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After reading chapters 1 and 2 of the McLaughlin & McLaughlin text, what three things can you now see as problems directly associated with our “Industrializing Structure for Delivery”? Utilize and support your opinion with research from the text and outside readings.
Your thread is due by 11:59 p.m. (ET) on Thursday, and your two replies are due by 11:59 p.m. (ET) on Saturday.
I need one Main Post (Minimum 400 words) and two Responses (200-250 Words each)
Below are the specific requirements for each part of this assignment.
THREADS:
· Must be at least 400 words.
· A minimum of one source is required (course textbook may be used).
· Citations used should be formatted in APA.
· Should thoroughly address the topic prompt, using citations as appropriate.
REPLIES:
· Must post at least two 200–250-word replies to your classmates per forum.
· Should expand upon ideas expressed in your classmates’ threads by adding new ideas to points that you agree with and/or explaining areas of disagreement.
· Should be posted intermittently throughout the forum. Do not complete all of the replies at one time; instead, allow for conversation to develop by posting multiple times throughout the week.
· A minimum of one source per reply is required (course textbook may be used).
· Citations used should be formatted in APA.
I have attached the Discussion Rubic as to how the Main post and Responses would be Graded. Please follow every single Instruction. There is a Video attachment too that will help in doing the work
I have also attached the Main post of two students you need to respond to. Please send me the main post as well as the responses
Required Resources:
McLaughlin, C. P., & McLaughlin, C. D. (2015). Health policy analysis: An interdisciplinary approach (2nd ed.). Sudbury, MA: Jones and Bartlett. ISBN: 9781284037777.
American Psychological Association. Publication manual of the American Psychological Association (Current ed.). Washington, DC: Author.
Iverson, C, Christiansen, S, & Flanagin, A. AMA Manual of Style: A Guide for Authors and Editors Current ed. New York, NY: Oxford University Press.
HLTH 556 Discussion Board Rubric
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Criteria
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Levels of Achievement |
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Content 70% |
Advanced 92-100% (A) |
Proficient 84-91% (B) |
Developing 1-83% (< C) |
Not present |
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Demonstrates content mastery and a well-rounded understanding of the issue. 1 8 points
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18- 16.5 points All posts display clear content mastery, and relate precisely to the assigned topic. |
16.49- 15.0 points All posts are related to the assigned topic, but do not provide evidence of subject mastery. |
14-1 points Posts are loosely related to the assigned topic, and do not effectively contribute to the development of the discussion. |
0 points Does not provide evidence of subject mastery. |
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Articulates a clear position on the topic with academic support. 1 8 points |
18- 16.5 points
Posts are balanced in their approach to the topic, but provide evidence of a clear, well-researched position on the topic. |
16.49- 15.0 points
Posts are mostly balanced, but do not provide evidence of a firm position derived from research or current literature. |
14-1 points
Posts show a clear bias, or do not provide a discernable position on the issue. Evidence of research is not present. |
0 points
Does not display evidence of individual thought or topical research. |
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Contributes to the overall discussion through relevant, substantive posts. 17points |
17-15.5 points Unique contributions are made to the discussion in both the original thread and two responses. |
15-14 points Contributions are made through an initial thread and two responses, but are definitional in nature. |
13-1 points Contributions made are minimal, and are derivative in nature. |
0 points
Contributions to the discussion are nominal.
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Structure 30% |
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Grammar and Spelling 8 points |
8-7.4 points Correct spelling and grammar used throughout essay. Posts contain fewer than 2 errors in grammar or spelling that distract the reader from the content. |
7.3 – 6.7 points Posts contain fewer than 5 errors in grammar or spelling that distract the reader from the content. |
6.6-1 points Posts contain fewer than 8 errors in grammar or spelling that distract the reader from the content. |
0 points
Posts contain greater than 8 errors in grammar or spelling that distract the reader from the content.
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APA Format Compliance 8 points |
8-7.4 points
Minimal errors (1-2) noted in the interpretation or execution of proper APA format. |
7.3 – 6.7 points
Few errors (3-4) noted in the interpretation or execution of proper APA format. |
6.6-1 points
Numerous errors (5+) noted in the interpretation or execution of proper APA format. |
0 points
Notable absences in required APA formatting.
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Assignment Requirements 6 points |
6 points Minimum word count of 400 words for the initial thread and 200 words for each response is met or exceeded. Initial post includes one unique, relevant scholarly reference |
5 points Minimum word count for each post is within 10% of the requirement. References to outside sources are included, but do not provide unique insight to the overall discussion. |
4-1 points Minimum word count for each post is within 20% of the requirement. Sources referenced are not scholarly or relevant. |
0 points
Word count for each post is not within 20% of the requirement. No outside references are provided. |
Discussion Board 1: Industrializing Structure for Delivery
Industrializing structure for delivery may be defined as the way in which the delivery of health care has undergone changes regarding how work is organized (Rastegar, 2004). These transformations are like the changes earlier industries went through (Rastegar, 2004). For example, the way Henry Ford used standardization to increase efficiency, quality and productivity (Rastegar, 2004).
The first noticeable problem about an industrialized structure for healthcare delivery is a marked difference in the relationship between the server and those being served (McLaughlin & McLaughlin, 2015). One example of this is telephone triage systems, which deliver impersonal, standardized advice (Rastegar, 2004, para. 5). When control moves from the physician to a more systematic process, the practice becomes less personal (McLaughlin & McLaughlin, 2015).
Physicians are uncertain what to do with the system because as McLaughlin and McLaughlin (2015) note (as cited in Rastegar, 2004), “…physicians report frustration with their loss of autonomy and with the pressures for efficiency expressed as a measure of the number of patients seen” (p. 41). Rastegar (2004) notes that this increased attention to time and productivity are connected to the standardization of physicians’ work (para. 3). This has caused some physicians to feel discontent about the lack of personal time with their patients (Rastegar, 2004). Continuing in this direction may endanger traditional values of the medical field, such as putting the patient’s interest first, moral responsibility and service to the community (Rastegar, 2004, para. 14).
A closely connected second problem has developed from an effort to increase access and reduce cost (McLaughlin & McLaughlin, 2015). The problem is fragmentation of care in that more and more labor substitutions have been made. For instance, a lot of medical work is done by less skilled and less expensive professionals than in times past. Today, nurse practitioners or physician’s assistants are often the first encounter for many patients (McLaughlin & McLaughlin, 2015). This has contributed to a significant decline in specialists’ income because just as technicians can now diagnose and a nurse can now offer treatment, so it is with primary care physicians, who now perform duties that were once limited to specialists (McLaughlin & McLaughlin, 2015).
A third problem obvious within an industrialized structure is mass production. For example, this approach is sometimes used for cataract surgeries (McLaughlin & McLaughlin, 2015). Besides the impersonal nature of such systems, the problem with this industrialized method is that humans have large anatomical differences (McLaughlin & McLaughlin, 2015). Industrialization in the car industry worked wonderfully, but using some of those same principles for the delivery of healthcare is problematic.
References
McLaughlin, C. P., & McLaughlin, C. D. (2015). Health policy analysis: An interdisciplinary
approach (Second ed.). Burlington, MA: Jones and Bartlett.
Rastegar, D.A. (2004). Health care becomes an industry. Annals of Family Medicine, 2(1),
79-83.
Industrializing health care delivery presents many challenges. This discussion post will review three problems associated with our industrializing of health care delivery. They are lack of personal care, fragmentation of patient care delivery, and physician dissatisfaction.
The first problem of industrializing health care is the lack of personalized care. In an effort to be efficient, specific questions are often asked to patients and then blanks are completed on the electronic medical record by the healthcare provider (Hartzband & Groopman, 2016). During these visits, patients often have limited time to actually interact with their provider and therefore less time to ask questions and have more personalized attention. In addition, trying to mass produce or use a standard set of protocols for each disease process does not always work when dealing with humans. Patients can have simple or complex problems therefore requiring tailored care for each individual (McLaughlin & McLaughlin, 2015, p. 43).
A second problem is the fragmentation of patient care delivery. This fragmentation presents coordination challenges for patient care (McLaughlin & McLaughlin, 2015). For example, when a patient sees their primary physician they may undergo many different tests. Then the patient is referred to a specialist, such as a cardiologist. When the patient sees the cardiologists, this physician may order many of the same tests already ordered by the primary physician. It is important for the two offices to communicate so that there are not duplication of tests which results in increase healthcare costs and increased frustration for patients.
A third problem of industrializing health care delivery is physician dissatisfaction. Physicians lose their autonomy when health care delivery is industrialized. They also have extreme pressure to be more efficient and see more patients (McLaughlin & McLaughlin, 2015). This was mentioned earlier in this discussion in regards to the 15 – 20 minute patient appointments. With declining physician satisfaction comes a decline in quality and quantity of doctors. Previously, several surgery residents in training had an attrition rate as high as 20%. That rate has now been reduced to 8%, but this has represented the institution of remedial training programs for current deficiencies. It is also forecast that there will be a shortage of 20,000 to 29,000 of general surgeons by 2030 (Commins, 2017, para. 5). In addition to physician dissatisfaction, industrializing delivery of health care is driving physicians to become employees of hospitals. With the changes in healthcare compensation, physicians are seeing a decrease in reimbursement driving them to give up private practice and become hospital employees. Those still in private practice are stressed with the expectation of seeing many more patients while watching their income drop (McLaughlin & McLaughlin, 2015). At the end of 2016, independent physicians were projected to decline to 33% (“The independent doctor will not see you now,” 2017). This is compared to 57% independent physicians in 2000.
Healthcare delivery is not “one size fits all”. As mentioned earlier, patients have simple to complex problems. There is a high variability of anatomy and physiology, psychological issues, etc. among patients that it makes it not realistic to have a “one size fits all” delivery of health care.
References
Commins, J. (2017). Remediation reduces surgery resident attrition. Retrieved from http://www.healthleadersmedia.com/physician-leaders/remediation-reduces-surgery-resident-attrition?nopaging=1
Hartzband, P., & Groopman, J. (2016, January 14). Medical Taylorism. New England Journal of Medicine, 374, 106-108. Retrieved from https://search-proquest-com.ezproxy.liberty.edu/docview/1757074061?pq-origsite=summon&accountid=12085
McLaughlin, C. P., & McLaughlin, C. D. (2015). Health policy analysis (2nd ed.). [VitalSource Bookshelf]. Retrieved from
The independent doctor will not see you now. (2017). Retrieved from https://www.accenture.com/_acnmedia/PDF-2/Accenture-The-Doctor-Will-Not-See-You #zoom=50
