The Consequences in the Shift of Medical Care: from Individual Medical Practitioners to Health Care Organizations.

 The consequences in the shift of medical care from individual medical practitioners to health care organizations, and how it relates to the view of health care professional is a very complex concept to relate.  According to the U.S. Census Bureau, 2004, (“15 percent of the population or 45 million people in the United States were without health insurance coverage during 2003.”) This fact can be one of the “consequences”, a health care provider might consider. Another important “consequence” might be the quality and care patients receive under new mandates.


According to the NASW for Social Work Practice in Health Care Settings and the Health Standards Working Group, “The health care system in the United States is complex and multidisciplinary in nature, and may include a network of services such as diagnosis, treatment, rehabilitation, health maintenance, and prevention provided to individuals of all ages and with a range of needs. Multiple sources of financing, ranging from Medicare and Medicaid to private insurance, provide further challenges. Many consumers lack health insurance or have inadequate coverage, which causes financial stress on consumers and providers.”


How is this shifting from individual care to macro-organizational care benefiting the people who do not have health coverage, while any informed person knows that the fee’s and penalties for not signing up for “Obama Care” are much less than the monthly and yearly premiums for the health care plan itself. “Accessibility to preventive, palliative, and curative health care depends largely on the client’s ability to pay, and often, people cannot afford existing fees.” (Social Work Practice in Health Care Settings. 2005). How much more damage will be done to our flawed U.S. health care system under the new white house administration?

Quality of patient care is another factor that must be considered switching to a more macro health care system.  How does this affect the quality of care that the patient receives under such an organizational frame work? “Traditionally, hospitals have been structured along departmental lines organized by skill area and professional scopes of practice. For example, the respiratory therapy aide and the respiratory therapist can be found in the Pulmonary Medicine Department and report to the Director of Pulmonary Medicine.


When a hospital patient requires respiratory therapy or tests of pulmonary function, such services are “ordered” from the Pulmonary Medicine Department. When, with work restructuring, such services are provided by a member of a patient care team on a hospital unit, departmental barriers may be blurred or broken because the respiratory aide on the care team now reports to the nurse who heads the team instead of, or in addition to, the Director of Pulmonary Medicine. If, as a member of the care team, the respiratory therapy aide is now trained to perform other patient care functions as well, or if nurses or nurse’s aides are also trained to perform some activities previously only performed by respiratory therapy aides, the clear alliance to one profession or discipline is challenged.” (The effects of health care industry changes on health care workers and quality of patient care Urban Institute 2013).

 Although there are many other consequences a health care provider might consider regarding this topic, these two mentioned above have a direct and immediate profound effect on the people and patients dealing with a new and yet constantly changing “Universal Health Care System”.


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