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Medical: WMA Questions: 1. Discusses why all physicians might feel difficulties to report formally any suspected inappropriate behavior? 2. With regard to assessment of any physicians’ impairment that may impede him/her form practicing medicine competently and safely: reflect on main environmental stressors/reasons that may interfere with physicians welfare and compromise his wellness and fitness for their role? And give some specific corrective intervention to safeguard them? 3. Review and analysis the essential elements of patient safety program in any designated hospital /and provide your recommendation for any improvements  4. What is the 1 question you have that you’d like answered immediately?    Answers: Traditionally medical profession members and physicians have been anticipated to take care of each other as family members; not as friends and definitely never as strangers. The Geneva declaration (WMA) incorporates a pledge, “My colleagues will be my sisters and brothers.” The professionals are also required to work cooperatively with colleagues to maximize care delivery to patients. In addition to that they are also obligated to report incompetent and unethical behavior by their colleagues. However, this might not be easy as it should be (Fujiwara et al., 2011).  Over time medicine has taken delight as a self-governing profession. The society and patients have accorded trust to the professionals, thus leading them to establish high behavioral standards and disciplinary procedures to look into accusations of misconduct and punishing of wrongdoers. This system fails as physicians may report others to attack their reputation for personal motives; they may also not report them because of sympathy or friendship. The consequences of reporting a colleague can be extremely detrimental to the reporter, including hostility from the accused and possibly from other colleagues. Despite the negativity, reporting is a responsibility so as to maintain the professions good reputation. Reporting is dependent on them as they are the ones that can recognize impairment, misconduct or incompetence but reporting colleagues to authority is however the last resort. They ought to inform their colleagues about their misconduct first and resolve the matter at that level. If not resolved they then have to discuss it with offender’s supervisor and leave it there. If it’s not resolved here, it may be appropriate to inform the disciplinary authority (Glanz et al., 2008). 2. WHO defines health to be a state of complete mental, physical and social wellbeing, not simply luck of infirmity or disease.  It has received criticism as unattainable though its just a broader commitment to ailing peoples overall health by making sure physicians take into account their own health first. There are a number of factors that can impede physician from practicing medicine competently and safely. Problems of substance abuse, alcoholism and the resulting mental health worries receive more attention though they are assumed to be disciplinary concerns. Impairment therefore is any mental or physical behavior/ condition with one’s ability to take part in professional activities safely (Reay & Hinings, 2009). Mild conditions can compromise physician’s welfare and later escalate to impairments. Environmental stressors also affect physician’s welfare. Disease manifestations interfere in varying degrees with the physicians’ ability in medical practice. This makes it complex to determine if a health compromised physician should continue patient care delivery. Chronic and acute diseases have diverse implications on physician’s ability depending on severity and treatability, and their impact also varies with nature their professional activities. For instance, one can continue delivering care though with precautions when suffering from common cold; but should avoid at all costs patients with critically compromised immunity. On the other hand ,physicians suffering from lethal infectious illnesses like tuberculosis, hepatitis C and HIV are complicated to address especially when they perform invasive procedures e.g. surgeons. Degenerative and cognitive difficulty diseases like Parkinson’s disease or multiple sclerosis, can also affect medicine practice though some accommodations can facilitate physicians to maintain or prolong their practice exclusive of jeopardizing their patients safety. However, if a physician is affected by a state that interferes with their ability to participate safely in care delivery, his/her colleagues should take it their responsibility to take actions that will prevent them from harming patients, the medical profession and the physician (Sanfey et al., 2012).  Timely intervention should be taken to ensure they cease to practice; permanently or temporarily.   There are also occupational stressors that take place among physicians. They are independent to training or specialty. They include sleep deprivation. Currently it’s more incapacitating compared to high levels of alcohol in the blood stream. To solve this, new rules have been set to limit the number of hour’s resident practitioner’s work; however independent practice during off hours is still a common practice. Some environmental stressors also interfere with their welfare, minimal strains e.g. occasionally feeling overwhelmed, causes simple inconveniences that may have simple solutions but may also create problems that affect team functioning and patient care negatively. Lastly it will be important for physicians to gain a healthier understanding of their appropriate responsibilities in accordance to wellness assessment and related care. This can go a long way in fostering improved patient satisfaction and quality of care.  3. Patient safety responsibility like many elements of patient care is not limited to a specific individual, department or office. At SUNY Downstate Medical Centre everyone plays a role in ensuring patient safety. This ranges from the food and services staff, laboratory staff, pharmacy, housekeeping staff to those in maintenance. The clinical staff also takes all elements of patient safety with great precautions (Theriot & Dupper, 2010). These include medication management, procedures and other elements related to patient care. Patient care is of utmost importance to all the staff. Patients are identified correctly therefore ensuring proper administration of medication, proper care procedures and laboratory specimen analysis. Upon admission, each patient receives an ID band that serves as an vital tool throughout the patients stay in the center. Hand hygiene is an important part of patient safety. During their time in the hospital, patients are advised to frequently use alcohol- based sanitizers or wash hands, especially after using the washrooms and before meals. This also serves as an effective of way of reducing germs spread and hospital infections (Feng & Zhao, 2008). In addition to that, the programs should be able to solve safety issues through: provision of a visible, strong and clear attention towards patient safety; implementation of an immediate system to analyze and report errors within the healthcare organization; provide education on patient safety; communicate findings/ arising issues thought the organizations faster and consistently;  incorporate best practices in the healthcare system governed by safety principles (Aiken, 2012);  put in place interdisciplinary players  training programs for healthcare providers; identify and analyze various system failures e.g. near misses and medical errors ; proactive redesign and evaluation of healthcare systems with an aim of improving care process therefore preventing errors from occurring in future. Lastly encourage patients and families to participate in the program and make inquiries (Cox, 2007). Organizations reflect their culture through what they do; processes, procedures and practices other than what they claim to believe in. A safety culture therefore is a set of practices and assumptions that help health organizations offer optimal care (Cox, 2007). What’s the future of patient safety as far as physician wellness is concerned?   References Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., … & Tishelman, C. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. Bmj, 344, e1717.  Cox, R. G., Zhang, L., Johnson, W. D., & Bender, D. R. (2007). Academic performance and substance use: findings from a state survey of public high school students. Journal of School Health, 77(3), 109-115.  FENG, X. F., & ZHAO, L. H. (2008). Essential of Hand Hygiene to Patients′ Safety in Hospital [J]. Chinese Journal of Nosocomiology, 12, 046.  Fujiwara, T., Kato, N., & Sanders, M. R. (2011). Effectiveness of Group Positive Parenting Program (Triple P) in changing child behavior, parenting style, and parental adjustment: An intervention study in Japan. Journal of Child and Family Studies, 20(6), 804-813.  Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2008). Health behavior and health education: theory, research, and practice. John Wiley & Sons.  Reay, T., & Hinings, C. R. (2009). Managing the rivalry of competing institutional logics. Organization studies, 30(6), 629-652.  Sanfey, H., DaRosa, D. A., Hickson, G. B., Williams, B., Sudan, R., Boehler, M. L., … & Richard, K. M. (2012). Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems. Archives of Surgery, 147(7), 642-647.  Theriot, M. T., & Dupper, D. R. (2010). Student discipline problems and the transition from elementary to middle school. Education and Urban Society, 42(2), 205-222.

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