Correspondence
Ethics and management objectives
La ética y los objetivos de gestión
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Prieto de Paula, S. Franco Hidalgo" "autores" => array:2 [ 0 => array:4 [ "nombre" => "J.M." "apellidos" => "Prieto de Paula" "email" => array:1 [ 0 => "jmprieto@saludcastillayleon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Franco Hidalgo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Complejo Hospitalario de Palencia, Palencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La ética y los objetivos de gestión" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read the interesting study by Alonso et al.,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> the title of which appears ambiguous to us, because it is unclear whether the word “for” means “in the perception of” or “directed at” (hospital physicians).</p><p id="par0010" class="elsevierStylePara elsevierViewall">There are 3 fundamental issues here: In the operational objectives, quantity is prioritized over quality; the clinicians are barely involved in preparing the objectives; and its approach is unfocused in terms of the reality of the healthcare system.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We have observed a reluctant attitude from the outset regarding the desirability of management efficiency. When we read “Although healthcare institutions should conduct efficient management... their ultimate goal is... optimal patient care”, the concessivity of “Although” slyly pits management against optimal care, as if one is not directed towards achieving the other.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The article has a number of nonspecific or generalized statements and states that physicians “... are incentivized to achieve quantitative results...”, that “... physicians are rewarded... for assisting more patients in a shorter time” and that management sends the proposed objectives to each department (from which we can infer a lack of participation) or that these are focused on indicators regarding the care of acute processes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">We do not know the sources consulted, but in any case, the authors appear to have employed a synecdoche by identifying the reality of the hospitals of the country that the authors used as reference. We agree with much of the statements expressed in the article, some of which are so evident that they are beyond discussion. However, we do not agree that the “classical” indicators are, in and of themselves, negative. For example, establishing a mean stay or establishing, according to the criteria of scientific societies, a consultation time or an objective of delay or rescheduling does not conflict with ethics but rather contributes to it. This is not the case (as indicated with almost exaggerated flippancy in the text) of “unjustified” early discharges or not prescribing “recommended drugs” but rather avoiding inappropriate hospitalization and using drugs rationally.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Prieto de Paula JM, Franco Hidalgo S. La ética y los objetivos de gestión. Rev Clin Esp. 2019;219:102.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Reference" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿Son éticos los objetivos de gestión para los médicos de nuestros hospitales?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.B. Alonso" 1 => "E. Pacios" 2 => "B. Herreros" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.06.002" "Revista" => array:2 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2018" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000002/v1_201902270625/S2254887418301991/v1_201902270625/en/main.assets" "Apartado" => array:4 [ "identificador" => "71813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Correspondence" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000002/v1_201902270625/S2254887418301991/v1_201902270625/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301991?idApp=WRCEE" ]
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