Managing and maintaining a hospital, and ensuring that the patients get the highest quality medical services possible at the same time is, in reality, more complicated than how most people think it is. In fact, this is one of the biggest ethical dilemmas that not only hospital administrators but also allied medical practitioners face in this era of contemporary medicine.
Hospitals are technically classified as businesses because they would not be able to exist, operate, and offer medical services to patients that require them without money. Like businesses, these medical institutions cannot do without revenues and profits; they have a financial department that handles basically everything about income and expenses. Naturally, if after some time, the two ends were not able to meet; this may lead to bankruptcy which would lead to the termination of all hospital operations. In the end, it is not only the hospital workers who will suffer but ultimately, the patients.
Now where do the problems lie? What usually happens is that whenever a private medical center experiences financial pressure, say for example, the budget for medical services has been reduced to about 20 percent for the upcoming year, that pressure is usually transferred to the patients. How? One common manifestation of such is the decrease in the overall quality of medical services catered to the patients. Because hospital administrators would naturally do anything to make both ends meet and save the hospital from bankruptcy—which in my perspective would be a much bigger problem, the quality of hospital services would most likely be compromised. This is real and happening in a lot of medical centers, both private and public.
Healthcare practitioners such as physicians, nurses, physiatrists, medical technicians, etc. have sworn an oath that they will do everything that is in their power to provide the highest quality of healthcare to their patients possible. Sure they are equipped with the necessary skills to treat and manage a wide range of medical conditions, more so if they work as a team, but without proper equipment and funding, they are practically as good as nothing. No experienced medical practitioner would wish to be employed in poorly-funded hospital because that would be a significant drawback for their career. Well, there are cases wherein a medical practitioner stays despite receiving poor compensation and experiencing poor working conditions out of sheer dedication to his work but such cases are rather rare. No matter how we try to flip things, it will almost always boil down to money and funding. This is the sad but real fact in the medical industry today. Sure, there will be enough graduates to fill in the vacant positions, but the question is, would they really be motivated to fulfill their oaths—to deliver the highest quality healthcare to their patients possible, knowing the ugly side of the industry.
As a future clinical laboratory technician, I have long expected that I and other medical workers would encounter this kind of dilemma. We can always use our skills to manage and educate our patients about their conditions but without proper support from the government and/or private funding, these efforts would be wasted. There will come a time when medical practitioners will shift to other industries offering better opportunities. This is how economics work. It encompasses everything, even the healthcare sector.
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Kothari, A., et al. "Lessons from the Business Sector for Successful Knowledge Management in Health Care: A Systematic Review." BMC Health Services Resource (2011).
O'Reilly, M. "Hospitals Apply Business Techniques in Attempt to Cut Cost of Delivering Care." CMAJ (1993).