Assignment Prompt & Instructions
RESPOND TO THE FOLLOWING PEERS POSTS
Courtney Post
Differences between community not-for-profit hospitals and large academic medical centers can range from their mission, services, staffing, and even funding. Community not-for-profit hospitals focus on providing basic services to meet the community needs while containing expenses (Rozier, 2020). Large academic medical centers target profitable services, well-insured patients, clinical trials, and additional funding available to teaching hospitals (Horwitz & Nichols, 2009). Additionally, large academic medical centers can provide a broader range of specialty care such as trauma centers, neonatal intensive care units, and burn units.
With community not-for-profit hospitals focusing on cost containment, staffing would be lean to ensure the hospital stays aligned with the budget. At a large academic medical center, higher staffing levels are anticipated for teaching and research, which leads to competitive salaries. Large academic facilities are "44% more costly per case than non-teaching hospitals" (Mechanic et al., 1998).
With a large academic facility entering the community, this could lead to lower reimbursement rates from insurance companies, and potentially a reduction in elective procedures due to cost, which would reduce the overall hospital revenue (Horwitz & Nichols, 2009). Contrary, a large academic facility would vastly expand on health care services provided to the area and community, taking higher acuity patients in times of need.
Briton Post
When comparing our large Academic Medical Center (AMC) to a community not-for-profit hospital, the most significant business implication stems from the costs associated with our "triple mission" of clinical care, research, and education. A community hospital's main goal is to get patients in and out quickly, but our facility has to plan for faculty salaries, research costs, and the natural inefficiencies that come with training residents (Cohen et al., 2022). This significantly affects staffing policies because we would have to hire highly specialized experts and maintain lower faculty-to-learner ratios, which drive up our operating costs and make us less agile than a community hospital that can operate with a leaner, clinically focused workforce.
If a for-profit organization were to build within a 10-mile radius, the most concerning financial impact would be the risk of "cream-skimming," in which the new facility targets the most profitable patients while avoiding complex or uninsured cases we are obligated to treat. For-profit companies have a duty to their shareholders to make money, so they would probably put a lot of money into high-margin treatments like orthopedics or cardiology to get patients who are already covered by insurance (Horwitz & Nichols, 2009). If we lose that profitable volume, we lose the ability to cross-subsidize our safety-net services and teaching programs, potentially forcing us into a deficit as we are left holding the bag for high-acuity, low-reimbursement trauma and Medicaid cases.
However, there are distinct financial benefits to being an academic facility that help balance these risks, primarily through revenue diversity and market power. AMCs have access to unique funding sources, like federal research grants and specific government payments for Graduate Medical Education (GME), to help pay for training doctors. This is different from a regular not-for-profit, which relies heavily on patient volume ( _Direct Graduate Medical Education (DGME) | CMS_, n.d.). Also, the status and brand awareness of being an academic center can give us more power in discussions with insurance companies, which lets us get better reimbursement rates than those of most community hospitals.
Remember to respond to Justine and Alexis post while being respectful of and sensitive to their viewpoints. Consider advancing the discussion in the following ways:
– Post an article, video, or visual related to cognitive dissonance, conformity, obedience, or persuasion to reinforce a peer's idea or challenge them to see their point from a different perspective.
– Paraphrase something from the original post. Then consider asking a question or sharing your personal experience.
JUSTINE POST
The videos suggest that our tendency to conform is below our awareness. It looks like our implied roles and expectations guide our choices more than our free will.
An example of a scenario that demonstrates how a person can conform to norms or obey authority without being aware could be how people are born into whatever religion their parents are and then are raised to believe it is true without question.
I experienced cognitive dissonance when I started on my health and wellness journey because I was eating right and going to the gym but still smoking cigarettes. I would consider myself a health-conscious person, so smoking cigarettes does not align with my idea of health. I am working on quitting now.
Our tendency to conform may differ across cultures due to the level of community involvement, individualism, religious practices and beliefs, and laws.
Understanding these concepts can be applied to emotional intelligence because the more we can understand and learn about the mechanisms behind human behavior, the better we can know ourselves. Being able to anticipate negative behaviors, and thus prevent some of them, would be a useful skill to have as well.
ALEXIS POST
After reviewing videos and reading material from Simply Psychology, it shocked me to see how blind we can be when we follow the crowd. The Stanford Experiment was interesting in that, within minutes, participants conformed to roles as a guard and/or a prisoner based solely on what group they were placed into. The Milgram Experiment demonstrated that subjects would comply quite far if asked by an authority figure. Finally, The Bystander Effect demonstrated that people won’t necessarily assist if others are around.
Social influence can be subtle, and we may end up doing it without thinking. Like if everyone in your presence pulls out his/her cell phone, you will be tempted to get your cell phone out. The same applies if you are in class, and everyone else is quiet and listening, you may find yourself not speaking up even if you have something to say.
This is something with which I've also personally struggled. There was a time when I kept taking up new tasks, even though I was already very tired. Despite this, I was okay with what was happening from an outward perspective, but inwardly, I was irritated with my own inability to assert my boundaries.
Conformity is also affected by culture. Some societies respect group consensus and authority, and so individuals conform openly. On the other hand, individualism may be espoused, but then individuals conform with the group in small ways nonetheless.
All of these relate to ethics. This set of experiments reveals how quickly individuals can be swayed by the group without considering whether it's right. Taking pause and thinking about what you're doing yourself can stop you from doing something negative, simply because it appears everyone else is doing it.