A Short Take on Hospital-Physicians

What - Hospital-physician relationships

Why - This is an enormous reform issue because hospitals and physicians spend 75% of all health care dollars. The truth is hospitals and doctors do not always agree because they compete for patients and cannot always decide who should be in control. But hospitals and doctors have a common purpose – to cure patients, alleviate pain, and provide a safe health care haven. In the end, this common purpose may bring them together

When – When will hospitals and doctors cooperate and collaborate? They already do in many respects, but they also compete for patients and payments and for control of patient care. It is a tense tango. Hospitals are open 24 hours a day and insist they offer comprehensive care. Doctors say patients can often be treated more safely and conveniently in their offices and their own facilities. Some hospitals and doctors are working to resolve these issues in the form of joint ventures or common ownership.

How – The question is: integrate or disintegrate? Should hospitals and doctors work together in one system? Or should they pursue their independent paths? It may seem obvious, but elective procedures, are best and more safely performed by physician in settings where the doctor is in total clinical control. Other things are best done in hospitals with 24 hour coverage, where patients are constantly monitored.

Where – Local politics and the statesmanship of hospital and physician leaders can best work out these problems. No solution fits all.

Who – It depends on what is best for the community. The interests of the public, hospitals, and doctors are intertwined. An example is the Walmart decision to align with local hospitals as partners or owners. Hospitals insist they do not want to compete with doctors, but to refer to them when appropriate. Doctors remain dubious about Walmart-hospital alignments