title: The ethics of dysfunctional professional relationships.
abstract: Dr N, the chief surgeon at a large private hospital who has been practicing there for decades, has noted recent changes in the administration that are troubling. Multiple advertisements proclaim awards that have not been achieved and various ads employed actors pretending to be patients experiencing miracle cures. Pressures on medical staff to practice more efficiently have become overbearing. Changes in bundling Medicare postoperative care have raised questions about future patient selection. There is a lack of transparency with minimal physician input. The much respected chief-of-staff has moved into the administrative side and no longer advocates for the professionalism of the staff. When Dr N meets with the chief-of-staff and objects to these changes, the chief of staff calls Dr N a complainer and tells him to forget about it. Nothing is done.
authors.affiliation: The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex. Electronic address: jwjones@bcm.edu.
authors.forename: James W
authors.initials: JW
authors.lastname: Jones
authors.affiliation: The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D001291:Attitude of Health Personnel; D000067088:Direct-to-Consumer Advertising / Q000941:ethics; D020445:Hospitalists / Q000941:ethics* / Q000523:psychology; D006801:Humans; D007325:Institutional Practice / Q000941:ethics*; D007398:Interpersonal Relations; D007587:Job Description; D008389:Marketing of Health Services / Q000941:ethics; D015279:Organizational Culture; D010379:Peer Group; D010819:Physician's Role / Q000523:psychology; D011050:Policy Making; D000068616:Professionalism / Q000941:ethics*; D014342:Truth Disclosure / Q000941:ethics