How different governance models may impact physician-hospital alignment

Area of Science:

• Healthcare Management
• Organizational Behavior
• Physician-Hospital Relations

Background:

• Hospitals use three primary models to govern physician relationships: traditional medical staff, strategic alliances, and employment.
• The impact of these governance models on physician alignment is not well understood.

Purpose of the Study:

• To compare physician-hospital alignment across the three distinct governance models.
• To investigate how employment and alliance models influence physician alignment relative to the traditional medical staff model.

Main Methods:

• Survey data from 1,895 physicians across 34 hospitals in eight systems were analyzed.
• Logistic equations controlled for physician nonresponse and selection bias into alliance and employment models.
• Multiple regression analysis estimated the effect of alliance and employment models on physician alignment.

Main Results:

• Physicians in employment models reported higher alignment with their hospitals on several dimensions compared to those in alliances or traditional medical staff models.
• No significant differences in physician alignment were found between the alliance and traditional medical staff models.

Conclusions:

• Employment models can enhance physician alignment on specific dimensions, even after accounting for selection effects.
• The overall impact of employment on physician alignment is modest, indicating that structural integration alone may not be sufficient.