Article on Medical Care Quality

of Care and Health Reform: Complementary or Conflicting)

Citation: American Journal of Law & Medicine, Spring-Summer 1994 20

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Subjects: Medical care_Quality control

Medical care, Cost of_Analysis

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Abstract: Responsibility for defining medical care quality, delivering quality medical care and bearing the burden of liability for lack of quality needs to be refocused away from the physician and vested with health care plans, patients and payers. Placing decision-making in the hands of individuals that did not have to face cost constraints has resulted in highly interventionist care that has become too costly. Patients, who ultimately pay for health care directly or indirectly, have been separated from the decision-making process by medical professionals and health care plans.

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Full Text COPYRIGHT American Society of Law & Medicine Inc. 1994

Implicit in any discussion of quality in health care are ideas about responsibility: who is responsible to define quality, who is responsible to deliver it, and who is responsible when the quality of care is unsatisfactory. The thesis of this arti

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icy, should no longer be based on the unusual needs of particular individuals. Reciprocally, we cannot afford to overturn otherwise justified policies simply because they do not serve a particular individual. In medicine as in law, hard cases make bad policy. The fact that a patient was not well served by a standard medical practice does not, of itself, mean that the practice is undesirable or should be changed. Unlimited funding might once have made it possible, perhaps even reasonable, to broaden standards to cover not just the majority, but also the unusual or extreme needs of particular individuals. But under financial constraints, courts must accept the fact that even the best medical policies will sometimes adversely affect individuals.(38) Second, courts' expectation that physicians will deliver an essentially uniform standard of care is now belied by the economic realities of stratified scarcity. Physicians working in inner-city public hospitals cannot always deliver the level of care that prevails elsewhere in the community.(39) And yet the affluence-based legal expectation of a uniform standard of care remains.(40) Physicians are potentially liable for offering lesser care in such situations, although the resource sho
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Some common words found in the essay are:
Liabilities Artesian, Court Washington, RESPONSIBILITY Surely, RESPONSIBILITIES Legal, RESPONSIBILITY Contemporary, ECONOMIC AGENTS, Domestic Product, PRIMARY LEVEL, Reducing UR, INTRODUCTION Implicit, health care, quality care, standard care, economic agents, tort law, quality health care, quality health, physicians deliver, ownership control, medical decisions, economic changes, health care plans, pay health care, ethical medical legal, health care requires,
Approximate Word count = 9692
Approximate Pages = 39 (250 words per page)

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