EHFCN_Spazioetico_30_03_2022.pptx

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EHFCN WEBINAR
“Watching with patients’
eyes. Patients’
expectations and
profitable moral hazards”
30th of March 2022
Massi...

DOCTOR «X» PATIENT «Y»
Characteristics of a doctor–patient
relationship
Information
ASYMMETRY
INTERESTS
alignment
Delegati...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

ANALYST
In health sector, FRAUD, CORRUPTION and
WASTE ANALYSTs:
• identify and analyse the areas of
potential risk threate...

INTEGRITY FAILURE
INFORMATION ASYMMETRIES CONFLICT OF INTERESTS

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she confes...

WHO’S DR.
ASYMMETRICUS
ACCOUNTABLE TO?
DR. ASYMMETRICUS

THE PATIENT
THE HOSPITAL’S CEO
THE TAXPAYERS
MY PROFESSIONAL
KNOWLEDGE AND
CONSCIENCE (deontology)
DR. ASYMMETRICUS
WHO’S ...

DR. ASYMMETRICUS
MRS. AMAUROSIS
AGENT
PRINCIPAL
DE-CONTEXTUALIZED
(SIMPLE) SCENARIO
• Hippocratic doctor takes care of his...

CONTEXTUALIZED
(COMPLEX) SCENARIO
• In a modern context the doctor receives a
delegation from a public or private organiza...

From Agency
theory…
…to “EXTENDED” Agency
theory
DR. ASYMMETRICUS
MRS. AMAUROSIS
AGENT
PRINCIPAL
DE-CONTEXTUALIZED
(SIMPLE...

MRS. AMAUROSIS
Mrs. Amaurosis is suffering from severe retinitis pigmentosa.
Having recently moved to the city, she went t...

“EXTENDED” Agency theory in the public
sector
PERFORMANCE
To guarantee professional performance
IMPARTIALITY
To grant equi...

• Relying on information asymmetry and trust,
Dr. Asymmetricus targets Mrs Amaurosis to a
very bad quality specialized cen...

PRIMARY INTERESTS
(public sector)
SECONDARY INTERESTS
PERFORMANCE
• To guarantee professional performance
DELEGATED PRINCI...

PRIMARY INTERESTS
(public sector)
SECONDARY INTERESTS
PERFORMANCE
• To guarantee professional performance
DELEGATED PRINCI...

PRIMARY INTERESTS
(public sector)
SECONDARY INTERESTS
PERFORMANCE
• To guarantee professional performance
DELEGATED PRINCI...

MORAL HAZARD #2
INTERESTS MIS-ALIGNMENT
(perceived)
PROFITABLE MORAL HAZARD
• Relying on Mrs. Amaurosis information
asymme...

PRIMARY INTERESTS
(public sector)
SECONDARY INTERESTS
PERFORMANCE
• To guarantee professional performance
DELEGATED PRINCI...

• Relying on Mrs. Amaurosis information
asymmetry and trust, dr. Asymmetricus
targets her to the best optical center, with...

1) … a decision, a behaviour or an information
management...
2) … associated to an organizational process…
3) … which thre...

The “extended agency theory” is more accurate to describe the
relationship between doctor and patient in a complex context...

THE RELATIONSHIP:
HOW IT IS
• How does a Recipient visualize the relationship?
• What are his/her expectations?
• Can we p...

NEEDY FAITHFUL SELF-PROCLAIMED
RECIPIENTS’ RELATIONAL PROFILES
(an exemplification)
Watching with patients’ eyes

MRS. NEEDY
Mrs Needy is a patient who constantly needs to undergo to diayisis.
Unfortunately public health services fail t...

MORAL HAZARD #1
• Dr. Kidney tells Mrs. Needy to show up
the next day at the public health center:
«I’ll handle this».
MRS...

MRS. NEEDY
CEO «Z»
AGENT
DELEGATED
PRINCIPAL
RECIPIENT
DELEGATING
PRINCIPALS POTENTIAL
RECIPIENTS MARKETS
DR. KIDNEY
TAXPA...

CEO «Z»
AGENT
DELEGATED
PRINCIPAL
DELEGATING
PRINCIPALS POTENTIAL
RECIPIENTS MARKETS
TAXPAYERS
THE RELATIONSHIP:
HOW IT IS...

Pathology - Degeneration
DR. KIDNEY
• Dr. Kidney becomes a relational HUB.
• The Association becomes a bottleneck. It mana...

MR. FAITHFUL
Mr Faithful’s daughter has recently undergone a
difficult surgery performed by Dr. Goddess, a public
ospital ...

MR. FAITHFUL
Mr Faithful’s daughter has recently undergone a difficult
surgery performed by Dr. Goddess, a public ospital
...

MR. FAITHFUL
CEO «Z»
AGENT
DELEGATED
PRINCIPAL
RECIPIENT
DELEGATING
PRINCIPALS POTENTIAL
RECIPIENTS MARKETS
DR. GODDESS
TA...

MR. FAITHFUL
CEO «Z»
AGENT
DELEGATED
PRINCIPAL
DELEGATING
PRINCIPALS POTENTIAL
RECIPIENTS MARKETS
DR. GODDESS
TAXPAYERS
TH...

MR. FAITHFUL
CEO «Z»
AGENT
DELEGATED
PRINCIPAL
DELEGATING
PRINCIPALS POTENTIAL
RECIPIENTS MARKETS
DR. GODDESS
TAXPAYERS
TH...

Pathology - Degeneration
• Benefits and exchange deals become pre-condition for service providing
• Patients are selected ...

MR. SELF-PROCLAIMED
The health insurance sends Mr. Self-proclaimed to a selected
hospital to carry-out a visit with Dr. Pe...

MR. SELF-PROCLAIMED
The health insurance sends Mr. Self-proclaimed to a selected
hospital to carry-out a visit with Dr. Pe...

MR. SELF-PROCLAIMED
INSURANCE CEO
AGENT
DELEGATED
PRINCIPAL
RECIPIENT
DELEGATING
PRINCIPALS SHAREHOLDERS
DR. PERTINENCE
TH...

AGENT
DELEGATED
PRINCIPAL
DELEGATING
PRINCIPALS
THE RELATIONSHIP:
HOW IT IS PERCEIVED
DR. PERTINENCE
AGENCY RELATIONSHIP
E...

AGENT
DELEGATED
PRINCIPAL
DELEGATING
PRINCIPALS
THE RELATIONSHIP:
HOW IT BECOMES
DR. PERTINENCE
AGENCY RELATIONSHIP
AGENCY...

Pathology - Degeneration
• Dr. Pertinence provides false statements under Mr. Self-proclaimed
pressure
DR. PERTINENCE

CONFLICTING RELATIONSHIPS
Agent
INTERPERSONAL RELATIONSHIPS
Coniugal bonds
Partnership
Family bonds
Habitual attendance
Se...

SPAZIOETICO
ASSOCIAZIONE PROFESSIONALE
https://spazioetico.com/
Email: info@spazioetico.com
Tel. +39.3334158347

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