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Arlen Meyers, MD, MBA

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Are the ethics of healthcare compatable with the ethics of business?

Healthcare providers need to be profitable to serve patients. But, the interests of the patient are primary over the interest of profits. Are the two co-exist?
Is physician entrepreneurship a contradiction in terms?

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    Feb 3 2014: "The etymology of 'business' stems from the state of being busy, and implies commercially viable and profitable work." Wikipedia

    Heathcare is one form of business. In fact, it is one of the most profitable businesses. People who work for clinics and hospitals, i.e. healthcare admininstrators, doctors, nurses, and medical technicians are some of the best compensated workers and their positions are some of the most stable. People get sick and need healthcare all the time. Healthcare business is not seasonal, unlike some other types of businesses.

    Ethics, good business practices, and good customer service are expected regardless of the type of service or business. These are even more critical in the business of healthcare, where some cases are a matter of life and death.

    Good medicine and good business practices are compatible. To succeed in healthcare business, one has to practice good medicine and good customer service, including not gouging your patients just because you can.

    MD and MBA should not be contradiction in terms.
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      Feb 6 2014: And how do you achieve that when the human is a biological creature driven not only by compassion and altruism but also by instinctive physical desires, emotion, lust, anger, greed etc.
      Sadly we will never be rid of these qualities and they will always invade the 'busy' venues we interact in.
      This is alright when life is upheld, but when you could lose your life, or suffer interminably then I refuse to accept your syllogistic simplification of medicine. Medicine was a field DEVELOPED by compassionate and altruistic minds to actively perform the duty of helping our fellow humans without discriminating between economic classes.
      It Transcends all other form of commercial activity to allow itself the stature of being business that is not the slave of commerce.
      It is ok for a trader to refuse you processed food since it is possible for you to grow your own. Therefore payment for staple food may be contentiously regarded as acceptable. But if you are in severe pain, or you have been knocked by a bus and cannot breathe, then to insist on payment first is beyond inhuman.
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      Feb 7 2014: I agree Rodrigo, that health care is a business, and like all businesses, it depends on how it is managed. So I agree that good medicine and good business practices are compatible

      You say...
      "Ethics, good business practices, and good customer service are expected regardless of the type of service or business. These are even more critical in the business of healthcare, where some cases are a matter of life and death."

      If the business part of health care is not managed well, it often contributes to compromising the health of the customer. If the "managers" of health care are simply looking at the bottom line and profit, they may not be aware that the profits may be at the cost of the care they are providing.

      We had a good example of this locally years ago with the big teaching medical facility in the area. It was once on the top ten in the country for good care. The board of directors were apparently looking primarily at the bottom line profit. They decided to redecorate the lobby, at the cost of a couple million dollars, and at the same time, they were decreasing the nursing staff by about 300 nurses. A lot of people, including myself were appalled at this, and it certainly was not the only poor decision the directors made, but it was a very public one.

      I had a relative and friends who were patients in the facility at the time, and it was VERY clear that there was a shortage of nurses, as the construction for the new lobby was happening. As I said, there were a lot of other very poor decisions, and finally, there was so much public outcry, most of the members of the board of directors were terminated. There was a legal matter with the chair of the board as well, regarding money he accepted from contractors.

      On the other side, my doctor and her husband have a small practice in a small town and don't make a lot of money, while providing health care to a small community. I would say that an organization like doctors without borders is in this category as well.
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        Feb 7 2014: Thanks for your insightful testimony, Colleen. We need a peaceful revolution or, at least, constructive evolution in healthcare, education, and public administration.

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