Managed care is a collection of activities that includes the improvement of care, the provision of health insurance, along the reduction of the cost of healthcare. Relationships between patients, clinicians, purchasers, and health plans are fundamental in healthcare delivery and can be characterized by compassion, fairness, consistency, truthfulness, and respect (Corey & Corey, 2019).
Trust in Managed Care Environment
Trust is critical in the proper functioning of the relationship, maintaining patients’ confidence, and promoting the patient’s best interest. In addition to this, they ought to consider the quality and cost of a healthy population. In this case, truthful communication is crucial in the healthcare environment. The degree of honesty and openness impacts this communication (Corey & Corey, 2019). The relationship between patients and clinicians ought to be intimate and observe ethical obligations. The clinicians ought to provide truthful and accurate records based on their impact on the present and future healthcare delivery.
The public, health plans, clinicians, and purchasers should share responsibility for properly stewardship of healthcare resources. All the parties in this relationship ought to facilitate the creation of healthcare policy involving access to and quality of managed care environment. The unique needs of the patients ought to be respected along with those of the community at large (Corey & Corey, 2019). The contracts should illustrate the commitment to fairness, consistency, effective and quality healthcare.
The parties in the delivery of managed care ought to promote an ethical environment to deliver efficient and efficient quality healthcare. Healthcare organizations and health plans ought not to jeopardize professional, ethical standards. All parties ought to protect the confidentiality of healthcare information.
The patient has to be well informed about the treatment and care options and their benefits and consequences (Corey & Corey, 2019). This involves providing appropriate information supporting their informed consent and refusal of treatment. Furthermore, clinicians should disclose conflicts of interest to their patients.
Managed care ought to be provided by qualified individuals, including formal education through the attainment of medical diplomas and degrees. This facilitates the provision of quality medical treatments and provides education to the patients on how to optimize their health. The clinicians are also required to facilitate the administration of justice, such as the estimation of age, reporting of injury, post-mortem examination, and examining poisoning cases, paternity fixation, drunkenness, mental illness, and potency (Corey & Corey, 2019).
The healthcare practitioner has a right to be pointed in legal, public, and government hospitals. The clinicians are expected to be members of associations and societies to reduce patient suffering. They are also required to avoid engaging in fraud, stated in the Claims Act. In general, healthcare is a right that should be afforded to every individual regardless of their socio-economic status.
Medical Malpractice in Managed Care
Medical malpractice is a legal cause of action that occurs when a healthcare or medical professional commits an act, omission, or deviation from the profession’s standards. One of the conditions for malpractice to be filed, legal duty should exist. Medical professionals ought to provide care to the patients, which is part of their legal duty. The second condition is the breaching of the medical standards of care. There is a need to illustrate that the clinicians breached the standard of care.
The accusers ought to prove that the doctor deviated from the standards of medical care as required by the law (Corey & Corey, 2019). The medical negligence caused harm to the patient after the establishment of negligence through the breach of the standards of medical care. There has to be a causal connection between the clinician’s malpractice and the patient’s health. Further, there is a need for damages for the injuries caused by medical malpractice.
One of the grounds for medical malpractice includes the patient’s failure to diagnose the patient’s medical conditions. Much medical malpractice is caused by misdiagnosis and the failure to provide a timely diagnosis. A patient can also claim malpractice if they sustain the injury during the treatment process. The doctor may make mistakes during the treatment process. 31 percent of the physicians have been sued for injuring the patient, be it by using medical instruments, pharmaceuticals, and acts (Corey & Corey, 2019).
The third ground involves the failure to treat the condition suffered by the patient. If a clinician fails in treating a patient, it would be medical malpractice. Poor documentation is another ground for malpractice where the clinician fails to document patient care accurately. Medication errors are also ground for malpractice, which varies from the administration of drugs and the inclusion of dosage errors.
Malpractice Lawsuits in Managed Care
Avoiding malpractice lawsuits is one of the most effective risk management strategies in delivering managed care. This involves avoiding medical procedures that involve a high risk to the patient’s health. For example, a doctor not performing a surgical procedure citing the risk involved would be avoidance. The clinician can also avoid patients who have previously had malpractice cases, based on their high risk of claiming malpractice in this case.
Furthermore, patients who complain and often take offense should be avoided (Corey & Corey, 2019). In addition to avoidance, I would also practice professional etiquette by being more cognizant in their communication with colleagues and patients. I would also get more training on dealing with difficult patients who may be frustrating the staff, other patients, or me. UKessay.com is the most legit essay writing services on managed care.
