Can Conflicts of Interest Affect a Patient’s Well-Being?
Dealing with an illness or the aftermath of an accident is emotionally and physically draining for all interested parties — especially the patient, family, and caregivers. Frustrations can build, personality clashes can explode into name-calling and undermining, and patient wellness can be lost in the shuffle.
But it doesn’t have to be that way. The key is taking a step back, understanding what constitutes a conflict of interest, and identifying the source of any potential conflicts before patient wellness is put at risk.
While not meant to be an all-inclusive list, these are some of the most common sources of conflict:
- Multiple Family Members: Whether it’s the spouse, children, or siblings, every family member involved with patient wellness and care has a unique relationship with the patient. That uniqueness — combined with decades-old interfamilial jealousies and resentments — can drive self-interest and a subordination of the patient’s needs to the family member’s. Examples would include:
- The financial pressures of paying for the patient’s care
- Disagreements over treatments and medications
- Resentment about disparities in how much time each family member is devoting to the patient
- Arguments over which of the patient’s normal activities should be allowed or banned (for example: driving a car, taking medications on their own, cooking or cleaning)
- Family Caregivers: Most elder abuse — especially embezzling and other forms of financial abuse — occurs at the hands of family members. Family caregivers — whether paid or unpaid — might take on bill-paying and check-depositing as a responsibility. Over time they may feel like they’re being taken advantage of and begin funneling money to themselves as compensation. In most cases, the patient has complete trust in the family members and would not suspect any type of financial misconduct. To avoid a situation like this, family members should agree at the outset to together review all expenses, outlays, and deposits once a month. Alternatively, they can hire a third-party to do the same.
- Paid Professional Caregivers: Paid caregivers tend to work through an agency and, without question, most put patient wellness and comfort as their top priority. Sometimes, however, paid caregivers are under pressure from their agency-employers to increase the number of hours worked or the types of service provided. Caregiving agencies may offer ancillary services or sell products like walkers or wheelchairs that the caregiver is expected to promote to patients and their families.
- Hospitals: The economics of today’s hospitals put a great deal of pressure to discharge patients as quickly as possible with little to no regard towards patient wellness. Turning over beds is the the way hospitals try to maximize their reimbursement revenue. Premature discharge, however, could be in direct conflict with the patient’s home situation and contribute to prolonged recuperation and/or readmission to the hospital.
- Assisted-Living, Nursing Homes, and Similar Facilities: With the same caveat as offered above, most healthcare-related facilities put the patient first; but that is not always the case.
- According to a report by MarketWatch.com, assisted living facilities view ailing residents as “cash cows” and charge extra for a variety of services that the patient may not want or need.
- A study by Medicare’s Inspector General, as reported by ProPublica, found “One-in-three patients in skilled nursing facilities suffered a medication error, infection or some other type of harm related to their treatment.”
- Contrary to popular opinion, the majority of assisted living facilities and nursing homes are for-profit (and frequently owned by large public companies). That profit motive may lead some facilities to discourage patient discharges for as long as possible.
As different as these potential conflicts of interest may appear, there is enough commonality that they can be addressed with a single solution — a third-party Care Manager. In addition to keeping the patient’s needs as the top priority, a Care Manager will maintain objectivity, be neutral to all parties, and be able to separate emotional feelings from factual information. The American Association for Retired Persons (AARP) recommends hiring a Care Manager whenever there’s the potential for any conflicts of interest: “A Care Manager can serve as another objective voice while guiding you toward the best health care resources in your area.”
At SMS we have eliminated any possible conflicts of interest. Care Management is all we do. We don’t sell products, manage assisted living centers, or offer rehabilitation services. We don’t try to upsell or cross-sell complementary services. Our sole focus is ensuring the patient receives the highest quality of healthcare possible — and isn’t that really what you want for yourself and loved ones?