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Question

A patient arrives at the emergency department and is admitted for increased pain with the source unknown. The on-call physician asks the intake staff, “What is the source of payment for the patient?” in order to assist with his decision to see the patient or not. The physician then declines to see the patient based on the insurance status.

What is the risk management issue presented in this scenario?

What do you propose to resolve the issues?
Step 1/2

Ans. 1 The risk management issue presented in this scenario is one of ethical and legal concern. The physician's decision to decline seeing the patient based on the patient's insurance status is a violation of the principle of non-discrimination in healthcare, as well as being a potential violation of the patient's rights to access medical care. This type of discrimination based on insurance status is illegal under the Affordable Care Act, which prohibits healthcare providers from denying medical care to patients based on their ability to pay. Importance of Promoting an Organizational Culture that Values Patient Essay

Explanation for step 1

Additionally, this scenario raises concerns about the physician's duty to provide adequate medical care to all patients, regardless of their financial status or insurance coverage. By declining to see the patient based on their insurance status, the physician is potentially putting the patient's health and well-being at risk, which can have serious consequences.
Furthermore, this type of behavior can also harm the reputation and credibility of the physician and healthcare organization, leading to potential legal and financial consequences, as well as loss of trust from the public and patients.
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Step 2/2

Ans. 2
To resolve this issue, a number of steps could be taken. Firstly, it is important to establish clear policies and procedures within the hospital or healthcare organization to ensure that all patients receive equal treatment, regardless of their insurance status. This can be achieved through education and training programs for healthcare staff, as well as through monitoring and enforcement of these policies.

Explanation for step 2

Additionally, it is important to promote an organizational culture that values patient-centered care and prioritizes the health and well-being of all patients, regardless of their insurance status. This can be accomplished through a commitment to continuous quality improvement and regular evaluation of the patient experience, as well as by recognizing and rewarding staff members who demonstrate a commitment to providing high-quality care to all patients.
Finally, it may be necessary to involve legal and regulatory authorities to address any instances of discrimination, such as filing a complaint with the appropriate state or federal agency. In cases where discrimination has caused harm to a patient, compensation or other remedies may be available.

Final answer

So, in this way this question can be answered. This is a sample answer and you should add your views too. Importance of Promoting an Organizational Culture that Values Patient Essay

Expert Answer

Question

A patient arrives at the emergency department and is admitted for increased pain with the source unknown. The on-call physician asks the intake staff, “What is the source of payment for the patient?” in order to assist with his decision to see the patient or not. The physician then declines to see the patient based on the insurance status. What is the risk management issue presented in this scenario? What do you propose to resolve the issues?

Step 1/2

Ans. 1 The risk management issue presented in this scenario is one of ethical and legal concern. The physician's decision to decline seeing the patient based on the patient's insurance status is a violation of the principle of non-discrimination in healthcare, as well as being a potential violation of the patient's rights to access medical care. This type of discrimination based on insurance status is illegal under the Affordable Care Act, which prohibits healthcare providers from denying medical care to patients based on their ability to pay. Importance of Promoting an Organizational Culture that Values Patient Essay

Explanation for step 1

Additionally, this scenario raises concerns about the physician's duty to provide adequate medical care to all patients, regardless of their financial status or insurance coverage. By declining to see the patient based on their insurance status, the physician is potentially putting the patient's health and well-being at risk, which can have serious consequences.

Furthermore, this type of behavior can also harm the reputation and credibility of the physician and healthcare organization, leading to potential legal and financial consequences, as well as loss of trust from the public and patients.

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Step 2/2

Ans. 2

To resolve this issue, a number of steps could be taken. Firstly, it is important to establish clear policies and procedures within the hospital or healthcare organization to ensure that all patients receive equal treatment, regardless of their insurance status. This can be achieved through education and training programs for healthcare staff, as well as through monitoring and enforcement of these policies.

Explanation for step 2

Additionally, it is important to promote an organizational culture that values patient-centered care and prioritizes the health and well-being of all patients, regardless of their insurance status. This can be accomplished through a commitment to continuous quality improvement and regular evaluation of the patient experience, as well as by recognizing and rewarding staff members who demonstrate a commitment to providing high-quality care to all patients.

Finally, it may be necessary to involve legal and regulatory authorities to address any instances of discrimination, such as filing a complaint with the appropriate state or federal agency. In cases where discrimination has caused harm to a patient, compensation or other remedies may be available.

Final answer

So, in this way this question can be answered. This is a sample answer and you should add your views too. Importance of Promoting an Organizational Culture that Values Patient Essay

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