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Medical School Ethics versus Business School Ethics

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Is Business Finally Embracing Medical Values?

[By Render S. Davis MHA CHE]

[By David Edward Marcinko MBA]

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In the evolutionary shifts in models for medical care, physicians have been asked to embrace business values of efficiency and cost effectiveness, sometimes at the expense of their professional judgment and personal values.

While some of these changes have been inevitable as our society sought to rein in out-of-control costs, it is not unreasonable for physicians to call on payers, regulators and other business parties to the health care delivery system to raise their ethical bar.

Tit-for-Tat

Harvard University physician-ethicist Linda Emmanuel noted that “health professionals are now accountable to business values (such as efficiency and cost effectiveness), so business persons should be accountable to professional values including kindness and compassion.”

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face-off

[Medicine versus Business]

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Assessment

Within the framework of ethical principles, John La Puma, M.D., wrote in Managed Care Ethics, that “business’s ethical obligations are integrity and honesty.

Medicine’s are those plus altruism, beneficence, non-maleficence, respect, and fairness.”

About the Author

Render Davis was a Certified Healthcare Executive, now retired from Crawford Long Hospital at Emory University, in Atlanta, GA He served as Assistant Administrator for General Services, Policy Development, and Regulatory Affairs from 1977-95.  He is a founding board member of the Health Care Ethics Consortium of Georgia and served on the consortium’s Executive Committee, Advisory Board, Futility Task Force, Strategic Planning Committee, and chaired the Annual Conference Planning Committee, for many years.

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Conclusion

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Emotional Intelligence [EQ] in Medicine

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The Five Basic Non-Cognitive Competencies

[By Render S. Davis MHA CHE]

[By Dr. David Edward Marcinko MBA]

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Many of us have encountered a person who may intellectually be at upper levels, but whose ability to interact with others appears to that of one who is highly immature.

This is the individual who is prone to becoming angry easily, verbally attacks co-workers, is perceived as lacking in compassion and empathy, and cannot understand why it is difficult to get others to cooperate with them and their agendas

[THINK: Sheldon Cooper PhD D.Sc MA BA of the The Big Bank Theory TV show].

Enter Daniel Goleman

The concept of Emotional Intelligence [EQ] was brought into the public domain when Daniel Goleman authored a book entitled, Emotional Intelligence.”

According to Goleman, emotional intelligence consists of four basic non-cognitive competencies: self awareness, social awareness, self management and social skills. These are skills which influence the manner in which people handle themselves and their relationships with others.  Goleman’s position was that these competencies play a bigger role than cognitive intelligence in determining success in life and in the workplace.

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robo

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Five Domains

He and others contend that emotional intelligence involves abilities that may be categorized into five domains:

  • Self awareness: Observing and recognizing a feeling as it happens.
  • Managing emotions: Handling feelings so that they are appropriate; realizing what is behind a feeling; finding ways to handle fears and anxieties, anger and sadness.
  • Motivating oneself; Channeling emotions in the service of a goal; emotional self control; delaying gratification and stifling impulses.
  • Empathy: Sensitivity to others’ feelings and concerns and taking their perspective appreciating the differences in how people feel about things.
  • Handling relationships: Managing emotions in others; social competence and social skills.

Source: Emotional Intelligence: what is and why it matters” – Cary Cherniss, PhD, presented at the annual conference of the Society of Industrial and Organizational Psychology, April 2000.

The Importance of Emotional Intelligence in the Workplace

Mike Poskey, in “The Importance of Emotional Intelligence in the Workplace.” continued his definition by stating that emotional intelligence is considered to involve emotional empathy; attention to, and discrimination of one’s emotions; accurate recognition of one’s own and others’ moods; mood management or control over emotions; response with appropriate emotions and behaviors in various life situations (especially to stress and difficult situations); and balancing of honest expression of emotions against courtesy, consideration, and respect.

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head

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A Set of Competencies

In 1995, Goleman then expanded on the works of Howard Gardner, Peter Salovey and John Mayer. He further defined Emotional Intelligence as a set of competencies demonstrating the ability one has to recognize his or her behaviors, moods and impulses and to manage them best, according to the situation.

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***

Assessment

So, how does all this relate to medical practice today? Please … do tell us!

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

About the Co-Author

Render Davis was a Certified Healthcare Executive, now retired from Crawford Long Hospital at Emory University, in Atlanta, GA He served as Assistant Administrator for General Services, Policy Development, and Regulatory Affairs from 1977-95.  He is a founding board member of the Health Care Ethics Consortium of Georgia and served on the consortium’s Executive Committee, Advisory Board, Futility Task Force, Strategic Planning Committee, and chaired the Annual Conference Planning Committee, for many years.  

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On Ethical Patient Advocacy

Medical Ethics in the Modern Era

By Render S. Davis MHA, CHE

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Few areas of life are as personal as an individual’s health and people have long relied on a caring and competent physician to be their champion in securing the medical resources needed to retain or restore health and function.

Nevertheless, this philosophy is currently in flux.

Foundation of Medicine

For many physicians, the care of patients was the foundation of their professional calling. However, in the contemporary delivery organization, there may be little opportunity for generalist physician “gatekeepers” or “specialty hospitalists or intensivists” to form a lasting relationship with patients.  These institution-based physicians may be called upon to deliver treatments determined by programmatic protocols or algorithm-based practice guidelines that leave little discretion for their professional judgment.

Personal Values

In addition, the physician’s personal values may be impeded by seemingly perverse financial incentives that may directly conflict with their advocacy role, especially if a patient may be in need of expensive services that may not be covered in their insurance plan, or are beyond the resources of a patient’s HSA or savings account.

Assessment

Marcia Angell, MD., noted during a PBS interview that the “financial incentives directly affecting doctors…put them at odds with the best interests of their patients … and it puts ethical doctors in a terrific quandary.”

Conclusion

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