Critical Examination: The Resident Series, Essay Example

The healthcare industry is central to a country’s economy as it determines the number of people willing to work. Access to healthcare requires seeing a healthcare provider on a timely basis to receive optimal health services. However, this is impacted by social issues such as cost, ethnicity and race, and sexual orientation. These social issues can impact one’s ability to access quality services. According to Koch (2018), social issues in healthcare impact all aspects of wellbeing, from physical and mental health to the treatment that patients receive. When seeking healthcare, it is impossible to ignore society’s values or the history of subjugation and oppression (Segall & Fries, 2011). Such issues have been explored in the film industry to show the problems that patients and care providers face.

One such film is The Resident, a series that features the duties and interactions of the Chastain Park Memorial Hospital staff members while exploring the administrative practices. The series is very thorough in depicting the problems mostly faced in the healthcare industry, although it has also been criticized for not being factual. For instance, Koch (2018) asserts that the series is more focused on entertainment than accuracy, as a series of HIPAA violations occur, such as taking a selfie in the operating room. Moreover, the series depicts doctors as superheroes who can solve cases in seconds, especially when facing an emergency. This is not the case in real-world scenarios where doctors are more concerned with stabilizing a patient and not making the exact diagnosis at that very moment. However, this article will critically examine the social issues that the series explores through three episodes.

Comrades in Arms (Sn1E03)

In this episode, the staff meets a billing consultant, who has been brought in to train them how to “upcode” procedures to bill higher amounts. The team also finds itself in a dilemma when the members have to save the lives of undocumented and uninsured patients. Dr. Bell experiments with a new procedure for his tremor.

• Capitalism

The social concept that this episode depicts is capitalism, which denotes an economic system where private actors own and control means of production based on their interests. Healthcare in the US is delivered by different distinct organizations, which comprise healthcare providers, insurance companies, hospital systems, and other stakeholders. This leaves this industry under the mercy of the private sector. The goal of making a profit is an essential feature of capitalism. This means that a community’s access to health care services is determined not by the generosity of private sector businesses, but by their concern for their interests (Segall & Fries, 2011). Both the private business owners and the community agree to make a transaction that meets their interests in the outcome because none can get what they want without addressing the needs of the other.

In capitalism, profit comes before service. This episode delves deeper into the monetary and administrative side of the healthcare industry. The hospital uses fee-for-service (FFS), allowing the billing consultant to demonstrate to the staff how to charge separately for each service they perform. The FFS reimburses payments for services despite their impact on patient health. The model is primarily concerned with the monetary side and disregards quality of care. This concern has caused a shift from this model to a value-based care model. The value-based model requires healthcare providers to be compensated based on patient health outcomes. This model incentivizes doctors to focus on service quality as opposed to quantity.

The episode illustrates how FSS results in high costs as the payments are not bundled. As the billing consultant shows, a charge is made for every procedure, test, and treatment every time a patient makes a consultation, sees a doctor, or is hospitalized. According to Segall and Fries (2011), the model promotes an overabundance of more expensive types of care, such as surgery, even when they are not needed. This is more common, especially when the patient has full insurance coverage and can pay for the services, as opposed to a person who does not have insurance coverage. Critics hold that FFS has been the cause of the unsustainable healthcare system in the US since caregivers focus more on increasing the number of billable visits, tests, and procedures instead of patients’ best interests. The billing consultant was fired after an unnecessary MRI nearly killed a patient.

However, the medical field calls the practitioners to practice kindness and compassion toward their patients and colleagues. This benevolence is seen to win when uninsured and undocumented coworker receives treatment against the hospital policy. Undocumented immigrants are foreign-born individuals who are living in the US without permission. These include individuals who enter the nation without authorization and those who come legally but linger after their visas. These people remain mainly because of better jobs, family reuniting, and increased safety. The worker is a medical transport worker who suffers from a retroperitoneal sarcoma that causes her to collapse from severe back pain. However, being an uninsured and undocumented immigrant, she cannot access care, which compels two medical staff to go against the administration and look for a surgical team to perform the surgery. Although the operation was successful, she still faces rehab challenges as it is estimated to cost about 2 million dollars.

Undocumented immigrants, as represented in the series, are in significant danger of becoming uninsured due to a lack of coverage options. According to Segall and Fries (2011), these do not qualify for employer-sponsored insurance, while other eligibility constraints prevent them from being part of Medicaid, Medicare, ACA, and CHIP. Even though community clinics provide low-cost care for these immigrants, it is generally confined to primary and preventive care, making specialty services challenging to obtain. The US healthcare system holds that every patient needing emergency care should be screened and stabilized. The Trump administration, on the other hand, saw a shift in immigration policies that significantly exacerbated immigrant concerns. Families became more fearful as a result, and they stopped accessing programs and services for themselves and their children, such as Medicaid and CHIP.

Identity Crisis (Sn01E04)

The episode follows the previous episode where the ER budget was cut to compensate for the cost of the medical transport worker in a surgery. This causes the ER to be understaffed as some employees are cut off. As an impact, mistakes and errors arise when a mix-up occurs when a death notification is delivered to the wrong family.

• Marxism Theory

This episode examines the Marxism theory, which is concerned with the impact of capitalism on labor, economic development, and productivity. The theory holds that a struggle exists between social classes, specifically between business owners and workers, which defines the economic relations in the capitalist economy. In this case, the hospital staff do not own the means of production and thus have little power in the economic system of the hospital. The employees are also replaceable in periods of economic crisis, which devalues their perceived worth. Although the hospital can employ enough staff to meet its workload needs, it may choose to maximize profit by overworking the available workforce with no pay increase. This leads to an unfair imbalance between the management and the staff as they are exploited for their gain.

Understaffing is a problem that affects many hospitals in the US as the owners work to maximize profit. In the series, the team finds itself understaffed as Ellen, a senior nurse is fired. An inexperienced nurse who, during a mass-casualty incident, mistakenly triages a patient replaces her. The wrong family is informed of their son’s death after the patient dies and is misidentified. This shows a lack of nonmaleficence in the management since the inexperienced staff caused more harm than would have occurred. The mass casualties overwhelmed the team, and the lack of experience of Ellen’s replacement leads to an error as she overlooks details of a patient. Segall and Fries (2011) add that understaffing occurs when a facility experiences a budget cut, a slowness in preparing staff and care providers upon retirement age. A lack of adequate staff has been shown to jeopardize patient safety.

The mass casualty in this episode shows that overworked care providers can suffer from burnout and fatigue that can impact their ability to undertake their tasks effectively. Although the replacement staff lacked experience, the mass casualties may have affected her ability to remain focused, which resulted in medical errors. Patients in understaffed facilities have to deal with increased in-hospital mortality, higher infection risks, and a greater number of falls. This is because a large amount of work that should be distributed to an adequate workforce falls under a few workers (Segall & Fries, 2011). Only when experienced and adequate workers can a facility report successful treatment cases, even for severe illnesses. For instance, Bell successfully treats a woman suffering from gallbladder cancer and requires an experimental operation after being rehired.

The action of the hospital has much impact on the health outcome of different patients. One major impact is the occurrence of medical errors, which encompasses incomplete or inaccurate treatment or diagnosis of behavior, disease, infection, injury, or other illnesses. Medical errors represent a serious public health concern and threaten patient safety. This issue is brought to light in a mass casualty incident when Ellen’s replacement mistakenly triages a patient. The error causes the patient to die and is misidentified. It also causes the wrong family to be notified of their son’s death. High error rates with severe impacts are more likely to happen in operating rooms, ICUs, and emergency departments. Segall and Fries (2011) note that in addition to the human life cost, it can exact other significant tolls, especially financially.

The Elopement (Sn1Ep07)

This episode features various themes and issues that affect the healthcare industry. The first issue regards an unethical treatment plan, which violates the principles of medical ethics. This is shown when Conrad disagrees with Lane over a treatment plan for a patient with terminal cancer. Sexual harassment is also depicted when an arrogant baseball player is admitted and sexually harasses Nic, who must devise a strategy to stand her ground.

Social Imagination

This episode focuses on the concept of social imagination, which is the ability to link personal challenges to larger social problems. This concept holds that it is paramount to examine the balance between systems and the people within them to understand their collection associations and social structures, which arise out of the conflict between different groups. This view not only helps observe but also exposes social injustices.

One such injustice is sexual harassment. For instance, Nic has to deal with verbal sexual harassment, which entails making sexual advancements in one speech. Bobby, a VIP patient, thinks so highly of him that he closes the lines when he meets a single woman who resists him. Nic had to deal with this every time she served him. Bobby takes advantage of his VIP status and thinks he can get everything he wants. Although this scene shows a provider harassed by a patient, this is not always the case, as patients are the most harassed. Patients expect care providers and other hospital personnel to treat them professionally and respectfully (Segall & Fries, 2011). Many patients, especially those with pharmaceutical side effects or physical limitations, fall victim to hospital staff due to these vulnerabilities.

According to Segall and Fries (2011), sexual assault and other forms of abuse are most common among healthcare workers who take advantage of patients’ vulnerabilities. These acts are most common because of their closeness with the patient. Thus, medical facilities are accountable to their staff and are required to deal with these crimes by holding the culprit responsible and giving them severe punishment. However, this is not always the case, as many hospitals prioritize their reputation and fail to protect their patients. As a result, reports of such crimes are not recorded nor passed to the authorities. The series also depicts different forms of abuse and mistreatment based on sexual orientation. For instance, episode nine of season four shows a homosexual couple being denied the opportunity to adopt a child because of their sexual orientation. Tina, the mother, is threatened to be disowned by her parents despite Bell’s attempt to help.

Another issue that relates to this concept is unethical Human experimentation, which entails experiments that go against medical ethics principles, such as not acquiring informed consent, torturing patients under the guise of research, and using pseudoscientific models. This is depicted in this episode where Lane, an oncologist, uses her clinic to experiment on cancer patients, such as increasing the standard chemotherapy requirement. Most care providers that practice unethical human experiments are secretive to ensure that no one suspects them. As a result, justice is not served even when a patient dies or reacts negatively to the treatment since no records point to them. As also shown in this episode, most care providers that engage in unethical human experiments have experience and executive positions in healthcare facilities. For instance, Devon, a resident in the facility, cannot do much since he can jeopardize his career if he chooses to investigate Dr. Lane and must use Conrad to investigate her records with other patients.

Segall and Fries (2011) show that care providers must adhere to legal, professional, and ethical guidelines, which structure how treatment and diagnosis should be made. The impact of unethical medical experiments can be potentially disastrous. For one, they can erode trust among colleagues, as shown in this episode where Conrad and Devon are suspicious of Dr. Lane’s cancer practice in her clinic. Any unethical practice can erode trust, making it challenging for colleagues at the same facility to work in harmony. Furthermore, it can result in a loss of confidence from the public. One approach that can help ensure care providers act ethically and professionally is investigating and reporting such cases through whistleblowing (Segall & Fries, 2011). Whistleblowing entails notifying those in authority or those outside the normal reporting structure about these practices and the practices that violate professional, ethical, and legal norms.

Conclusion

The Resident covers different social issues in the current healthcare system. These problems affect care delivery as some patients are denied services or encounter unethical medical practices. Although the series does not depict the real life of doctors and their residents while in care, it is thorough in pointing out the issues that prevent patients from receiving optimal services. The main concepts that are revealed in the series include the social imagination, capitalism, and Marxism theory. This shows various issues that the healthcare industry faces such as high costs and medical errors. For instance, high mortality rates are attributed to increased medical errors. There is a fresh, honest, and brutal perspective on medicine in the media, which is depicted in TV series. Although there are many medical dramas, The Resident stands out due to its authenticity in defining these issues.

References

Koch, D. (2018). Why ‘The Resident’ Is A New Kind Of Doctor Drama. https://www.bustle.com/p/is-the-resident-based-on-a-true-story-the-fox-drama-aims-to-tackle-a-different-side-of-the-medical-world-7903959

Segall, A., & Fries, C. J. (2011). Pursuing health and wellness: Healthy societies, healthy people. Oxford University Press.