Doctor's Dilemma: A Case Study on Healthcare Management and Doctors

This case study, titled "Doctor's Dilemma," analyzes the challenges faced by Dr. John Matthews, a cardiac surgeon, when approached by Clinton Memorial Hospital. The study focuses on the impact of value-based healthcare, as mandated by the U.S. Department of Health & Human Services (DHHS), which prioritizes appropriate medical procedures to reduce unnecessary costs. The discussion explores benchmarks such as average length of stay, complication rates, and patient satisfaction to enhance healthcare quality. The assignment proposes an action plan for doctors that combines medical procedures, effective time management, and reduced mortality and morbidity rates. It also examines factors like re-hospitalization rates, the efficiency of the cardiology department, and the role of associative health care facilities. Bloom et al.'s schemes for operation, performance, target, and patient management are also discussed as key elements in improving healthcare efficiency. Ultimately, the case study aims to help doctors make conclusive decisions based on evidence-based research and international benchmarks, addressing challenges posed by new healthcare systems.

Running head: DOCTOR’S DILEMMA-A CASE STUDY
DOCTOR’S DILEMMA-A CASE STUDY
Name of the Student:
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Table of Contents
Introduction................................................................................................................................2
Discussion..................................................................................................................................2
Conclusion..................................................................................................................................5
References..................................................................................................................................6

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Introduction
Advanacement in medical procedures has paved the way for healthcare industry,
providing quality and timely care to the client. Financial accounting of numerous medical
procedures that are essential specifically in particular cases have become a quiescent part
while preparing healthcare facility management. U.S. Department of Health & Human
Services (DHHS) have postulated a value-based approach, rather than a volume-based
approach in medical care. It implies, determination of exact medical procedures and
diagnostics that are needed for each particular cases, preventing excessive cost of
unnecessary medical tests and procedures that burden patient’s family (Baker, Baker &
Dworkin, 2017). In this report, effectiveness of value-based approach on doctor or general
physician’s decisions to remain associated with healthcare organizations, are explored in
context to plausible benchmark that could be implemented to enhance the outcome.
Discussion
The case study focuses on understanding and decision-making factors as experienced
by a cardiac surgeon, namely, Dr. John Matthews, who was approached by Clinton Memorial
Hospital to sell his practice. Being aware of DHHS regulations of value-based approach,
which constrains practice of unnecessary medical procedures and penalizes via payment
deduction, the doctor, is skeptical about how it would affect his routine practice and
diagnostic parameters along with hospital administration. Although, he has referred patients
to the respective hospital, endangering his independence of private-practice is a formidable
factor that is involved in this case.
Certain benchmarks could be applied to help resolve the challenges faced by doctors.
‘Benchmark’ data obtained from top institutes, are studied elaborately and implemented

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across all the healthcare industries to enhance quality care and disease assessment. Increasing
competition among healthcare industries has made resource management along with patient
satisfaction and minimum average length of stay (ALOS), a mandatory strategic response
(Jones, 2013). Eliminating surgical infections and medical errors (Anderson et al., 2014) are
key factors for patient satisfaction, including a better understanding of the mental status of
the client and reducing cost for medical treatment. Enhancement in this area could be
achieved by comparing evidence-based practices and optimizing areas that are lacking. Some
key points that needs to be addressed are- Average length of stay, rate of complication, rate of
infection, surgical site infections, efficacy of pathology labs, possibilities of tumor formation,
re-hospitalization rate, mental health and satisfaction of the patient. Analysis of all these
factors and deriving an action plan for the doctors, combining various medical procedures to
reduce misunderstanding of medical conditions, along with an effective time management
and significant decrease in mortality and morbidity rates of admitted patients, should be
devised.
Re-hospitalization rates or re-admission to ICU can be a critical factor to determine
efficiency of clinical supplements and efficacy of the diagnosis prescribed by the medical
practitioner (Bradley et al., 2013). In the abovementioned scenario, efficiency of cardiology
department could be examined by accounting mortality rates per month, adverse effects of
prescribed drugs, number of MRSA victims, costs and success rate of implants (like
angioplastic stain, pacemaker) and CABG, unscheduled readmission to ICU. These data
provide the necessary information and measures that should be commenced to reduce risks in
cardiac patients. Associative health care facilities like pathological tests, medical
technologies like MRI and CT scan unit, availability of emergency ambulance could also be
included in this analysis to ensure a proficient healthcare management system (Von Eiff,
2015).

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Efficiency of healthcare management could be addressed by the schemes provided by Bloom
et al., (2009)-
1. Operation Management
 A flexible layout and resource distribution to meet variable patient flow.
 Tuning clinical protocols and legitimate changes in health insurance policies
according to client circumstances.
2. Performance Management
 Weekly or monthly sessions involving medical and non-medical staffs to
discuss about performance and potential areas of improvement.
 Preparation of statistical data to measure the efficacy of the implemented
strategies along with worker’s ability to fulfill assigned objectives .
 Elaborate meetings concerning root causes and plausible solutions.
3. Target Management
 Specific targets for employees that will cumulatively produce enhanced results
in a broader scale (beneficiary for the healthcare institution).
 Integration of short, properly sequenced, achievable targets to achieve larger
goals.
4. Patient Management
 Providing critical appraisal for the top performers and reward them for their
contribution.
 Removing lacking performers from their respective field and replacing them
with eligible candidates.
 Taking feedback from the patient and patient’s family to determine efficiency
of strategies implemented.

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Conclusion
Various evidence-based research methodologies, targeted to examine the efficacy of
current healthcare management and modulations ensuring further enhancement in this area
could help the doctor to reach a much conclusive decision. Coping to a new system always
poses challenges for both doctors and healthcare administrators. Therefore, international
benchmarks should be assessed, and suitable implementation of strategies are required to
resolve the problems faced by medical professionals and in healthcare industries.

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References
Anderson, D. J., Podgorny, K., Berrios-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene,
L., ... & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care
hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88.
Baker, J. J., Baker, R. W., & Dworkin, N. R. (2017). Health care finance. Jones & Bartlett
Learning.
Bloom, N., Propper, C., Seiler, S., & Van Reenen, J. (2009). Management practices in
hospitals. Manuscript, London School Econ.
Bradley, E. H., Curry, L., Horwitz, L. I., Sipsma, H., Wang, Y., Walsh, M. N., ... &
Krumholz, H. M. (2013). Hospital strategies associated with 30-day readmission rates
for patients with heart failure. Circulation: Cardiovascular Quality and
Outcomes, 6(4), 444-450.
Jones, R. (2013). Average length of stay in hospitals in the USA. British Journal of
Healthcare Management, 19(4), 186-191.
von Eiff, W. (2015). International benchmarking and best practice management: in search of
health care and hospital excellence. In International Best Practices in Health Care
Management (pp. 223-252). Emerald Group Publishing Limited.