On the subject of DB/DT:  ethics, rules, varying standards of individual
clinical practices, etc. notwithstanding, the bottom line is PROFIT.  If you
look very closely at ALL clinical settings, the bottom line has to be
"healthy" (seemingly at whatever cost) or the business fails.  With the US
economy faltering, business owners, board members and trustees are more than
likely interested in the path of least resistance when it comes to ethics,
i.e. as long as you're not doing anything harmful enough to hurt business,
rock on.  I am absolutely and certainly not implying, in any way, that the
"suits" don't hold themselves to high standards of ethical business behavior
(perhaps some do, perhaps some don't).  I am just jaded, I guess, by all the
improprieties that are regularly surfacing from behind the scenes in the
corporate world.  Healthcare is no different, it is a business.  The
questions I would have are two:

1.  The cart before the horse: does the business side of healthcare exist
and do what it does to keep the wheels spinning in order for us to provide
excellent care to our recipients; or do we provide our service to the
recipients as a means of generating revenue for the business (is the dog
wagging the tail, or vice-versa)?  and

2.  When you've applied ethical framework guidelines to how you're
practicing, and asked all the appropriate questions, and answered them to
the best of your interpretation, do you stay put or move on to something
that better aligns with your personal practice philosophy?

Thanks, Ron and others for allowing freedom of expression on this site.

Bill Maloney, OTR





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