1. Changes for Doctors
• Shortage of doctors
• Increased demand for Primary Care Physicians
• Increased numbers of patients to be seen
• Decreased reimbursement rates
• Fewer small, privately-owned doctor offices
• Increased operational costs & malpractice
insurance
• Shorter time spent with each patient
• Increased job strain and role conflict
• Need for better ER management
• Managed by a Rewards & Penalties System
• Creation of Accountable Care Organizations
• Billing under Bundled Payments
• Penalized for high-cost health plans
• Fewer physician-owned hospitals
• Closing of small, currently struggling hospitals
• Potential layoffs
Changes for Hospitals
McDonaldization Theory
• Elements of the fast-food industry have seeped into
healthcare
• Epitomized by Burger King’s “Have it your way”
slogan
• Focus on Efficiency, Calculability, Predictability, and
Control
• Emphasis on quantity vs. quality
• Loss of empathy
The United States (US) is currently implementing
some of the most dramatic updates to the American
healthcare system since the introduction of Medicare
in 1966. Considering health insurance’s lack of
accessibility and healthcare’s sometimes unaffordable
costs this has millions of Americans distressed and
seeking changes be made immediately.
This research is intended to examine the US
healthcare industry and how the Healthcare Reform
Movement and Affordable Care Act of 2010 will
transform the industry, including its many
components comprised of doctors, hospitals,
businesses and the average American worker. The
theory of McDonaldization can elucidate how
healthcare is becoming increasingly rationalized, all
of which spills into every aspect of the industry and
will most certainly have a profound effect upon
American citizens in the near future.
Introduction ELEMENTS
Of McDonaldization
IMPACTS
On Healthcare Industry
Efficiency
• Utilizing the optimum treatment
methods/solutions
• Medical procedures with pre-designed steps that
must be followed
• Emphasis on speed of service delivery, i.e. Short
Stay & Day Surgery
Control
• Increased quality control
• Use of more non-human technology i.e. blood
pressure machine, computerized scale or robotic
surgery
Calculability
• Frequent monitoring and observing of the
industry
• Emphasis on quantity
• Production of measurable results, i.e. how many
patients seen per hour
Predictability
• Standardized and routine patient experiences
• Increased preventative care to anticipate future
illnesses
• Increased insurance costs/spending on employee
benefits (small businesses most affected)
• Refusal to hire future employees with
predisposed health conditions (i.e. obesity, heart
disease, diabetes) or people who smoke
• Less re-investment in the business
• Possible layoffs
• Less hiring of new employees
• Encouraging employees to work more part-time
hours rather than full-time hours
• Increased cost-saving strategies
Concerns for Businesses
Effects on the American Worker
• Better overall health
• Increased worker productivity
• Decreased absenteeism at work
• Increased job satisfaction
• Potential wage cuts, hold on raises or pay-freezes
• Lack of work promotions
• Hiring-discrimination due to predisposed
health conditions of workers
• Reduction to part-time status
In conclusion, healthcare reform was implemented to
decrease costs and increase access for more Americans.
In addition to these intended changes, the effects of
McDonaldization will instigate further changes in the
healthcare industry too, such as needing to see more
patients in shorter time frames. Businesses will need to
insure workers while balancing costs and maintaining
high production. Lastly the American worker can
appreciate better healthcare, but it may come with some
costs, such as fewer hours or lack of promotions.
Conclusion
References
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Healthcare Reform: Healthcare Industry and Worker Impacts
Rebecca Derbes
Lebanon Valley College