Transforming the conditions of medical practitioners’ professional activities in the process of the healthcare service optimization

Abstract

Today, medical administration assesses any practitioner’s performance efficiency based on the revenue they bring to the medical establishment. The consequences of the substitution of such traditional concepts as “patient”, “doctor” and “medical care” pursuant to the market approach to the medical function by “client”, “service provider” and “medical services” have been fully revealed. Following market paradigm, meaning that the “customer is always right”, patients have become more demanding of practitioners’ work. Medical practitioners under the conditions of overloading and overscheduling, strict regulations of the relationship with the medical establishment authority and insurance companies make mistakes more often. The main instrument for evaluating medical activities is multilayered legal documents, generated by various medical management entities and poorly coordinated with each other. Meanwhile, control practice follows its own rules and laws, and the complexity of the instrument makes no obstacle for the inspectors. Among insurers and officials there has developed a strong conviction in the physicians’ guilt, and that they a priori deserve criminal sentence. This conviction has been replicated by the media (for which such sort of materials helps to raise ratings according to the laws of the yellow press), and it has become shared by society, in particular, by patients. The number of patients’ complaints to the Investigative Committee of the Russian Federation has been increasing rapidly. In response to the “patients’ terrorism” practitioners have adopted a strategy of “protective medicine”, minimizing the risks of treatment to the detriment of its effectiveness. The established practice of doctor-patient relationship is equally harmful to both of them. Traditional professional medical values have turned out to be in conflict with the new requirements of the medical institution authorities caused by the commercialization of the medical care. Although most practitioners have the strength to overcome the crisis of workplace values due to the humanistic component of their profession, their medical activity is accompanied by dissatisfaction and burnout. Healthcare service optimization has resulted in strained relations between patients and healthcare providers.

Keywords

• commercialization
• market mentality
• “patient terrorism”
• professional values
• burnout