The Hospital-Physician Relationship

Abstract

The traditional hospital-physician relationship in the United States was an implicit symbiotic collaboration sheltered by financial success. The health care economic challenges of the 1980s and 1990s unmasked the weaknesses of this relationship as hospitals and doctors often found themselves in direct competition in the struggle to maintain revenue. We recount and examine the history of the largely implicit American hospital-physician relationship and propose a means of establishing formal, explicit hospital-physician collaborations focused on delivering quality patient care and ensuring economic viability for both parties. We present the process of planning a joint hospital-physician ambulatory surgery center (ASC) at a not-for-profit academic institution as an example of a collaboration to negotiate a model embraced by both parties. However, the ultimate success of this new center, as measured in quality of patient care and economic viability, has yet to be determined.

Suggested methods to improve physician-hospital relationships in Canada

“…In addition, the economic problems convinced the healthcare administrators to put a limit on healthcare spending, and this change in practice revealed the issues in the relationships between hospital administrators and physicians. 75,76 Therefore, the relationships of physicians and administrators are professional if the former is in charge of caring for patients and the latter is in charge of preparing the material objects for the provision of patient care. 59…”

“…In addition, the economic problems convinced the healthcare administrators to put a limit on healthcare spending, and this change in practice revealed the issues in the relationships between hospital administrators and physicians. 75,76 Therefore, the relationships of physicians and administrators are professional if the former is in charge of caring for patients and the latter is in charge of preparing the material objects for the provision of patient care. 59 Gradually, hospital administrators realized that sharing power with physicians benefits hospitals because physicians are the high spenders of the budget and their involvement in decision-making enables hospital administrators to influence the control of the budget.…”

Orthopedist involvement in the management of clinical activities: a case study

“…an exclusive right to decide who is authorized to carry out tasks and how [18]) did not find it easy to adhere to programming the clinical activities under their responsibility. In this regard, a number of authors highlight the importance of trust [6,13,22] in a relationship based on shared values, the definition of collective concerns, and the standardization of productive practices. Consequently, trust is a tool for predicting action and achieving objectives.…”

“…Physicians' involvement in the management of clinical activities in health care institutions is therefore of high importance, as the cost, quality, and relevance of patient care depend on the attitude, actions, and level of their cooperation with other health professionals [6]. Research shows that physician involvement in the management of hospital clinical activities is critical to the safety and quality of care [7,8].…”

A game theory model of the physician preference item supply chain

“…In contrast, the hospitals, which must pay the difference between the PPI procedure cost and the insurance reimbursement, are understandably sensitive to the price of PPIs, which can be significant. For example, for some orthopedic procedures the PPI costs can be up to 40-80 percent of the reimbursement received, according to industry reports cited by Hariri et al (2007) and Montgomery and Schneller (2007). In addition to this challenge, in regions with multiple hospitals, physicians are able to select the facilities where they perform a given procedure and may consider the availability of a PPI at a facility when determining where to admit patients (Burns et al 2009;Robinson 2008;Schneller & Smeltzer 2006;Wilson et al 2008).…”