Wielding Organizational Influence in Health Care

Not long ago, most physicians were solo practitioners, but today large and complex organizations dominate the health care sector. Organizational cultures shape policies, policies shape practices, and practices express the reasons clinicians have for acting in relationships with patients. Distributing authority and responsibility in health care environments is not only a function of a clinician’s professional background and training, but also how organizations wield power and situate encounters and relationships among clinicians, patients, and other stakeholders.

Volume 22, Number 3: E177-259 Full Issue PDF
  • From the Editor in Chief
    Mar 2020

    Oscaring Parasite

    Audiey C. Kao, MD, PhD
    Racism against Asians and Asian Americans related to COVID-19 contagion fear is irrational, as threat of influenza is far more real. Exacerbated by abundant poor health information, viral xenophobia follows a history of de jure Asian exclusion.
    AMA J Ethics. 2020;22(3):E179-182. doi: 10.1001/amajethics.2020.179.
  • From the Editor
    Mar 2020

    Organizational Ethics for US Health Care Today

    Patrick S. Phelan
    Clinical practice has evolved with diversification of health care organizations, each of which plays key roles in acquiring and mobilizing resources in the sector.
    AMA J Ethics. 2020;22(3):E183-186. doi: 10.1001/amajethics.2020.183.
  • Case and Commentary
    Mar 2020

    How Should Commerce and Calling Be Balanced?

    Richard Gunderman, MD, PhD
    Corporatization in health care has complicated clinicians’ and organizations’ efforts to balance interests of individual patients against an organization’s bottom line.
    AMA J Ethics. 2020;22(3):E187-192. doi: 10.1001/amajethics.2020.187.
  • Case and Commentary
    Mar 2020

    What Should Physicians Consider Prior to Unionizing?

    Danielle Howard, MD
    Some physicians who value collective bargaining remain concerned that patient services could suffer, but unionization can be driven by a focus on improving care.
    AMA J Ethics. 2020;22(3):E193-200. doi: 10.1001/amajethics.2020.193.
  • Medicine and Society
    Mar 2020

    Do Conflict of Interest Disclosures Facilitate Public Trust?

    Daylian M. Cain, PhD and Mohin Banker
    Even disclosed conflicts of interest can be dangerous in health care settings, but disclosure might not be the panacea many seem to take it to be.
    AMA J Ethics. 2020;22(3):E232-238. doi: 10.1001/amajethics.2020.232.
  • History of Medicine
    Mar 2020

    Community Health in Rural America During the Mid-20th Century

    Amber Dushman, MA, MLIS
    The AMA’s Council on Rural Health (1945-1975) collaborated with domestic health care organizations in the mid-20th century to improve access to health care in rural areas.
    AMA J Ethics. 2020;22(3):E248-252. doi: 10.1001/amajethics.2020.248.
  • Personal Narrative
    Mar 2020

    Pronouns and Advocacy in Medicine

    Nat Mulkey, BUSM
    This article considers one student’s experience after coming out as nonbinary and voicing that their pronouns are they/them.
    AMA J Ethics. 2020;22(3):E255-259. doi: 10.1001/amajethics.2020.255.
  • podcast-2003
    Podcast
    Mar 2020

    Ethics Talk: COVID-19 Pandemic Response

    Editor in chief, Dr Audiey Kao, talks with Dr Matthew Wynia about allocation of critical care resources and clinicians' duty to show up to work during public health emergencies.