Emergency Physicians' Ethical Issues with Hospital Business Models.

emergency physicians ethics healthcare access hospital business models patient care

Journal

The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174

Informations de publication

Date de publication:
12 Mar 2024
Historique:
received: 15 08 2023
revised: 25 12 2023
accepted: 06 03 2024
medline: 27 5 2024
pubmed: 27 5 2024
entrez: 26 5 2024
Statut: aheadofprint

Résumé

The changing hospital business model has raised ethical issues for emergency physicians (EPs) in a healthcare system that often prioritizes profits over patient welfare. For-profit hospitals, driven by profit motives, may prioritize treating patients with lucrative insurance plans and those who can afford expensive treatments. Private equity investors, who now own many for-profit hospitals, focus on short-term financial gains, leading to cost-cutting measures and pressure on EPs to prioritize financial goals over patient welfare. Nonprofit hospitals, mandated to provide charity care to the underserved, may fail to meet their community service obligations, resulting in disparities in healthcare access. This review examines the ethical challenges faced by emergency physicians (EPs) in response to the evolving hospital business model, which increasingly prioritizes profits over patient welfare. Emergency physicians face ethical dilemmas in this changing environment, including conflicts between patient care and financial interests. Upholding professional ethics and the principle of beneficence is essential. Another challenge is equitable access to healthcare, with some nonprofit hospitals reducing charity care, thus exacerbating disparities. EPs must uphold the ethical principle of justice, ensuring quality care for all patients, regardless of financial means. Conflicts of interest may arise when EPs work in hospitals owned by private equity firms or with affiliations with pharmaceutical companies or medical device manufacturers, potentially compromising patient care. Emergency physicians must navigate these ethical issues while upholding professional ethics and advocating for patients' best interests. Collaboration with hospital administrators, policymakers, and stakeholders is vital to address these concerns and prioritize patient welfare in healthcare delivery.

Sections du résumé

BACKGROUND BACKGROUND
The changing hospital business model has raised ethical issues for emergency physicians (EPs) in a healthcare system that often prioritizes profits over patient welfare. For-profit hospitals, driven by profit motives, may prioritize treating patients with lucrative insurance plans and those who can afford expensive treatments. Private equity investors, who now own many for-profit hospitals, focus on short-term financial gains, leading to cost-cutting measures and pressure on EPs to prioritize financial goals over patient welfare. Nonprofit hospitals, mandated to provide charity care to the underserved, may fail to meet their community service obligations, resulting in disparities in healthcare access.
OBJECTIVE OBJECTIVE
This review examines the ethical challenges faced by emergency physicians (EPs) in response to the evolving hospital business model, which increasingly prioritizes profits over patient welfare.
DISCUSSION CONCLUSIONS
Emergency physicians face ethical dilemmas in this changing environment, including conflicts between patient care and financial interests. Upholding professional ethics and the principle of beneficence is essential. Another challenge is equitable access to healthcare, with some nonprofit hospitals reducing charity care, thus exacerbating disparities. EPs must uphold the ethical principle of justice, ensuring quality care for all patients, regardless of financial means. Conflicts of interest may arise when EPs work in hospitals owned by private equity firms or with affiliations with pharmaceutical companies or medical device manufacturers, potentially compromising patient care.
CONCLUSION CONCLUSIONS
Emergency physicians must navigate these ethical issues while upholding professional ethics and advocating for patients' best interests. Collaboration with hospital administrators, policymakers, and stakeholders is vital to address these concerns and prioritize patient welfare in healthcare delivery.

Identifiants

pubmed: 38797612
pii: S0736-4679(24)00068-4
doi: 10.1016/j.jemermed.2024.03.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Kenneth V Iserson (KV)

Department of Emergency Medicine, The University of Arizona, 4930 N. Calle Faja, Tucson, Arizona. Electronic address: kvi@u.arizona.edu.

James H Paxton (JH)

Department of Emergency Medicine, Wayne State University School of Medicine, University Health Center (UHC), Detroit, Michigan.

Daniel R Martin (DR)

Department of Emergency Medicine, Ohio State University, Columbus, Ohio.

Evie Marcolini (E)

Department of Emergency Medicine, Geisel School of Medicine at Dartmouth, Dartmouth Health, Lebanon, New Hampshire.

Classifications MeSH