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Structural characteristics of medical group practices
Administrative Science Quarterly
|February 9, 1985
Summary
As medical group practices grow in size and service complexity, they become more bureaucratic with increased administrative levels. Larger groups, particularly multispecialty ones, shift decision-making from clinicians to administrators.
Area of Science:
- Healthcare Management
- Organizational Studies
- Medical Practice Administration
Background:
- Medical group practices are evolving organizational structures.
- Understanding their structural characteristics is crucial for effective management.
- The trend towards larger and more complex group practices necessitates analysis.
Purpose of the Study:
- To explore the structural characteristics of medical group practices.
- To identify how size and service complexity influence organizational structure.
- To examine the shift in decision-making authority within these groups.
Main Methods:
- Analysis of structural characteristics in 247 medical group practices.
- Investigating the relationship between practice size, service complexity, and organizational features.
- Comparing administrative and clinical decision-making roles.
Main Results:
- Increased size and service complexity correlate with more hierarchical levels and bureaucracy.
- Service complexity primarily influences the formation of subdivisions.
- Practice size is more influential on administrative levels.
- Large group practices, especially multispecialty ones, exhibit a corporate style.
Conclusions:
- Medical group practices adopt more formal, bureaucratic structures as they scale.
- Organizational complexity and size are key drivers of structural changes.
- Decision-making power increasingly transfers from clinicians to administrators in large group practices.