Positive Effects of Managed Care

Published: 2017-10-10 08:24:53
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The paper discusses management analysis. The focus is on the ways in which managed care affects the organization relationship with the buyers, sellers, general community, the government and the doctor-patient relationship. Managed care affects the above aspects as it acts as a link between doctors and each of the above aspects affecting direct contact, which lead to the impacts discussed. The paper also lightens most of the key aspects incorporated in management analysis. In healthcare, there is a need to ensure that there is good analysis to enable the institution to run quite effectively. From a healthcare perspective, managed care is essential, although to some extent; it affects how doctors and patients relate to one another.

Key words: Managed Care, Buyers, Sellers, Community, Government, Doctor-Patient Relationship

Managed Care Matters

Management is a term that explains ways and tactics used in institutions to ensure that they meet their set goals and objectives. In the healthcare context, there are some plans, techniques, efforts, and strategies used in the health center to achieve expected positive results. A proficient example of a body that plays key managerial functions is the Health Maintenance Organization (HMO) based in the United States. The body plays the fundamental role of arranging medical care in the health centers through the health insurance. Managed care schemes spread rapidly in the 1990s (Wiley, 2015). From the advent of the schemes in the 1990s, there have been impacts on the organizations’ relationship with their buyers, sellers, general community, and the government. A number of scholars based on their literature work would argue out that managed care came in as an intermediary factor that to some extend affected ways they applied to deliver prompt services in hospitals.

Managed care has affected the relationship between an organization and its buyers. Before the advent of the managed care schemes period, there was a direct relationship and contact between buyers and healthcare organizations (Millenson, 2012). Through the direct contact, healthcare personnel would pass buyers’ complaints and grievances to their manufacturers to ensure that healthcare meets their needs and requirements. Benefits from the direct contact ensured of satisfactory services to the buyers as they contribute to the nature of the commodity favorable for their use. In addition, direct contact played a key role as a way of delivering prompt services to buyers as they had a chance to opinionate on adjustments that organizations would make to ensure consumer satisfaction.

Managed Care Facility

Managed care also affects the relationship of the organization to its sellers. Organizations must have very good relationships with their sellers and people who distribute their products. To start with, such people play the key role in advertising the institution, which creates positive competition among the organization and other institutions of its kind. Sellers also create a good rapport with the clients and people they sell the product to during distribution. Managed care has reduced the use of salespersons as a means of distributing the product in the market and has denied the sellers to create management strategies to enable the organization to survive competition from other organizations (Robert, 2012). Positive organization enables to provide high quality services. Such effects could sense danger in future as the reduction of high competition might degrade the product quality.

Additionally, managed care affects the general community at large. The general community comprises of the people who utilize the services provided by the health centers. In the field of public health, the people ensure that the community receives mass education on maladies and the way one could survive with such conditions (Feldman, 2008). Examples include deadly diseases such as H.I.V and sexually transmitted diseases. Due to lack of mass education, community members could stigmatize an individual suffering the deadly disease. According to most scholars, managed care has led to reduction of health education that benefited the community in many ways.

Managed Care Setting

Managed care services have extended to affecting an organization’s relationship with the government. The government plays a crucial role in subsidizing of health care to ensure that health centers provide prompt services to the entire community. Managed care has affected that relationship. Most governments in a global context view managed care as a branch that makes the health centers quite stable on their own leading to them using most of the funds set aside as subsides for other purposes. To add on, the subsidizing role helped medical care to advance effectively in remote areas most people in remote areas face quite a huge number of challenges including feeling neglected. They could also hardly access private medical care as it is costly and they lack enough income to enable that access the medical care.

Managed care has affected the doctor-patient relationship through the challenge of secrecy. Most people would rather hold on to the signs, symptoms, parts affected or give physicians and doctors either half of the information or incomplete information about their conditions. Such acts are suicidal as they might lead to higher cases of misdiagnosis in a healthcare viewpoint (Robert, 2012). In comparison to the pre-managed care error, patients felt safe trading all the information to the doctors as it would remain a secret between the two. In the present world, managed care has affected such secrecy through its communication measures. Such circumstances makes patients doubt if they could confide their secrets to the doctors as the pre-existing secrecy status no longer exists (Salinas, 2016). To add on, managed care institutions affects patients as they hardly incorporates them in decision-making. Before managed care, patients would have a chance to choose treatment and medical measures before treatment. The reason behind this is that some patients have personal beliefs, traditional beliefs or religious faiths that do not allow them to take some treatment in hospitals. For the above reasons, patients should take part in treatment to ensure of satisfaction in the medical services one receives in hospitals (Millenson, 2012). Patient participation is a key factor that builds the patient doctor relationship and through the managed care, there has been dilution in the patient participation in medical care affecting the general doctor patient relationship.

How Managed Care Works

 Managed care deters doctors to exercise their ethical obligations. Ethics play a key role to ensure that there is secrecy in communication between doctors and patients. Some conditions, diseases and affected organs ought to remain a secret been the doctor and the patient (Millenson, 2012). The reason behind this is that some conditions affect one’s esteem and his or her relation with the entire community. Such situations make some patient not to open up with fears of their secrets moving out to more people through the managed care systems. In addition, doctors and physicians ought to respect a patient’s autonomy. A patient should have the right to have his or her independence in the reception of medical care. Such factors affect the doctor patient relation hindering providence of best services with medical ethics as the framework.

Managed care has affected the health care practitioners in a number of ways. Firstly, it has assumed the functions played by organizations to finance and provide healthcare. That has affected quite a number of roles initially played by the practitioners (Strand, 2008). A good example is the person playing the role of the initial care practitioner now plays the role of a mere gatekeeper. He or she now just functions as personnel who count the cost of containing a patient in the hospital and cost incurred during the patient’s care (Millenson, 2012). Most people view it as new venture that degrades positions initial roles that medical personnel used to play. That could have led to ignorance of most of the policies incorporated in health care through managed care by the personnel. Some scholars have predicted of managed care taking away most of the roles of medical professionals (Almaden, 2016). To add on, such problems stretch to some physicians not giving patients effective medical services, which shows damage in the doctor-patient relationship?

In conclusion, medical management is vital. However, medical management through managed care has quite a number of effects on organizations’ relationship with buyers, sellers, general community, the government and the patient –doctor relationship. In the providence of better services, the patient-doctor relationship should be effective and the relationship between an organization, its buyers, sellers, the government and general community should be good. Communication needs to be effective to ensure that there is secrecy and trust between the patients and the doctors. To add on, there should be direct contact between an organization and its buyers, sellers, government and general community for the organization to offer effective and provide prompt services. Managed care has hereafter affected the patient doctor relationship since its advent.

 

References

Almaden, S. (2016). Patient- Centered Medical Home Care (PCMH). Or Other Settings Continue To Call For Case Management Services: Will Utilization Review Role Become Muffled With That Call? Journal of Managed Care Nursing, Vol. 3, No. 2. Pp. 31-33.

Communication.

Feldman, D. Dennis H, and Edward. G. (2008). Effects of Managed Care on Physician-Patient Relationships, Quality of Care, and the Ethical Practice of Medicine. Journal of Arch Intern Med. Vol 158, No. 15. Pp. 1626-1632.

Millenson, M. (2012). Building a Better Care Relationship with Effective Doctor-Patient. Group practice journal. Vol. 5, No. 1. Pp. 12-14.

Robert, D. (2012). Patients and Doctors — the Evolution of a Relationship. The New England Journal of Medicine. Vol. 366, No. 1.  Pp. 581-585. DOI: 10.1056/NEJMp1110848

Salinas, M. (2016). Managing Inappropriate Requests of Laboratory Tests: From Detection to Monitoring. The American Journal of Managed Care. 

Strand, V. (2008). Improved Health-Related Quality Of Life With Effective Disease-Modifying Antirheumatic Drugs: Evidence From Randomized Controlled Trials. American Journal of Managed Care. Vol. 14, No. 4. Pp. 234-54.

Wiley, E. (2015). New Trade Agreements and what They May Mean for Public Health and Health Care. Official Journal of the World Medical Association, Vol. 61. No. 1. Pp. 1- 23.

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