Hospital-medical staff tensions: an historical overview and analysis

Hospital-medical staff relationships have become a focus of major interest to both administrators and physicians. As a consequence of competition and prospective payment, these relationships are more interactive, more interdependent, and potentially more conflictual. Such conflicts are rooted in recent historical changes in hospitals and the practice of medicine within hospitals that now confront physicians. This paper analyzes several of these changes and examines six specific areas of conflict occasioned by them. The intent is to review why hospitals perform those actions which anger or alienate their medical staffs. Final comment is reserved for two principles that these parties should follow in resolving their conflicts.