Apparent can be said for healthcare, but

 

 

 

 

 

 

 

 

 

 

 

            Apparent
authority (also known as “ostensible authority”) is a concept used in agency
law that refers to the situation that arises when a principal, such as a
corporation, indicates to a third party that an officer or agent is authorized
to act on its behalf and the third party relies in good faith upon such authority.
(US Legal, 2016) It is used as a defense when implied or actual authority does
not exist. Even though they are not hospital employees, many physicians such as
anesthesiologists; radiologists; pathologists; and specialists in emergency
medicine, nuclear medicine, and other clinical fields- have contracts with
hospitals to provide services to hospital patients. (Showalter, 2015) The
theory was confirmed recently by a New Jersey state appellate court, which held
that a hospital may be vicariously liable for a staff doctor whom a patient
reasonably believes is providing treatment on behalf of the hospital. (Ruling
may up risk, 2009)

            Healthcare
risk management is a diverse profession in a dynamic and evolving healthcare
industry. Healthcare risk managers hold a wide variety of titles and work in a
cross-section of organizations. (ASHRM, n.d.) Risk management in healthcare is
potentially more important than in any other industry. (Moskowitz, 2015) In
most industries, an organization develops and implements risk management
strategies in order to prevent and mitigate financial losses. (Moskowitz, 2015)
The same can be said for healthcare, but this includes patient safety. Risk
management in the healthcare industry can mean the difference between life and
death. (Moskowitz, 2015) In order to manage risks, health leaders must
establish what could happen, how likely something is to happen, and what the
severity would be. After this has taken effect, it must be determined how the
organization can mitigate those risks, limit their impact, and what the
potential exposure of those risks would be if they were not contained.
(Moskowitz, 2015)

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            The
relationship between physicians and hospitals is a complicated thing. The
physician-hospital alignment is becoming more important as hospitals seek to
lower costs, improve care, and prepare themselves for payment models that
reward collaboration. (Becker’s, 2011) Physicians and hospitals have had an
almost adversarial relationship that too often has been characterized by a lack
of trust. (Epstein, 2014) When developing a physician contract, hospitals
should clearly define their expectations in terms of performance improvement activities
such as reducing infections, establishing better communication with nurses, or achieving
clinical benchmarks. (Epstein, 2014) Physicians should be involved in those
expectations and should be making strategic decisions within. If physicians
feel a hospital is dictating what they must do and how they must do it, they
are likely to resist it. (Epstein, 2014)

In
order to keep the hospital-physician relationship alive and continue to grow,
hospitals need leaders who are adept at fostering communication by reaching out
and listening to their colleagues. Physicians do not want to feel they are
being managed by hospital administrators. It is critical for physician leaders
to take a visible and active role in establishing and sustaining rapport among
their peers. (Epstein, 2014) Physicians want to feel like they are part of an
organization. They need to see how they are benefitting from the relationship.
Sharing technology can help improve the partnership while also improving a
hospital’s interoperability. (Epstein, 2014) Hospitals absolutely cannot function
without close physician collaboration. They rely on physicians to admit
patients to their facilities, refer to their specialists, and to use their
lucrative diagnostic services. (Goldsmith, 2016)

As
a health administrator and having that relationship between physician and
agency, I could conclude that without it, an organization would not be able to
work. The relationship between a physician and the hospital is so important because
all important or undecided health matters of patients are dealt between the
two. If you don’t have one or the other, who takes care of things that need
taking care of? For example, you can’t have macaroni pasta without the cheese.
It’s just plain and boring and it loses the really meaning to “mac and cheese.”
But when the cheese is added in, it blossoms into this perfect dish of pasta
and cheese and it works so well together while getting the job done. It’s the
same thing for the physician-hospital relationship. They both have to work well
together in order to get the job done and make things work in accordance with
the hospitals and the quality of care. As a hospital administrator, it is
important to hire the most ethical and competent physicians. They must validate
the performance of potential physicians before contracting out and making sure
they do not present a liability issue for the hospital.

There
are many ways health administrators can help the relationship be productive for
both parties. According to an article from Vital WorkLife, there are 6 things
administrators can do for physicians. (Godfrey, 2015) They include the
following:

1.    
Work
closely with physician leaders to help keep the practice groups stable, improve
physician satisfaction and reduce turnover: attend
physician meetings when possible as a positive presence so the physicians
recognize they are being heard and acknowledge, while allowing them to drive
the agenda. (Godfrey, 2015)

2.    
Create
career paths for physicians to prepare them for leadership roles with
increasing responsibility: provide rotating committee
memberships, task forces, research opportunities, and executive/leadership
coaching. (Godfrey, 2015)

3.    
Share
with the physician the financial and operational goals of the hospital:
help them view the hospital’s objectives through an administrator’s eyes.
(Godfrey, 2015)

4.    
Make
regular visits into the community to meet the hospital’s constituents on their turf:
visit local post-acute facilities, make joint calls on the hospital’s referral
sources, such as community primary care physicians and thank them for their
confidence in the hospital’s capabilities. (Godfrey, 2015)

5.    
Openly
share information about physician turnover and retention rates:
connect this effort with physician and patient satisfaction scores to set up a
formal program for improvement. (Godfrey, 2015)

6.    
Provide
the physicians with more protected nonclinical time for engagement-related
activities: offer physicians the training and
educational resources to increase their knowledge in such fields as health care
economics and to improve skills such as team-building dynamics and
interpersonal communications. (Godfrey, 2015)

 

 

 

 

 

 

 

 

 

 

 

References

Showalter,
J., S., (2015) The Law of Healthcare Administration. (7th ed)
Chicago, IL: Health Administration Press: A division of the Foundation of the
American College of Healthcare Executives.

            Ruling may up risk for ‘apparent
authority.’ (2009) Healthcare Risk
Management, 31(4), 43-44. Retrieved
from  https://kaplan.brightspace.com/d2l/le/content/48562/viewContent/3935151/View

            American Society for Healthcare Risk
Management (ASHRM) (n.d) Overview of Healthcare Risk Management Profession.
Retrieved from http://www.ashrm.org/about/HRM_overview.dhtml

            Moskowitz, D. (2015) The Importance
of Healthcare Risk Management. Investopedia.
Retrieved from  https://www.investopedia.com/articles/personal-finance/072315/importance-healthcare-risk-management.asp

            Becker’s
Hospital Review. (2011) 7 Reasons Hospitals Struggle to Align With Physicians. Retrieved
from https://www.beckershospitalreview.com/hospital-physician-relationships/7-reasons-hospitals-struggle-to-align-with-physicians.html

            Epstein,
J. (2014) Fostering Hospital-Physician Relationships: 5 strategies. Managed Healthcare Executive. Retrieved
from http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/fostering-hospital-physician-relationships-5-strategies

            Goldsmith,
K. (2016) The Tangled Hospital-Physician Relationship. The Health Care Blog. Retrieved
from http://thehealthcareblog.com/blog/2016/05/11/the-tangled-hospital-physician-relationship/

            Godfrey,
L. (2015) 12 Ways Administrators & Physicians Can Improve Engagement. Vital
WorkLife. Retrieved from http://vitalworklife.com/blog/2015/09/12/12-ways-administrators-physicians-can-improve-engagement/

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