Healthcare gatekeeping process

Institution

Name

Gatekeeping in healthcare plays a significant role to both the institution staff and patients, but it could be attached to certain problems. In healthcare, gatekeeping could cause difficulties for researchers. The process involves the denial of access certain healthcare facilities, services, researches, medical practitioners, or patients. It is known to occur in various stages in research projects (Lee, 2005). On a similar aspect, there are gatekeeping processes at the patient’s level. A patient cannot get access to the GP without consulting the receptionist. A GP is a physician who is not a specialist but treats all illnesses. It is the work of the receptionist to check on the GP’s schedule. The denial of the patient’s access could come in when the GP is not on duty, or the appointment list is completely full (Lee, 2005). Patient may not certainly find gatekeeping beneficial but rather provoking from the associated restrictions. There could be minimal financial savings from gatekeeping per patient, but there are advantages associated with the process. It is therefore important as a patient to look at some of the advantages associated with gatekeeping in healthcare or the disadvantages associated with it.

Taking a scenario whereby the GP is busy on attending to a patient in his or her office, disruption may not be accommodated. There is no point of every new patient checking by himself or herself on the GP’s schedule and thereby intervening in his or her critical medical activities. The intervention could be harmful and could even result to mistakes in especially timed medical processes. It is therefore the obligation of the gatekeeping personnel, such the secretary to determine whether a patient could see the physician or not (Lee, 2005). The receptionist should try all the best to ensure that their medical practitioners are not presented with excess appointments.

During medical research activities, patients need to be protected. Gatekeeping in research is done deliberately to protect vulnerable subjects especially patients and sometimes their families. Their vulnerability makes is impossible to allow them participate in research. The idea behind patients’ denial to participate in research is their lack of experience and for the safety because of their health conditions. They could not be allowed to take part in research interviews given that medical practitioners are sometimes restricted through gatekeeping (Lee, 2005). Healthcare gatekeeping within healthcare research processes is therefore useful in patients’ protection.

In order to minimize the costs associated with heath care gatekeeping, some new technologies are being implemented. Sometimes physicians are recommended to assist in gatekeeping. In this case, it becomes possible for the primary physicians to function as gatekeepers for every member in their client groups (Weinstein, 2001).

Gatekeeping at the research level could have gatekeepers get enough information about any proposed research. It is through this information that the gatekeeper would be in a position to make informed decisions in granting permission to the researcher’s request or not. The gatekeeper may turn down the request following schedule problems or vulnerability of the researcher to risks. He may demand that the proposal go through the Local committee for research ethics or not. This would probably save the institution many possible losses that would have emanated from the research (Sommers & Wholey, 2003). A patient would consequently avoid higher medical charges placed to them in compensation for such losses. The medical institution would in addition evade the risk of blames from the public who could shun its reputation.

Positives benefits associated with gatekeeping could also include the help of refining a project by the key gatekeepers. A key gatekeeper may as well come up with suggestions of constructive restrictions (Lee, 2005). An instance is whenever they firmly decide that medical practitioners such as nurses cannot be called for interviews during their working time. If a nurse breaks for an interview, the patients could surfer by lacking the particular nurse’s attention at that juncture. A compensation for the time loss during an interview of a nurse by the researcher may be determined (Fullerton, 2008). The gatekeeper may not be in the position to make such decisions but he or she would have directed the researcher to the responsible committee. The researcher may be expected to compensate for the lost time during the interview session in monetary terms.

Some researchers could be inexperienced and could as a result have problems constructing their project timetables. Their impatience could push them to fail in waiting for a response from the key gatekeepers’ responses with respect to the letters posted these experience gatekeepers by the researchers. This impatience could however lead to the denial of their access and consequently a definite failure of a chance for their research (Sommers & Wholey, 2003). This may not directly benefit patients but to a great capacity, it does. It is also the responsibility of the gatekeeper make decisions based on researcher’s age, credibility, gender, or trustworthiness.

Physicians have an ethical role in gatekeeping. Physicians are expected to provide patients with the best medical care services possible hence; their role in gatekeeping could be a roadblock to their success in medical service delivery efficiency. A patient may gain the feeling that an institution dominated by such cases is not the best for them. A tradeoff between a medical service to a patient and gatekeeping after every patient encounter could be disastrous in terms of time and efficiency (Weinstein, 2001). If a physician compromises his or her patient in attendance in favor of another anonymous patient, the patient in office may feel intimidated as far as his or her health is concerned. Few people could be in a position to stand such a medical practitioner’s behavior.

Gatekeeping by key medical practitioners such as doctors and physicians could be destructive and harmful to patients’ patience and health. It is not cost effective either and the institution may be subjected to great time losses and inefficiencies in various medical operations. Physicians could best attain the limits of their healthcare resources if they act in the interest of their patients (Weinstein, 2001). Medical practitioners should incorporate the associated limitations they could stimulate with the fact that patients face compromises in order to achieve high quality healthcare. Health care services are never free but are centrally expensive. Any loss of time and associated with inefficiencies would be a cost to the affected patient and the institutions as a whole.

In solving problems associated with gatekeeping, the associate cost effectiveness has to be considered. Cost-benefit analysis may be based on the available resource and the population served by the health care institution. From a single patient perspective, gatekeeping could be costly. The marginal cost diminishes with increase in the number of patients just like in any other economically producing farm. A small healthcare that serves very few patients may demand some other medical practitioners to serve in gatekeeping in order to minimize the labor costs associated with a professional gatekeeper. Costs or benefits should not only be counted in monetary terms but also in social terms and net savings in the future healthcare services or facilities. Effective gatekeeping process can help decrease complications associated with future patients and practitioners alongside decreasing problems related with insurance while at the same time saving on time and money in the end (Grumbach & Bodenheimer, 2002).

References

Fullerton, M. (2008). Looking for solutions in healthcare for 2006 and beyond. Retrieved October 18, 2012, from Physicians as Gatekeepers-Journal: http://realist2.squarespace.com/journal/2008/1/4/physicians-as-gatekeepers.html

Grumbach, T.S. & Bodenheimer K. (2002). Understanding Health Policy: A Clinical Approach. 3rd Ed. New York, NY: The McGraw-Hill Companies.

Lee, P. (2005). The process of gatekeeping in health care research. Nursing Times VOL: 101, ISSUE: 32 , 36.

Sommers A.R. & Wholey D.R. (2003). The effect of HMO competition on gatekeeping, usual source of care, and evaluations of physician thoroughness. Managing Health Care. vol 9 issue 9 , 618-627.

Weinstein, M. C. (2001). Should physicians be gatekeepers of medical resources? Journal of Medical Ethics, vol 27, Issue 4 , 268-274.