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Healthcare and Social Media

Social media has been introduced to the healthcare industry and has made a global shift in how patients and healthcare professionals connect.  Physicians are now utilizing websites such as Facebook, Twitter, Instagram, and Tumblr to make their social media presence known. Most healthcare professionals use these sites to interact with their current and future patients and also to blog their ideas about certain healthcare topics such as birth control and weight loss.  These websites can provide some beneficial information to patients and also encourage dialogue between patients and providers, however if taken out of context, these website can pose some major ethical issues. Some ethical dilemmas that can derive from healthcare and social media sites include the distribution of medical advice via the social network, discussion of private health issues, improper contact with patients, inappropriately diagnosing patients, and misrepresentations of credentials among others (Lee, 2012). 

Such violations can result in disciplinary actions against the physician such as suspension of medical license or revoking a physician’s license all together (Lee, 2012).

A recent study conducted on 48 state medical boards reported that 44 of them have received reports of violations of online professionalism (Lee, 2012). The violations ranged anywhere from physicians asking their patients out on dates, to insulting their patients for their poor healthcare habits.  Other violations were severe enough to breach HIPPA laws such as that of a medical student videotaping a doctor inserting a chest tube into a patient whose face was clearly visible and then posting the video on YouTube (Lee, 2012).

Cases such as these can have major implications on the physicians and can cause them to lose their license to practice. It is important that physicians use better judgment when using social media sites for both professional and personal use. Although the physicians may not intend to cause harm to patients, use of social media can ultimately cause more harm than help.

Reference:

Lee, S. M. (2012). Social media in health care create risks, benefits. San Francisco Chronicle , Retrieved from http://www.sfgate.com/health/article/Social-media-in-health-care-create-risks-benefits-3650284.php

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Developing an Accountability Framework

Recently during my Healthcare Quality class we completed an assignment about accountability in healthcare and the key forces in which accountability is driven by. Accountability in healthcare is defined as “the procedure and process by which one party provides a justification and is held responsible for its actions by another party who has an interest in the action”. (Ransom, Joshi, Nash & Ransom, 2009) After learning about accountability I took the time to research further into the matter. A subject regarding accountability explained the development of and accountability framework. Simply put, accountability is maintained through two mechanisms known as accreditation standards and report cards. The first mechanism; Accreditation, are  standards that are generally maintained by The Joint Commission on Accreditation of Healthcare Organization (JACHO) and the National Committee for Quality Assurance (NCQA) These two organizations have standardized systems for accrediting hospitals and managed care organizations (McGlynn, 1997) . The other mechanism; report cards have been developed to maintain accurate records of hospitals, health plans, and physicians. For instance, information such as hospital mortality rates and procedure specific reports are released as public knowledge which as a result holds these facilities accountable for maintaining quality care for their patients. The most common example of a report card was developed by the NCQA’s Health Plan Employer Data and Information Set (HEDIS) (McGlynn, 1997).

The use of report cards as public knowledge is useful in developing an accountability framework because it allows the public to be aware of the type of care the facility is providing. The information provided in these reports cards requires each facility to be responsible for the information and record keeping for their facility (McGlynn, 1997). Once this information has been made public, the rise in quality will continue due to the facility being under direct comparison with similar facilities. I think the use of report cards to develop and accountability framework is a great idea. This will not only be and comprehensible tool for the public but it will also give mangers of facilities the opportunity to compare and complete external benchmarking quickly and efficiently.

Reference:

McGlynn, E. A. (1997). Six challenges in measuring the quality of health care. Health Affairs , 16(3), 7-21. Retrieved from http://content.healthaffairs.org/content/16/3/7.full.pdf

Ransom, E., Joshi, M., Nash, D., & Ransom, B. (2009).The healthcare quality book, vision, strategy, and tools. (2 ed.). Washington, DC: Health Administration Pr.

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Providing care with minimal benefit

Nurses and doctors in hospital settings are often troubled with having to care for terminally ill patients with no possibility of making a full recovery. These patients are often in the Intensive Care Unit which is a very stressful environment to work in. After working for several months on a patient who shows no progress, some nurses may feel that their effort is going to waste on a patient who should not be in their care. Cases such as that of Terri Schiavo, who remained in the hospital in a vegetative state for over 15 years due to a lengthy court case between family members is a perfect example for this blog. Not only did Mrs. Schiavo require around the clock care, but she showed no signs of improvement and nurses and doctors were constantly under attack when the court case became public knowledge. As a nursing manager or CEO of the hospital it is important to keep the moral of staff members working in such a stressful situation, although it is often a difficult task to take on.

Although it may be difficult for the families to make decisions about the end of life care, I think it is important for families to understand the role of the hospital. Hospitals are not designed to house patients without any possibility of recovery. They were built to treat, cure, and discharge patients that are able to do for themselves. Although I do believe that families should have all the time they need to make the right decisions for their loved ones, I strongly believe that once the doctor has stated there is nothing else that can be done, families should utilize the hospice facilities. These types of facilities are designed to care for patients who are facing end of life decisions. The staff members are trained to provide quality care and help families make the best choices for their loved ones. Families should not look at hospice care as a place that has given up on their loved ones, rather a place that will provide the best possible care for their loved ones in their current state. 

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Doctors withholding medical treatment information

Recently a study conducted by the American Medical Association’s Institute of Ethics revealed that 30 % of more than 700 doctors surveyed stated that they sometimes withhold medical information about treatment options from patients they believe will not be able to afford it (Stanculescu, 2012) . On the contrary to this survey, according to the AMA’s code of medical ethics, physicians have been obliged to assure the release of medically appropriate treatment alternatives, regardless of cost (Stanculescu, 2012). Some of the reasons doctors have begun withholding information from patients is from the fear of being asked to cheat insurance companies so that patients can receive care they are not eligible for. Another reason stems from those doctors whose revenue is tied to managed care companies. However, many doctors who participated in the survey stated that time constraints is the number one difficulty and reason for withholding medical information. Doctors are expected to explain difficult medical information to patient’s who often don’t have the time to comprehend (Stanculescu, 2012).

Although there are doctors who believe in censoring medical information based on a patients inability to pay, there are other medical professionals who believe that the act of withholding information is wrong. These professionals argue that doctors can be wrong about the medical coverage or the patient may have other resources which are unknown by the doctor. It is a known fact that many health insurance plans do not cover liver transplants, however thousands of transplants take place every year through private donations of organizations (Stanculescu, 2012). All in all, these medical professionals should not consider cost when prescribing treatment as finances is not an ethical issue, as patient care is.

I would have to agree that doctors should not withhold medical information from patients. The financial ability or inability to pay for treatment should not be a factor when prescribing treatment to the patient. It is up to the patient to provide the financial resources to pay for the treatment. Many doctors stated that they felt bad if they had to tell a patient about a treatment that they could not afford, however if I were in their shoes, I would rather tell the patient about the treatment and they have a chance to receive the help they need rather than withhold the information and never give them the chance at life.

Reference:

Stanculescu , C. (2012, July 08). Are doctors withholding treatment info?. Retrieved from http://abcnews.go.com/Health/story?id=116722&page=1