DRGs, bylaws, and staff privileges: is confrontation inevitable?

Concerted action to control health care costs under prospective pricing is a relatively new joint venture for hospitals and medical staffs. In particular, definition of "problem" physicians and specification of economic cause for removal from medical staffs will undoubtedly be more difficult to accomplish than might appear at first blush. At the same time, hospital administrators must expect to be held accountable for mismanagement and management excess.