The Role of Hospitals
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1. The existence of a hospital implies the existence of systems and structures of responsibility and appropriate practitioner and administrative roles that are clearly defined. Nothing about clarity of definition per se necessarily interfered with the limits of practitioner discretion or authority as far as the lines of administrative responsibility and power are concerned. Yet the case of Widener demonstrates the potential for misunderstanding when behavior of persons on the line needlessly conceals readily available information from recipients of care. It is as if the cardiologist failed to be fully informative to Widener because she did not wish to have to explain policy. On the other hand, the nurse down the line was in the position of justifying practitioner behavior, not on account of practitioner qualifications but on account of our system, our policy, our teaching hospital.The administrative policy structure, which was concealed from the patient before the operation, was used to pressure justification of medical behavior after the operation. Further, the policy was asserted as a practitioner's instrument of entitlement, with the presumption that a patient is not necessarily entitled to information that will help him make a decision but that the patient is obliged to accept the same information as justification for having been prevented from making the same decision. At minimum, Widener has been on the receiving end of a profoundly arrogant insult. Fortunately, not p
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he tickets with no one the wiser but then is found to have used them, the loss of public trust and the implication of cover-up are the minimal consequences of the entire transaction. Public exposure makes it also highly likely that the sales rep's attempt to do an end run around price-and-quality competition would have the effect of eliminating rather than ensuring his company's ability to make a sale.
The decision about whether to use the tickets seems comparatively uncomplicated if Stimson is CEO of a privately owned company. Such companies are presumed to be driven by a profit motive and are meant to compete to the best of their financial and strategic ability. Additionally, embedded in structures of competition and profit is the whole range of activities associated with marketing, production, and distribution. Thus it might be argued that whatever facilitates vendor-manufacturer rapport is both good business and good-faith marketing effort.
But the role of decision maker in any environment that intersects with the public good, as in the case of a nursing facility, is not of the same character as that of a decision maker in, say, a sporting goods store. Consider the obvious disconnect between hospital equipment and championsh
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Approximate Word count = 4684
Approximate Pages = 19 (250 words per page)
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