The Health Care Industry in the United States

Over the last few years, the United States has seen its health care system undergo significant and rapid transformations (Shi & Singh, 2008). Changes in the various components like health insurance, industrial developments, and the general increase in the cost of health care providers have impacted heavily on both the health care service providers and the recipients (Sultz & Young, 2006).

The essay focuses on the physician attitudes and patients that have combined to produce the characteristic “sick role” expected of hospital patients. Given the need for efficient operation and governance in hospitals, the paper analyses the various factors that contribute to the tension that usually exists among the medical staff, board of trustees, and the administration. Moreover, the continued “professionalization” of nursing through advanced degrees, specialization, and clinical practice are discussed together with the implication for the nurses. The causes and implications on the stakeholders of the shift from inpatient hospitalization to ambulatory care services are also identified. Lastly, this paper highlights the important challenges that have to be dealt with by hospitals to accommodate the competition from managed care.

The attitudes which the physicians have towards the patients have produced the “sick role” characteristic. It entails the privileges and demands that a patient should enjoy by being ill (Sultz & Young, 2006). The productivity of the sick person in society is reduced since he or she is not functioning normally. Due to the state of being sick, the physician is expected to take care of the patient and ensure that he or she gets well. The sick person is not to perform the ordinary chores and should not be blamed for their health state. However, the patient should show the willingness of getting well soon by seeking proper medical care.

The success of all operations in the hospital highly depends on the harmony among the various stakeholders like the medical staff, board of trustees, and administration. Tension among them vastly affects the efficiency and effectiveness of the hospital. Several factors can be identified to be the major causes of tension in the governance of hospitals. One of the contributing factors is a divergence of goals for the administration and the staff (Maxwell, 2007).

Whereas the management seeks to ensure that the hospital remains financially solvent and efficient, the medical staff strive to offer the best health care services regardless of the financial implications. The hiring and firing process has also been identified as the cause of tension in hospitals. Hospital management may harass and threaten the staff or even fire them anyhow. This implies that there must be cooperation and teamwork among all the stakeholders in the running of a hospital (Maxwell, 2007).

Nursing has notably become “professionalized” through advanced degrees, specialization, and clinical practice. This has caused an increase in salaries demanded by nurses as well as their responsibilities. Hospitals have therefore been forced to seek alternative ways of addressing this problem (Sultz & Young, 2006). Currently, most hospitals employ the services of non-nurses to perform most of the technical tasks meant for trained nurses. This trend has significantly transformed the nursing profession from its traditional object of the hands-on patient. This may turn to be a disadvantage for the nurses since they cannot be employed in hospitals due to their increased demands. However, academic advancement and proficiency in health care provision by nurses may force private practitioners to seek their services.

The number of uninsured Americans has been on the increase for a long period. Most physicians have fought to set up their health care provision centers especially ambulatory services. Ambulatory care refers to outpatient care provision and its growth has lately been on the increase. This move has significantly changed the structure and management of the health care system in the United States (Sultz & Young, 2006). Ambulatory surgery offered by private physicians has seen many consumers attended to outside the hospital at a manageable cost. This has been facilitated largely by technological advancement in the health care industry which has brought new and efficient ways of diagnosis and treatment (Shi & Singh, 2008).

Private health care providers who offer highly specialized services have emerged as stiff competitors for the hospitals and the implications on customer volume have been significant. The private practitioners have ensured that their facilities are aesthetically pleasing, equipped with the latest facilities, and the services are customer-friendly. Following the decline in the number of health care consumers, hospitals have been forced to also shift from inpatient care to ambulatory care provision (Sultz & Young, 2006). However, modern developments in the ambulatory care system are mainly focused on the quality of services provided relative to the cost.

The essay has by large discussed the various challenges experienced in the health care industry in the United States. It is evident from the essay, therefore, that greater effort must be made by all stakeholders to enhance the quality of health care services provided.


Maxwell, R. J. (2007). Management of hospitals in the 21st century. McGraw-Hill Plc.

Shi, L. & Singh, A. D. (2008). Health care provision in America: a systems approach (4th ed.). Jones & Bartlett Learning.

Sultz, A. H. & Young, M. K. (2006). Health care USA: understanding its organization and delivery (5th ed.). Jones & Bartlett Learning.