Physician’s duty doesn’t shrink as health care organizations get bigger

Physicians increasingly find themselves employed by large organizations in the health sector. Distributing authority and responsibility in health care environments is a function of a clinician’s professional background and training. These distributions influence how organizations wield power and influence encounters and relationships among clinicians, patients and other stakeholders.

The March issue of the AMA Journal of Ethics® (@JournalofEthics) features numerous perspectives on wielding organizational influence in health care and gives you an opportunity to earn CME credit. Don’t miss these articles:

1. “How Should Commerce and Calling Be Balanced?”

   1. Corporatization in health care has complicated clinicians’ and organizations’ efforts to balance interests of individual patients against an organization’s bottom line.

2. “What Should Physicians Consider Prior to Unionizing?”

   1. Some physicians who value collective bargaining remain concerned that patient services could suffer, but unionization can be driven by a focus on improving care.

3. “How Should Organizations Respond to Repeated Noncompliance by Prominent Researchers?”

   1. Institutional review boards must report human subject research protocol deviations and university leadership might also need to motivate compliance with federal regulations.

4. “What Should Health Care Organizations Do to Reduce Billing Fraud and Abuse?”

   1. Upcoding and misrepresenting clinical information constitute fraud, cost a lot, and can result in patient harm and unnecessary procedures and prescriptions.

The journal’s March podcast features expert Tara Montgomery. She founded Civic Health Partners, an organization dedicated to accelerating culture change in health care. She discusses how to identify and respond to health care organizational cultural influences on service delivery and quality.

Zackary Berger, MD, is an associate professor in the division of general internal medicine at Johns Hopkins and faculty in the Johns Hopkins Berman Institute of Bioethics in Baltimore. Dr. Berger’s work focuses in part on health care for undocumented immigrants. In the podcast, he discusses physician advocacy and how to motivate organizational change.

Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

The AMA Journal of Ethics CME module, “Ethics Talk: How to Change Organizational Culture” is designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™.   

The offering is part of the AMA Ed Hub™, an online platform that brings together high-quality CME, maintenance of certification, and educational content—in one place—with relevant learning activities, automated credit tracking and reporting for some states and specialty boards.   

Learn more about AMA CME accreditation. 

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication. The journal also invites original photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

Upcoming issues of the AMA Journal of Ethics will focus on anesthesiologist-surgeon relationships as well as sharing health decisions. Sign up to receive email alerts when new issues are published.

If you’re in Chicago during the summer of 2020, join the AMA Journal of Ethics in supporting art, medicine, and the exhibit, “Portraits in Health Care,” featuring paintings of patients and caregivers by artist Mark Gilbert, PhD.