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Competing and conflicting interests are a common occurrence in a multifaceted and complex system of healthcare. Any form of change integration through reforms and programs will inevitably lead to some groups benefiting from its, whereas others might oppose the alteration. The general interaction between a traditional hospital and organizations, such as pharmacies, telemedicine and retail clinic, and emergency medical services (EMS), can be in conflict due to reforms on quality-of-care improvements.
Pharmacies are one of the most common healthcare organizations, which primarily focus on supplying and selling pharmacological products. These might include medications, pills, and other critical items that help ones health. However, there is a natural conflict of interest between pharmacies and hospitals, where one is focused on treating a patient, and the other wants to sell the products that assist the treatment procedure. Therefore, the goal of in-hospital doctors is to find the most optimal and plausible way of improving a persons health, but pharmacy and related parties seek to boost sales. It is stated that there are questionable ethics regarding the general influence of drug rep visits1. Such an approach might negatively influence a physicians prescription habits, which might lead to unnecessary complications and overdose. Therefore, the entire hospitals performance might suffer due to pharmacies advancing their interests.
The competing interests might take place between a traditional hospital and telemedicine and retail clinic. The main reason is that both seek to achieve proper patient treatment, but the means of achieving these objectives are different. The concept of medical retail encompasses such functional areas as tele-education, telematics in the field of medical research, telematics in the field of medical service management, and telemedicine itself2. Telemedicine is a method of providing medical services to patients who are at a great distance from specialists, using information and communication technologies after receiving the information necessary for the diagnosis, treatment, and prevention of disease. Telemedicine is currently developing in a number of main areas. Telemedicine consultations are the most famous and widespread telemedicine service. The object of telemedicine consultation can be a clinical case of a particular patient or individual data from a clinical examination. In particular, counseling using radiological survey data is widely practiced. However, the latter direction has its drawbacks associated with the peculiarities of making a medical decision in the absence of complete information about the patient.
Healthcare is a specific branch of the national economy, focused primarily not on obtaining economic benefits, but on fulfilling a social function. It is important to note that it is focused on ensuring and maintaining the health of citizens. As a result, one of the main political factors influencing the health sector is undoubtedly legislative regulation and control by the state. First of all, this refers to the laws that directly regulate the medical services market and determine the procedure for the circulation of medical products. In addition, this includes medical products and medical devices and requirements for the infrastructure of medical care. It is the state that sets the vector for the development of the medical market as a whole for both state institutions and private investors. This, in turn, implies strengthening control over the patients personal data, without the exchange of which the provision of telemedicine services is impossible. In addition, it is important to note the development of state programs aimed at preventive goals, which, in the future, may have a significant impact on the structure of the healthcare sector.
Emergency medical services are another type of healthcare organization that can possess competing interests with a traditional hospital. EMS seeks to provide mostly pre-hospital treatment and transfer a patient to definitive care. Any form of change that will obligate the given organization to give a certain amount of care would mean that EMSs effectiveness will drop significantly. However, such a change will benefit hospitals because patients will arrive with partial care provided for them. It is stated that overcrowding and ambulance diversion are the primary challenges of EMS, which lead to worsened patient outcomes, such as mortality, morbidity, and cost increase3. Thus, it is evident that there is a conflict of interest between emergency medical services and traditional hospitals regarding a load of responsibilities. EMSs are usually the first point of entry for the patient into a healthcare system, which means that it needs to operate as efficiently as possible. However, hospitals also want to receive patients who are well-cared and not on the verge of death.
Improving the quality of care can have a major impact on the interaction between a traditional hospital and the given three healthcare facilities. For example, a reform that discourages the excessive use of medications and other pharmaceutical products due to quality-improvement changes might hurt pharmacies. The management or healthcare system officials might emphasize the importance of organic and natural treatment models, where pills are not needed. In addition, telemedicine can exhibit a competing interest with a hospital in regards to quality care. For instance, a program that requires the physical presence of a patient with a physician can generate the issue. In the case of emergency medical services, a change based on imposing more obligatory care for EMS can severely hinder the facilities performance.
The health sector is a complex system that is influenced by various macroeconomic factors. This influence is realized through stakeholders or stakeholders with varying degrees of power in the industry and the level of interest in the processes taking place in it. The main stakeholders are patients and their families, healthcare facilities, medical specialists. They are characterized by the least power and the greatest degree of interest in everything that happens in this area. An increase in the degree of their influence is possible with the consolidation of their parts. At present, such associations are formal in nature and cannot act as a real force that has a structural impact on the industry. However, they can have an indirect effect through the formation of consumer literacy of patients. It is important to promote the professional development of medical professionals, which, in the long term, can lead to significant changes in the health sector.
In conclusion, competing interests can take place among healthcare organizations, such as traditional hospitals, EMSs, telemedicine clinics, and pharmacies. The latter one is focused on increasing sales, which might not go along with a hospitals goal of treating patients effectively. Retail clinics also might possess competing interests due to any form of a requirement that involves physical examination or assessment. Lastly, emergency medical services can be heavily burdened by a reform that introduces an obligatory amount of care to the EMS facilities.
References
Aringhieri, Roberto, Mariaelena Bruni, Sara Khodaparasti, and John van Essen. Emergency Medical Services and Beyond: Addressing New Challenges Through a Wide Literature Review. Computers & Operations Research 78, (2017): 349-368.
Gott, Marjorie. Telematics for Health: The Role of Telehealth and Telemedicine in Homes and Communities. Boca Raton, FL: CRC Press, 2018.
Meier, Barbara. Conflicts of Interest with Pharmaceutical Industry. NPAlliance, 2020. Web.
Footnotes
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Barbara Meier, Conflicts of Interest with Pharmaceutical Industry, NPAlliance, Web.
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Marjorie Gott, Telematics for Health: The Role of Telehealth and Telemedicine in Homes and Communities (Boca Raton, FL: CRC Press, 2018), 45-57.
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Roberto Aringhieri et al., Emergency Medical Services and Beyond: Addressing New Challenges Through a Wide Literature Review, Computers & Operations Research 78, (2017): 358.
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