My humble answer: The two big ones that I'm concerned about most is delaying time and wasting time. I think much of what we do keeps people alive when we should let nature take it's course. Example: someone comes in full arrest, is blue and has taken a major anoxic hit, yet we spend hours -- maybe even days -- trying to save that patient. If he lives he's a ward of the state at the cost of millions of dollars. If he dies he still costs thousands in our efforts to save him. However, it's not my decision to make. If someone hasn't already declared what they want at the end of their lives, or if they don't have a responsible person making those decisions, it can get pretty tricky.
The other thing that concerns me as unethical are all therapies we do just to make sure the patient meets criteria for reimbursement, or just because the doctor wants the patient or patent's family to think we're doing something. I think this is a waste of my time and all of our money. For example: CMS won't reimburse for pneumonia patients unless the patient was sick enough to need oxygen, breathing treatments and something else I can't remember. So to cover our bases doctors simply order all of these procedures on every patient admitted with a certain DRG (diagnosis). I feel it's unethical to give breathing treatments to people who don't need them, yet I do so all the time because they are ordered.
Facebook
I also find myself lying to patients and telling them what I'm doing will help them get better. I find this is unethical. Yet I find I have no choice in the matter. If a doctor tells a patient one thing, I feel it's my obligation to back up the doctor.
No comments:
Post a Comment