The Changing Health Care Landscape and Implications of Organizational Ethics on Modern Medical Practice

作者：Castlen Joseph P; Cote David J; Moojen Wouter A; Robe Pierre A; Balak Naci; Brennum Jannick; Ammirati Mario; Mathiesen Tiit; Broekman Marike L D^*

来源：World Neurosurgery, 2017, 102: 420.

DOI：10.1016/j.wneu.2017.03.073

• Administration
• Ethical climate
• Hospital
• Leadership
• Organizational ethics
• Quality management

INTRODUCTION: Medicine is rapidly changing, both in the level of collective medical knowledge and in how it is being delivered. The increased presence of administrators in hospitals helps to facilitate these changes and ease administrative workloads on physicians; however, tensions sometimes form between physicians and administrators.
ANALYSIS: This situation is based on perceptions from both sides that physicians obstruct cost-saving measures and administrators put profits before patients. In reality, increasing patient populations and changes in health care are necessitating action by hospitals to prevent excessive spending as health care systems become larger and more difficult to manage. Recognizing the cause of changes in health care, which do not always originate with physicians and administrators, along with implementing changes in hospitals such as increased physician leadership, could help to ease tensions and promote a more collaborative atmosphere. Ethically, there is a need to preserve physician autonomy, which is a tenet of medical professionalism, and a need to rein in spending costs and ensure that patients receive the best possible care.
CONCLUSION: Physicians and administrators both need to have a welldeveloped personal ethic to achieve these goals. Physicians need be allowed to retain relative autonomy over their practices as they support and participate in administrator-led efforts toward distributive justice.

• 出版日期2017-6