A situation in the case study demonstrates the facts that are in favor of Dr. Jones. First, Dr. Jones was not on shift and was resting with his family when the hospital needed help with urgent patients. At the same time, the hospital was paying members of a competing group to cover the Emergency room and had different contractors for group members (Buchbinder & Shanks, 2012). Consequently, organizational issues in this situation are longer working hours for the general physicians and lower salaries, as well as the injustice that arises from paying a competing group instead of doctors who work harder.
The background of this situation is expressed in several factors that justify the actions of Dr. Jones. Since the hospital had agreements with contractors and was paying a competing group to cover the Emergency room, Dr. Jones did not have to respond to the call. He works during his working hours, and although it is more beneficial for patients if he and other general physicians cover the Emergency room, the hospital does not pay them for this work. For this reason, there is no legal and fair reason to call Dr. Jones, although his refusal to help a patient raises a moral dilemma. It is not the patient’s fault that the hospital has not been well organized, so Dr. Jones can feel guilty for refusing to help.
On the other hand, there was a factor that could interfere with the right of the patient to get quality help from Dr. Jones. The doctor has already drunk wine, which may affect his professional skills and even harm the patient (Buchbinder & Shanks, 2012). Although there is no information about the influence of wine on Dr. Jones, working after drinking alcohol is unethical and illegal and, therefore, would create another dilemma even if the physician agreed to help (American Medical Association, 2016). Thus, Dr. Jones made the right choice by refusing to work, since the opposite decision could violate the ethical code and could lead to legal consequences for the physician.
Consequently, one can assess that this situation is the result of miscommunication as well as a serious violation of the ethical and working rules by the doctor who was assigned to cover the emergency room. The doctor was obliged to answer the call and help the patient; however, he or she was negligent and did not fulfill his or her duties. At the same time, the miscommunication and approach to organizing and paying staff hours led to the fact that Dr. Jones was also unable and unwilling to help the patient outside of his working hours.
The ER physician, in this case, has two options for a possible solution to the situation. First, he or she could send a staff member to the on-call physician’s home to report the problem. Alternatively, the ER physician can serve the patient himself or herself or with the help of other team members with sufficient competence. Recommendations for management are the establishment of fair wages for professionals, as well as the creation of a clear schedule and statute with the rights and responsibilities of personnel covering the ER. In addition, this schedule can also include an additional responsible physician in case the on-call physician does not respond. Thus, even in unforeseen situations, the hospital will always have doctors who can help patients.
References
American Medical Association. (2016). Code of medical ethics of the American Medical Association. American Medical Association.
Buchbinder, S. B., & Shanks, N. H. (Eds.). (2012). Introduction to health care management (2nd ed.). Jones & Bartlett.