Medical Associates, a healthcare establishment that offers a variety of treatments such as surgery, recently started seeing a decline in the amount of money it is reimbursed for delivering medical assistance. As a cost-cutting measure in response to the reduction in reimbursements, the management implemented new personnel policies, including substituting nurses with medical assistants who get lesser pay. This management choice displays the dynamic complexity features of change, tight coupling, trade-offs, and nonlinearity.
Change is a feature of dynamic complexity, and it is present in the Medical Associates workforce case. The decision had instant repercussions, but this personnel change will remain a longer-term concern when other staffing transitions happen. The administration continues to hire employees with lesser pay to take the position of departing or retiring registered nurses. In addition, internal shifts persist when nurses are reassigned to other physicians (Braithwaite, 2018). The administration fostered a dynamic working atmosphere by consistently instituting new policies and regulations.
In addition to this, the administration chose to recruit medical assistants with lesser salaries to save money; however, this approach has drawbacks. The practice replaces more qualified and experienced nurses with those with fewer skills. In exchange, the medical practice can utilize the savings to pay other costs. Some trade-offs are unfavorable and result in additional issues, such as a greater turnover rate when nurses start to leave their positions. Additionally, the approach stands to lose senior physicians who do not desire a medical assistant to substitute their nurses.
According to Alpers (2018), 78.5 percent of health facilities reported a physician shortage. Sixty-six percent of respondents reported a nursing shortage, whereas fifty percent reported a scarcity of nurse practitioners and medical assistants. This research indicates that there is a greater scarcity of physicians than nurses at all levels. Medical Associates prioritize the wants and wishes of physicians over those of nurses since retaining physicians is more important than retaining nurses. The problem persists, and as time goes on, the clinic will continue to see shifts in personnel recruiting and will be subject to more consequences stemming from this decision.
Furthermore, the choice to make personnel adjustments is likewise an illustration of tight coupling. When a nurse working with a senior physician decides to quit their position, the senior physician is instantly impacted by the nurse’s choice. A domino effect is created amongst personnel as a result of the unfavorable response of the senior physician (Ginter, 2018). All the physicians, both senior and junior, and the nurses, were impacted when the nursing assignments were changed. It is possible that tight coupling will be more obvious in certain departments than in others, such as the ones dealing with surgeries and greater skill levels.
Additionally, Medical Associates’ move to reduce expenses by employing lower-paid workers illustrates nonlinearity. The planned outcome was to save funds by paying employees less. The funds might then be utilized in other forms to mitigate the revenue loss caused by reduced reimbursements. Nevertheless, some of the decision’s repercussions were unfavorable and had a greater impact than expected. Because of their magnitude and unpredictability, these effects are nonlinear (van Wietmarschen et al., 2018). Because of the staffing decision, there was a shift within the practice, and nursing reevaluations were changed in response to the needs of the senior physicians. Some employees grew furious, resulting in a greater turnover rate. The remaining nurses will likely have more tough and demanding duties as they take up the slack left by departing nurses and replace them with less qualified workers. Medical assistants can only undertake some of the jobs and responsibilities of nurses. The remaining nurses have a decreased chance of staying in the field since they are less satisfied with their jobs.
In conclusion, the Medical Associates situation is precarious and might end in disaster. In this case, the presence of dynamic complexity features such as change, tight coupling, trade-offs, and nonlinearity demonstrates how complicated the medical setting is and how complex it may be for medical management to make a decision.
References
Alpers, L. M. (2018). Distrust and patients in intercultural healthcare: A qualitative interview study. Nursing Ethics, 25(3), 313–323.
Braithwaite, J. (2018). Changing how we think about healthcare improvement. Bmj, p. 361.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.
van Wietmarschen, H. A., Wortelboer, H. M., & van der Greef, J. (2018). Grip on health: A complex systems approach to transform health care. Journal of evaluation in clinical practice, 24(1), 269-277.
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