Physician influence in interorganizational relationships between academic medical centers and community hospitals

This study analyzes cooperative interorganizational relationships (IORs) between two different types of health care organizations. It proposes a power perspective analysis to better understand why IORs which represented many rational advantages to both partners were so difficult to realize in practice and often with only modest results. Hypotheses are tested explaining how physicians, as groups, exert important controls and can largely determine the results that can be realized in any IOR aimed at modifying medical education and patient referrals.