Hospitals and physicians: an organizational model for a changing healthcare environment

New reimbursement methods are forcing hospitals and physicians to work more closely together to retain patients and improve efficiency. In the last 10 years, most academic medical centers have reorganized hospital-physician relationships to maximize revenues and assure a stable flow of patients. This article examines the organizational model adopted by Pacific Medical Center in Seattle (formerly the U.S. Public Health Service Hospital), when it was transferred from federal to community control in 1981. Planners analyzed the history and mission of the institution, the community being served, and the legal options in the state. The chosen organizational structure is outlined, and the authors present the strengths and weaknesses of the model. The implications for other healthcare institutions considering restructuring are discussed.