Nursing Leadership Responses

Please respond to each of the 2 discussion posts below. Each response should be 1/2 page in length and 1 source each.  #1 Respond to Patricia F. Week 2 – Discussion LDR 4400             I believe kickbacks are an unfair trade practice and are illegal.  A leader needs to maintain their values and for me, that includes treating everyone the same, no special treatment or favors.  Honesty, integrity, respect, and openness are the key values that great leaders possess.  If a leader starts taking kickbacks all these are negated.  I believe Lee Cockerell (2008, p. 250) had the same idea when he stated, “great leaders not only know what their values are but allow those values to guide their every decision”.             The following example shows an organization that willingly accepted kickbacks and the outcome.  Robert Bourseau and Rudra Sabaratnam, MD who were former owners of California Medical Center agreed to pay $10 million to resolve a civil lawsuit for paying recruiters to bring homeless people in for unnecessary medical treatment (Becker’s Hospital Review, 2020).  Robert Bourseau was sentenced to 37 months and ordered to pay $4.1 million in the restitution of the Medicare fraud (Becker’s Hospital Review).  Receiving kickbacks result in restitution and imprisonment.             News travels fast in an area where there is a reported fraudulent case.  Patients would not trust the hospital and would choose to take their business to a neighboring hospital.  Former patients and their families would be second-guessing if the medical treatment they received from the California Medical Center were unnecessary.  The result could be additional lawsuits from patients and insurance companies.  Financially it will affect the hospital for years, and they will need to change their name.  The goal is to encourage patients to use the hospital, believing that changes have been made to rectify the situation.  The company needs to have values that provide support for their mission and vision statements posted in the facility for patients and staff.  For example, if a company truly values improving the lives of patients, then their mission and vision statement should reflect these values.  Every employee should be reminded of these values and required to practice the process with each interaction with patients, families, and other staff members.  The process could be as simple as a smile within ten feet of a person or acknowledging a person as you pass by.  If the owners of California Medical Center were practicing the value and culture at their hospital, then they would not have even thought twice about accepting any type of kickback and would have been prepared to do the right thing when an ethical dilemma arose.  Lee Cockerell (2008, p. 249) stated what needed to happen in this situation, by the need to evaluate your ethical standards before making a difficult choice.             At my facility, it is illegal to take any monetary amount for services rendered.  By creating a policy that addresses an employee’s expectations concerning acceptable gifts demonstrates the hospital’s values and cultural beliefs.  We are allowed to accept small gifts like flowers, food, or a thank you card.  My preference is to accept a gift that can be shared with my peers to show appreciation and hold a value of less than $50.  Otherwise, I would graciously decline the gift.  My experience has been receiving flowers that were placed at the nurse’s station as a thank you for all staff members, pizza for the staff, and thank you cards. Reference Becker’s Hospital Review. (2020). 10 big anti-kickback and stark cases involving hospitals in 2010. Retrieved September 5, 2020. (Links to an external site.) Cockerell, L. (2008). Creating magic: 10 common sense leadership strategies from a life at Disney. Doubleday.     #2 Respond to Kelley The scenario presented by Cockerell in the video of being offered a kickback by a taxi company to only allow them to take guests to and from the airport presents a bit of an ethical dilemma. It doesn’t benefit the company Cockerell works for or the hotel guests, and really only benefits the person receiving the kickback and the taxi company. I would say it is an unfair trade practice.  When trying to find examples of organizations taking kickbacks, it appeared to me as if it is an illegal practice, at least in the healthcare industry. I found a case of 2 physicians and a drug company salesman that were indicted for a kickback conspiracy. The physicians received money and other items of value  to write prescriptions for patients that did not need the drug. The physicians went so far as to falsely diagnose their patients in order to prescribe the drug they were receiving kickbacks to prescribe (United States Department of Justice, 2019).  Their careers and practices were destroyed as a result of receiving kickbacks, and public perception is that these professionals violated the trust of their patients. This behavior shows that they value money over the well being of their patients, who are also customers of their healthcare organizations. Cockerell’s first leadership strategy is inclusion. This strategy is to treat each and every employee as if they are valuable and to provide them with a sense of responsibility and a role in the decisionmaking process of the organization. (Cockerell, 2018, p 34). If decisionmaking is made in a transparent fashion and every employee has a voice if they so choose, the practice of management receiving kickbacks would be completely out of the question.  I am not in a leadership position at my healthcare organization, but I do recall going over everything that could be considered a kickback in orientation and being told explicitly to never take any money or items of monetary value. There is a compliance department that deals with all facets of legal, ethical, and business standards, and we are encouraged to contact them if we ever have any questions about appropriate behavior. I feel like it would be hard to manage kickbacks as a healthcare leader, simply because it is difficult to ensure that everyone you manage is following the standards that you set out. There also seems to be gray areas, and one would need to have a lot of specific knowledge about the legal aspect of what constitutes a kickback. I think having a culture where completely ethical and legal business practices are adhered to strongly would be important on an organizational level.  References Cockerell, L. (2008). Creating magic: 10 common sense leadership strategies from a life at Disney.DoubledayPublishing Group/Random House, Inc United States Department of Justice. (2019). Physicians and pharmacy sales reps indicted for kickback conspiracy in which doctors allegedly received money in exchange for writing unnecessary prescriptions of Nuedexta.

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