The practice of medicine, long valued for individual entrepreneurship and physician control, has undergone dramatic change. Physicians now face vexing oversight of case and utilization management and loss of control over the allocation of health care dollars. Managed care organizations control health costs by arbitrarily refusing reimbursement for certain medical procedures and reducing payments for others. Since medicine is now a less attractive career option, will fewer high performing individuals choose to become physicians? What are the implications for the quality of care? cite at least one scholarly source
Health care
Physician care is an enormous enterprise in the United States, with more than $515 billion (Martin, et al., 2012) in 2010 representing the work product of more than 750,000 practicing physicians. It is undoubtedly the most respected and successful professional activity in U.S. history. Yet, today, the American physician community is in turmoil. Despite hospital systems and health officials calling out the need for more primary care doctors, graduates of U.S. medical schools are becoming less likely to choose to specialize in one of those fields. Part of it has to do with income. The ultimate responsibility for each individual patient`s medical care rests with the physicians. With fewer individuals choosing to become physicians, there will be many implications for the quality of care.
depending on whether they are under or over 16 years old that youth justice social workers have to be aware of. Children and young people under the age of 16 who offend are generally referred to the Children’s Reporter. However if over the age of 16 and offend then they are generally reported to the Procurator Fiscal, and go through the adult justice system. This can be in direct contrast to the view that developmentally 16 to 18 years old should be considered children as suggested by Thomson (2010). The only exception to this rule is if the young person is between the age of 16 to 18 years old and subject to compulsory measures under the Children’s Hearing (Scotland) Act 2011 (s.199). Part of the complexity of the social work role in a youth justice setting is the fact you have to work effectively over both these distinct processes. Practice that crosses the complexities of both these distinct processes must take into account the childcare system which focusses on welfare needs of that individual child or young person and the adult criminal justice system which focusses on the nature of the offence and protecting the public interest (Audit Scotland 2001).
Research has shown that young people who are involved in serious offending are ones with the most complex needs (McAra and McVie 2010). Evidence suggests that almost all young offenders have suffered various kinds of abuse, neglect, deprivation and misfortune (Arthur 2007). Due to these complex needs along with dealing with their offending behaviour we must address any underlying factors such as complex family history, school truancy and social deprivation which have led to their offences. These complex needs can’t always be dealt with by one service alone. Hence inter-agency working is crucial to the work done in a youth justice setting in the drive for desistance. Youth justice social work involves working with different professional groups, agencies and organisations including close links with police, education, health, psychological services and other specialist services. For effective inter-agency work to occur there must be an understanding of differing roles and responsibilities as well as the commitment to work together (Mitchell 2011).
Where the child or young person’s needs involve two or more agencies working together delivering a service to the child or young person and their family then a lead professional will be needed (Scottish Government 2012). The lead professional is responsible for co-ordinating the multi-agency care plan for the child or young person, making sure the different agencies act as a team and that the help they are offering fits in with the plan and provides t