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Trends in hospital/physician relationships
L R Burns1, R M Andersen, S M Shortell
1Department of Management and Policy, College of Business and Public Administration, University of Arizona, Tucson.
Health Affairs (Project Hope)
|January 1, 1993
Summary
Physician-hospital conflicts have risen, particularly in traditional areas like nursing quality. New market pressures worsen existing disputes more than creating new ones, especially for younger doctors.
Area of Science:
- Healthcare Management
- Medical Economics
- Physician Relations
Background:
- Hospital-physician relationships are crucial for healthcare delivery.
- The healthcare landscape has evolved with increased market competition.
- Understanding evolving physician-hospital dynamics is essential.
Purpose of the Study:
- To analyze the changes in hospital-physician relationships over time.
- To identify trends in conflicts between physicians and hospitals.
- To assess the impact of the competitive marketplace on these relationships.
Main Methods:
- Two surveys of all physicians in Pima County, Arizona, were conducted in 1985 and 1990.
- Data collected focused on the nature and frequency of conflicts.
- Analysis compared findings between the two survey periods.
Main Results:
- Conflicts in hospital-physician relationships increased across most areas between 1985 and 1990.
- Traditional conflict areas (nursing quality, equipment response) showed the largest increase.
- New marketplace issues (hospital influence on practice) showed a smaller increase.
- Younger physicians reported higher prevalence of both traditional and new conflicts.
- The competitive market exacerbated existing conflicts rather than introducing entirely new ones.
Conclusions:
- Hospital-physician conflicts have intensified, particularly in established problem areas.
- The competitive healthcare market amplifies traditional disputes among physicians.
- Younger physicians are disproportionately affected by these escalating conflicts.