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Ethical Issues01:27

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Stakeholder expectations in practice-based medicine.

Ann E Mills1, Mary V Rorty, Patricia H Werhane

  • 1University of Virginia, Center for Biomedical Ethics, Box 800758, Charlottesville, VA 22908, USA.

The Journal of Continuing Education in the Health Professions
|December 12, 2003
PubMed
Summary
This summary is machine-generated.

Physicians are moving to new practice structures, facing value conflicts. This study proposes a process to help adjudicate these competing goals in practice-based medicine.

Keywords:
Health Care and Public Health

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Area of Science:

  • Medical Practice Management
  • Healthcare Organization
  • Physician Economics

Background:

  • Physicians are increasingly leaving solo practices due to competitive pressures.
  • New organizational structures and technologies are emerging in medical practices.
  • Suggestions for practice improvement often assume alignment between practice goals and stakeholder expectations.

Purpose of the Study:

  • To examine the assumption that aligning practice goals with stakeholder expectations drives improvement.
  • To address the inevitable conflicts of value in resource-scarce medical environments.
  • To propose a process for adjudicating value conflicts in practice-based medicine.

Main Methods:

  • Conceptual analysis of practice structures and stakeholder theory.
  • Examination of the implicit assumptions in medical practice improvement literature.
  • Development of a framework for value conflict adjudication.

Main Results:

  • Practice improvement is not solely achieved by aligning goals with stakeholder expectations.
  • Value conflicts are inherent in group medical practices.
  • A structured adjudication process is necessary for resolving colliding goals.

Conclusions:

  • Aligning practice goals with stakeholder expectations is insufficient for improvement.
  • Physicians must have mechanisms to manage inevitable value conflicts.
  • A proposed adjudication process can aid practice-based medicine in resolving these conflicts.