Please response to your peers discussion post. Be brief, each discussion should NOT exceed a paragraph. Also when writing please write in first person.
Discussion 1
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Describe how US hospitals in your region have been structured to accommodate the roles and decision-making autonomy of physicians.
I found this great quote while reading about the involvement of physicians in hospitals. I know it is directed towards healthcare but I feel that most if not all existing businesses will need to learn and grow through the dynamic landscape or organizations today. People in the future will need to learn organization the way their forefathers learned farming. — Peter Drucker. Medical decision making is an organizational process. Even at the level of individual clinical judgment, a myriad of prior “organizational” decisions have been made that affect what appears to be an autonomous clinical judgment made by a trained professional. For example, a surgeon’s choice of a given technique for a particular operation has been conditioned by prior decisions, such as the number and types of operating rooms available, types of equipment purchased, the quality and mix of surgical assistants and nursing staff, and the organization of the operating room schedule itself. The surgeon’s decision may also be influenced by prior decisions made by the hospital’s quality assurance committee. Truly “micro” decisions involving individual clinical judgment and “macro” decisions involving larger organization-wide resource allocation and policy issues are highly interrelated. The nature of physician involvement in hospital decision making must be understood within this context. When allowing for physicians to have autonomy within the constraints of rulings made by all our local St. Luke’s and St. Alphonsus seem to both foster a sort of allowable as long as it is within bounds. Allowing physicians to remain in control of their patients options and health plan while not leaving the hospital entity open to more extreme liabilities.
In your opinion how are medical homes and accountable care organizations reshaping the corporation of healthcare?
I believe that the emergence of the above types of care options shows the shift that American has taken in general and that is more quality of life, care, self care and comfort. It is no longer about the sterile hospital environment attempting to elongate life by every second possible, instead it is about the quality of life that is being lived. The effective coordination of a patient’s health care services is a key component of high quality and efficient care. Two relatively new models in health policy—the patient-centered medical home (PCMH) and Accountable Care Organizations (ACOs)—provide an opportunity to increase the extent and effectiveness of care coordination in the United States. The two models can work in tandem, with medical homes providing the direct coordination of services and Accountable care organizations (ACOs) providing the infrastructure and incentives to facilitate collaboration across different types of providers and organizations. The goal of reshaping is of course quality care at an affordable rate. A new type of cooperation between physicians, hospitals and other providers that cut down on duplication and unnecessary procedures and tests; that make the system accountable both for processes and outcomes; and that share economic risk among the providers. Cooperation can look like ACOs, or “bundling,” patient centered medical homes (PCMHs) and co-management.
References
Scott, W. R. “Managing Professional Work: Three Models of Control for Health Organizations.” Health Services Research 17 (Fall 2019), pp. 213-240
Weisbord, M. R. “Why Organization Development Hasn’t Worked (So Far) in Academic Medical Centers.” Health Care Management Review 1 (Spring 2019), p. 18.
Discussion 2
Describe how US hospitals in your region have been structured to accommodate the roles and decision-making autonomy of physicians.
One of the major hospital systems in Texas has begun partnering with primary care physicians and specialists so that patients have continuity of care. The PCPs and specialists have their individual practices where they can have autonomy over how they choose to care for their patients but have the ability to access a larger base of knowledge to help with the care they provide.
In your opinion how are medical homes and accountable care organizations reshaping the corporation of healthcare?
Medical homes and accountable care organizations are reshaping the corporation of healthcare by providing care on a continuum for their patients. The care they provide is value-based, not fee-based. They are focused on improving the quality of care while coordinating with qualified practitioners and medical providers.