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9TOURISM AND RECREATION
INFLUENCE OF PROFESSIONAL ETHICS OF DOCTORS ON THE DEVELOPMENT OF MEDICAL TOURISM
Candidate of Economic Sciences, docent - Abdramanova G. K;
Undergraduate - Otarbay A. G.
Kazakhstan, Astana, Eurasian National University
Abstract: The article deals with the professional ethics of doctors and its influence on the development of medical tourism. The aim of the research is that the human resources are an important feature - the people in carrying out their tasks are investing in the production process of medical services not only their strength, but also intellectual and spiritual capabilities. It emphasizes the need to develop their own ethical standards, reflecting the care of doctors about the interests of patients.
Keywords: professional ethics, medical tourism, medical tourist, Joint Commission International (JCI), accreditation of medical organizations.
The transformation of the social order in the new values requires from medical institutions introduction of market mechanisms, which provides for the rational use of resources: financial, material, technical and human resources. Optimization of human resources especially in the conditions of shortage of medical staff - a leading way to increase efficiency and the development of medical tourism in general. Under these conditions, personnel in the field of medical tourism should pay particular attention to ethics, honesty, and respect for patients and within the team.
Medical tourism - a new, fast-growing segment of international tourism that involves traveling to obtain highly specialized care and treatment outside the country of residence. In the broadest sense, medical tourism is defined as the sphere of medical and hospitality industry, which is connected into a single market system, including both medical institutions and different branches of business [1].
Human resources have an important feature - the people in carrying out their tasks are investing in production process of medical services not only their strength, but also intellectual and spiritual opportunities. Production and quality of its products in the form of medical services to a large extent determines the success of the medical staff and management activities. The success of any organization depends on the professional ethics of staff. It is impossible to succeed in the field of quality organization that has not created its interior space, its domestic production environment, special intra organizational atmosphere.
Professional ethics - one of the fundamental theoretical bases of any professional activity. It represents a science of professional ethics, a set of ethical standards of behavior, a set of professional values and categories that reflect the essence of the profession and ensure the relationship between people, developing in the process of labor and the resulting content of their professional activities [2]. Professional ethics, as well as ethics in general, is not developed, it is gradually produced in the course of daily activities of people together. It organizes lessons in the process of historical practice experience, typical for this type of activity; it generalizes and improves with the improvement of this type of activity. Therefore, professional ethics can be seen as a kind of common morality, which carries the specific features arising from view and the type of activity.
Medical tourists' satisfaction with medical services is one of the criteria for assessing the activity of the medical institution, which reflects both positive and negative trends in the development of medical tourism in the public opinion. Getting high-quality, adequate care should fully satisfy the patient, however sometimes the opposite happens. Most causes of dissatisfaction can be divided into two groups. The first depends mainly on health care organizations: dissatisfaction with the organizational moments (timetable of the organizations and individuals turn, shortage of staff), violation of ethics and deontology among health personnel, violation of examination and treatment techniques, or lack of skills, poor material and technical base. The latter depends on the patient: unreasonable requests and requirements for medical personnel, violation of doctor's instructions (as a consequence, the lack of effect of treatment).
What could impact on the patient's expectations and on his evaluations of work of the medical personnel? The most common representation of the patients themselves about where, who and what kind of care they should have, formed on the basis of experience, which includes education, interest in medical topics, past illnesses and their outcome, the result of contacts with medical professionals and the reason prompted to seek medical help. Certain influence the opinion of the nearest environment of the patient, especially if a person is easily suggestible.
Contact with a health professional has a great impact on satisfaction with medical care of the patient. The man in the white coat has certain rights relating to the life and health of the patient, so his actions - under special attention. These rights are required to turn the doctor to the patient and society.
Substantiated dissatisfaction of patient is the lack of attention on the part of medical personnel, rudeness. It is evidence of an inverse relationship between satisfaction of medical care and claims for medical staff: less mentions of the negative manifestations on the part of medical personnel, the higher the level of satisfaction.
Factors, which influence the patients' satisfaction with medical care a lot of. In the first place - series of patient expectations in regards to the scope of medical examinations, the process and the outcome of treatment. What factors affect the patient while choosing a clinic? The most common representation of the patients themselves about where, who and what kind of care they should have, formed on the basis of experience, which includes education, interest in medical topics, past illnesses and their outcome, the result of contacts with medical professionals and the reason prompted to seek medical help.
It should also be noted a different attitude to the assessment of medical care of patients and health professionals. Since the majority of patients, in the first place, evaluate the convenience and comfort of conditions in hospitals, and then, apparently, more important factors such as the number of complications after medical procedures or patient mortality. Health care workers primarily worry about mortality, complications of medical interventions, but the comfort and convenience of patients the most frequently do not take into account. To solve the aforementioned problems, organizations conduct various activities, government reforms and innovations.
For example, Kazakhstan is actively carried out reforms aimed at improving the quality and safety in health care. These include the accreditation of health care organizations in the standards, the relevant international safety and quality requirements. However, implementation of these reforms depends on the willingness of health care organizations, their employees, and especially managers, to change.
In order to improve the quality of medical services, selection and unification of the most efficient and reproducible methods for the treatment in a number of countries were accepted standards of medical care, taking into account international experience, expert advice and national characteristics. In order to confirm compliance with these standards are conducted accreditations of healthcare organizations.
It is carried out in order to evaluate, manage and improve the quality of health services, obtain preliminary information about the health facility while placing state orders for the provision of such services in the framework of guaranteed free medical care (in an international context - by the insurance companies to assess the level of trust to the services specific clinic) and focus on the end result. Accreditation confirms the compliance of the medical organization established quality standards, as well as implementing the right of patients to receive the highest quality and safety of services.
Joint Commission - a nonprofit organization, that has been active in the United States for 75 years in order to improve medical quality and safety. Joint Commission is the largest and the most prestigious accrediting agency in the United States and around the world. Since 1994, an international program of Joint Commission International (JCI) has operated, which aims to improve the quality and safety of health care in the international community. At the same time standards of Joint Commission International was recognized as "gold standard" of international health service.
Accreditation is obtained only by hospitals with a very high potential: the implementation of standards requires a lot of time and investment. So, only 400 hospitals have JCI accreditation, most of which are located in the USA, Turkey, Singapore, the United Arab Emirates, South Korea. In the postSoviet space are only 6 clinics have JCI-standard, five of which - in Astana and one - in Moscow (illustration 1) [3].
The standards are divided into patient-oriented and organizational (management standards). The first includes the correct patient identification of standards, continuity of treatment, the patient's
rights and responsibilities, health education, and etc. Management standards include management of quality, infection control and safety of buildings, human resources management, information and guidance.
Gulf countries
1 clinic has JCI-standard
Kazakhstan
5 clinics have JCI-standard
Singapore
13 clinics have
JCI-standard
Fig. 1. Countries with JCI- accredited hospitals Note - the scheme made by the author based on the data [3]
In the process of implementation of JCI standards are involved all employees of the clinic: clinical staff (physicians, nurses, specialists laboratories and pharmacies), support staff (nurses, cleaners, drivers, engineers, etc.), administrative staff (management, lawyers, human resources, economists, etc.). It promotes greater collaboration between employees, creation of favorable conditions in the collective, as well as increases their professionalism, which is the basis of professional ethics. Moreover, the standards prescribe the responsibility of not only the hospital staff, but also other companies that provide services to the clinic (for example, companies involved in garbage disposal, catering of patients, cleaning premises and territories of hospitals).
Within the framework of the implementation of JCI standards and preparation for the accreditation each clinic is developing a plan for improvement, which are determined by the so-called Champions - employees who need to make a plan work, organize a permanent job on writing the rules and procedures of standards and measurable elements, check their performance and provide continuous training.
Practice shows that the government of already accredited clinics has noted specific changes in activity. In particular, the reduction in the number of medical errors, decrease in nosocomial infections, decrease in the average length of stay of patients in a hospital bed; cost reductions; increase patient, staff satisfaction; raising the status of nurses.
Thus, the practice of national accreditation is constantly evolving, adapting to changes in social, political and medical environment. Accreditation provides clinic's staff motivation for continuous self-improvement, professional growth, striving to improve the quality and safety of medical services, patient satisfaction.
In addition, in 2016 to ensure the quality and responsiveness of the health system in Kazakhstan will be developed and implemented a national program for the development of medical ethics and communication skills of health workers, with the involvement of the general public, educational institutions, professional associations and the media [4]. The basis for effectively improving the quality and safety of health care will be a system of quality management based on the standardization of all production processes in medical organizations.
Approval of clinical guidelines and protocols for use in clinical practice will be carried out jointly with specially created expert advisory agency - the Joint Commission on the quality of medical services. The basis of the local quality management systems will be the internal audit service of medical organizations. Their activities will be constructed on the introduction of a unified system of risk management and regular auditing of clinical processes with the involvement of independent medical experts [5].
Therefore, at the present time in all health organizations is implemented a system of quality management of medical care, which in addition to expert assessment of medical care includes assessing the level of satisfaction with medical care of patients. But the implementation of systems of quality management will not bring the desired result, if you do not change the fundamentals of the organization - a system of values, management style, problem-solving approaches, everything that is usually understood by the corporate culture.
The following to professional ethics contributes to the success of medical practice, the choice of methods and means of achieving these goals, elevates a person, creates a favorable psychological climate in the professional field that provides the moral health of the individual, the medical team and the entire professional community. Possession of professional ethics allows structurally understand the situation, the participants which are healthcare professionals and patients, health professionals and relatives of the patient, medical professional and his colleagues.
In conclusion, we note that at present time professional standards are developing and improving, changing social relations. And in this new picture of the world than ever important to be able to respect the people around us as it is the main advantage of the professional ethics of representatives of the service sector and medicine.
REFERENCES
1. Krista, W. (2012). Medical Tourism: Trends and Opportunities. Las Vegas: University of
Nevada.
2. Zhavoronkov, E.P. (2009). Management of organizational culture: manual. Novosibirsk: Sibmedpress of NSMU.
3. Accreditation of medical organizations as a factor of development of the company, http://camonitor.kz/14488-akkreditaciya-medicinskoy-organizacii-kak-faktor-razvitiya-kompanii.html
4. The development of medical ethics program will be developed in Kazakhstan, http://www.zakon.kz/4732977-v-kazakhstane-budet-razrabotana.html
5. On people's health and the health care system: Code of the Republic of Kazakhstan, http: //www .zakon.kz/zdorov_kodex.html
