Question

Using the case study below, titled “The New Toy at City Medical Center”, discuss the following: Dr. Jones is the second highest revenue producer from the General Surgery Department. How should the usage of the capsule endoscopy equipment be handled? What specific steps should be taken to avoid this situation in the future? Capsule endoscopy is used to examine parts of the gastrointestinal tract that cannot be seen with other types of endoscopy. The process uses a very small camera attached to a long flexible tube to view the intestinal tract. The technology is particularly useful when disease is suspected in the small intestine and can sometimes diagnose sources of bleeding or causes of abdominal pain such as Crohn’s disease or peptic ulcers. A group of gastroenterologists at the City Medical Center proposed the purchase of capsule endoscopy equipment through the Capital Equipment Purchasing process. After the equipment was approved and the purchase initiated, providers began the process of applying for specific privileges to use it. Three gastroenterologists, Drs. Smith, Sams, and Amalfi, applied for credentials and were approved by the department of gastroenterology and, ultimately, the Medical Center Board of Directors to use capsule endoscopy. After the three gastroenterologists began to use the new equipment, they discovered that a surgeon, Dr. Jones, intended to use the capsule endoscopy equipment for procedures, too. Having done this procedure at another competing hospital on numerous occasions, Dr. Jones had also been privileged through the department of surgery and, ultimately, the City Medical Center Board of Directors. When Dr. Jones put his first case on the schedule for the gastroenterology suite where the capsule endoscopy was to be performed, Nurse Tattler called the gastroenterology department and alerted them to this potential intrusion. Drs. Sams, Smith, and Amalfi were outraged. They had advocated for the equipment, and this poacher was attempting to enter their domain. While each of them told Dr. Jones that they liked him “as a person,” they were not willing to share their new toy with him or the surgery department. They felt strongly that they “owned” the equipment and the suite. He would just have to go elsewhere. Dr. Jones pointed out to the trio that the hospital purchased the equipment with capital equipment dollars; the Department of Gastroenterology did not pay for it. In addition, the suite and the nurses who staffed the suite were employees of City Medical Center, not of the Department of Gastroenterology. And, he had been privileged by his department and the City Medical Board of Directors. Tempers flared, and the chairs of the two departments were informed of this escalating conflict. Since Dr. Jones had scheduled the procedure and the patient was expecting to have it the next morning, the chairs called an emergency meeting with all the involved parties. 1. Are the physicians considered "team players"? Why or why not? 2. How do you resolve the matter, what questions would you ask as Chair of the Departments? 3. Would the physicians behavior be considered "patient centric"? 4. Describe how you would avoid these situations going forward.

Answer 1

Answer =

As the equipment was bought by the hospital from the funds available in the hospital only thus it is important that these equipment are used by all the doctors in the hospital. But if we look at the seniority then Dr. Jones should be given more chances to use that equipment and he can have a greater say in deciding how the equipment can be utilized by the other departments. Apart from this, it is also important for the rest of the doctors to have an agreement about the timing of using the equipment in the different departments of the hospital. It would be better if they develop a schedule and can move the days of using the equipment by the different departments. Apart from this, this is also advisable for Dr. Jones to fix his appointments with the patients after having clear communication with the rest of the departments about the availability of the equipment.

In order to avoid this kind of conflicting situation, it is better to have clear communication among the doctors. Thus it is important for Dr. Jones to see and communicate with the rest of the doctors about the availability of the equipment and accordingly, they can fix the appointment with his patients. The hospital can also think of developing a master schedule that will be sent to all the doctors informing when the equipment is free or when that equipment id allocated to them so that they can arrange their appointments.

Answer 1= Physicians are the part of the team as they all come together in the hospital to treat the different types of patients and thus they must act as a team. In many cases, they can seek suggestions, help and assistance form, other doctors.

Answer 2= This situation can easily be resolved by having the schedule of availability of the equipment and in case of any emergency, then that particular doctor can request the other doctors to accommodate his or her request.

Answer 3= Yes, as the main objective of any physician is to treat the patient and thus they do everything looking at the requirement of the patient that makes their activity patient-centric.

Answer 4= As mentioned earlier, by having a proper allotment schedule and coordination, clear communication among the doctors, this conflicting situation can be managed quite well.

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