Ethics in contemporary health care management and medical education

• Published in: Journal of evaluation in clinical practice Vol. 26; no. 3; pp. 699 - 706
• Main Authors: Balak, Naci, Broekman, Marike L.D., Mathiesen, Tiit
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Inc 01-06-2020; Wiley Subscription Services, Inc
• Subjects: Delivery of Health Care; Education, Medical; Ethics, Medical; health care; Health care policy; health policy; Health Services Administration; Humans; Medical education; Medical ethics; Medical philosophy; Medicin och hälsovetenskap; philosophy of medicine; philosophy of medicine; health policy; medical education; medical ethics; health care
• ISSN: 1356-1294; 1365-2753; 1365-2753
• DOI: 10.1111/jep.13352

Rationale
The health care landscape is changing: it has become the largest part of the economy and changes in public management systems will greatly affect how we practice medicine in the future. Medical education will be more important than ever to ensure patients get the best care with empathy. However, new public management systems implemented without thorough analysis might challenge medical education. An increasing number of public health care institutions provide services based on competitive market rules and express their goals in financial terms and have set financial gains as their main goal, which contradicts the fundamental nature of medical ethics and practice.
Aims and objectives
To explore new public management to identify potential problems and offer possible solutions for medical education and health care institutions.
Methods
A scoping review of the literature on public administration, hospital management, professionalism, ethics, and medical education was undertaken to map evidence on the topic and identify main concepts and knowledge gaps in the influence of management systems on the quality of medical educational practices.
Results
If the accelerating changes in public management are cursorily analysed, medical education may lose the esteem in which it has long been held globally. Without precautions, the so‐called new public management medical faculties will—at best—generate economic benefit, following a business model with strict quality rules, regulations, standardized products, and complex analysis and measurement systems. However, these faculties will function at a level far below the ideal of teaching institutions distinguished for their outstanding components, creativity, and ambience.
Conclusions
Patients and teaching values are not reducible to financial terms only and the acknowledgement of non‐financial values is fundamental to achieve quality in health care and education. The most essential step could be selecting managers who will implement public management principles while taking into account both business requirements and medical ethics.