much of a part of the office "family" and was a huge asset to the Doctor's who owned it. After working there for many years, a new receptionist was hired and the manager had become very good friends with her outside of work. Several years down the road, there was an issue of payment for a scheduled vacation where the receptionist refused to pay and the friendship dissolved but not without issue.

Many rumors at work were spreading about the Office Manager being rude and disrespectful to others, purposely changing schedules without notifying anyone, and giving employee discounts to friends and family secretly. A meeting was scheduled with the Doctors, the office manager, and the receptionist to discuss what was actually happening and to get both sides of the story. There was no actual proof of any wrong doing in the end so the Doctors had decided that the issue was more of an outside problem that was wrongfully and purposely brought into the office in hopes of the Office Manager being fired.

Nothing had been changed and everyone was told to focus on their jobs but rumors were still being spread so the Office Manager had decided that she could no longer take the abuse of the other employees and resigned.

Many medical office's have a decision making model that is used to determine how to deal with this sort of problem. First, they would typically get the history and conflict information to they know all of the details before preceding. This was done during the meeting. Then they determine how to correct the situation by comparing various outcomes, the impact of the lives of the employees and the office, and weighing those to determine what is best for everyone. Deciding that this issue was a personal conflict and choosing not to do anything about it was the mistake that this office made. I feel they did not think about the impact that rumors can have on someone especially a manager who needs the employees respect. The outcome of the situation bore no responsibility on the right party, the receptionist, so with no consequence for her actions she continued abusing the manager and involving the other employees as well.

My stance on this is that the Doctors of this office should have stood by their manager and followed a decision making model because they are very helpful in these ethical problems. There was no clear evidence of any wrong doing on her part and they did know about the personal issue between the two so it was clear what was actually happening. In the end they lost their manager and close friend for no good reason when they would have been able to keep their manager and their great office environment had they followed a good decision making model to get the best outcome.  

References

author, n. (n.d.). Office Ethics. Retrieved from Southwestern Learning: http://www.swlearning.com/swepstuff/previews/files/careerreadiness/0538726164/ethics_ch01.pdf

Ingram, D. (n.d.). What are the steps in the decision making process of a manager? Retrieved from Small Business Chron: http://smallbusiness.chron.com/steps-decisionmaking-process-manager-10601.html

Primary Care "Deserts"

I want to talk about a growing problem in the medical field. Yes I am focused more on management of medical offices but if there's a shortage of primary care doctors then there is a shortage of doctor's offices that need to be managed.

According to a recent report from the Association of American Medical Colleges, we will lose 100,000 primary care doctors by 2025. There are places throughout the U.S. that are primary care "deserts" or simply, they lack efficient amount of primary care doctor's in that area especially in rural ones. Our primary care doctors are the ones that spend more time with us and our family. They take care of our basic medical needs and refer us to specialists if what we need is beyond their expertise.

Living in rural Nevada, I see the need for more primary care doctors especially pediatricians. I have two children who have more medical needs than most and a great pediatrician (for my kids) is hard to come by in our county. I have had only one doctor that I felt knew what she was doing and did what was best for my children but she retired. I am still looking a doctor that I can trust to take care of my children's health needs.

One of the issues causing this problem is pay. Our primary care doctors are paid less then specialists and surgeons although they tend to work longer hours. This alone would veer potential medical students into a different direction. I personally would rather see my primary doctor than a specialist because she knows me and went through everything with me and same for my children's doctor. If our primary care doctors were paid more, we would see a higher demand for these positions and we would have more to choose from that would fit with our family's needs.

With many new doctors choosing to work for hospitals instead of private practice and medical students choosing specialties instead of primary care, it leaves those of us looking for private practice office managers with less options. We could look into working for hospitals but that would require different hours and days. The main reason I went into this field is to have the option of working in an office environment that was open only on week days and closed at a decent time so I can be with my kids. Also, working for the bigger offices and hospitals takes away from being able to know your patients that come in, to know their families, and to have an impact on their lives.

It's important to have a receptionist that knows when your child actually does need to be seen asap, it is important to have a billing/accounting person that you can turn to for payments when you are running low on money, it's important to have an office manager on staff to make sure that the office and employees are spending their time making sure everything is ran smoothly, inventory is stocked, patients are getting the care they need, and the physician is able to focus on their patient and not basic office duties. When there's a shortage of these doctors then there's a shortage of these offices, and a shortage of office manager positions.

References

court, e. (2016, April 4). America's Facing a Shortage of Primary Care Doctors. Retrieved from fierce practice management: http://www.marketwatch.com/story/americas-1-million-doctor-shortage-is-right-upon-us-2016-04-01

Electronic Health Records

Electronic Health Records or EHR is an electronic version of a patient's health history. Many medical providers have switched all of their paper files over to electronic files. Of course with new technology, there will always be pros and cons.

Harvard Business Review has stated that EHR's "triple aim" is to reduce cost, improve quality, and enhance patient experience. The hope is to provide the medical professionals a way to have all of the patient files, including labs, images, prescription history etc. right at their finger tips so they can focus more on the patient when entering the room.

I feel that this has actually provided patients with better experiences and I feel that way as a patient. I like that in a couple of swipes on my Doctor's tablet and she can determine what course of action should be taken for my illness. I like the fact that she can send over my prescriptions to my chosen pharmacy and it will be ready by the time I get there. It's nice that she can see all of my test and imaging results on her tablet without digging through a file for them. They are neatly organized and it seems to be fast and efficient for her as well. It also helps that my Doctor's office also has an online portal where I can go to see my own results, see doctor's notes, and get any information on past appointments.

Like I had said in the beginning though; there's always pros and cons. In an article written in 2013 by Sam Narisi, he writes about a survey that was taken involving 212 practices where 58% of the physicians were not satisfied with their EHR system. The reasoning they gave was that doctors spend more time on documentation and see fewer patients. They also were dissatisfied with the specific software that their office was using because of inadequate training and support and poor usability. With saying that, they also saw the benefits to these new systems like being able to access patient history remotely, a reduction in missing patient charts, and payments from federal programs for adopting EHR's. While trying to figure out the new systems, they were still hopeful that adopting this new system it would provide better communication, improve care quality, and higher productivity.

All new technological systems have issues that need to be ironed out but with support and training it seems as though our medical professionals will have a new system that will provide them with more benefits to their work and to their patient care.

References

Jeff Butler, J. F. (2015, December 8). How to Make Electronic Health Records an Asset Instead of a Burden. Retrieved from Harvard Business Review: https://hbr.org/2015/12/how-to-make-electronic-health-records-an-asset-instead-of-a-burden

Narisi, S. (2013, December 6). Pros and Cons of EHR systems, according to Doctors. Retrieved from Healthcare Business and Technology: http://www.healthcarebusinesstech.com/pros-and-cons-of-ehr/