September 05, 2014
Patient-physician relation is the vital element of medical practice. International Code of Medical Ethics states, “A physician shall owe his/her patient complete loyalty and all the scientific resources available to him/her.” Ideally, it is the physician’s experience and clinical training that helps him or her gauge the situation and decide on the patient’s future course of treatment. However, the physician has to take into consideration a host of issues such as pressure to use new equipment as a marketing strategy, insurance or even a lawsuit filed by the patient because the physician inadvertently overlooked into the diagnosis. These matters may seem like a one in a hundred cases, but they are not so rare. Although most doctors make correct or at least the best possible decision taking into consideration the patient’s health, there are factors influencing the decision making process. Here are some of the major problem areas that need a careful understanding before a physician makes a decision.
This is one of the biggest influencers in making decision. While 15% of them do not exercise any influence, about 50%influence little influence. However, 35% patients exercise a major influence on the physicians. They demand an extra test to exercise extra caution. Although physicians try to educate the patients on the unnecessary treatments, there are many who give in so as to avoid losing the patient to a potential competitor.
Everybody fears the law. Therefore, a major influence on decision making is thanks to the defensive mechanism. Studies suggest that physicians not only order tests to protect themselves, but also change ways of practice when the risk of malpractice increases.
Reimbursements are clearly a matter of concern. 70% doctors have actually admitted that they take the reimbursement and revenue into account while deciding on procedures and tests to be performed. This is one reason why reimbursement reforms and pay for performance have garnered so much attention recently. Since the key to healthcare cost control is the physician’s decision, many think that financial carrots and sticks are a way to change them.
Pressure from Administrators
Hospital administration exercises extreme pressure on their panel of doctors. This is true although many doctors say they face no pressure at all. There are hospitals that pressurize the physicians into getting the patient admitted in the hospital for a specified number of days so that the hospital revenue gets added. Sometimes, they even ask the physicians to prescribe the patients specific tests which may be completely unnecessary. This is especially the case if the hospital has new equipment in place. Patient undergoing testing using the new equipment is simply a marketing strategy by the hospital administration.
Pressure from Third Party
Pharmaceuticals and other such third party companies also pressurize the physicians into recommending their drugs and other such products for the patients. This is another marketing strategy by the companies to popularize and market their products. Physicians attached to hospitals often find it difficult to elude this interference since there is immense pressure from both pharmaceutical companies as well as hospital administration.
If treated individually, the above causes do not influence the decision. However, when they come together, it plays a huge role on the morale of the physician and thus influences the decision making prowess.