The impact of corporate structures on physician inclusion and participation.
This study examines the impact of corporate arrangements on the hospital-physician relationship. Specifically, it investigates the effects of for-profit ownership and membership in a multihospital system on physician inclusion (salaried employment, hospital-based practice) and participation (involvement in governance and management). Contrary to common perceptions and several hypotheses drawn from the literature, corporate arrangements are associated with low physician inclusion and high participation. There is no indication that corporatization of healthcare restricts the physician's freedom of movement or decision-making role. It is instead argued that health care corporations do just the opposite in order to please physicians, promote physician welfare, and to gain legitimacy.
Burns
L R
LR
Department of Management and Policy, College of Business and Public Administration, University of Arizona, Tucson 85721.
Andersen
R M
RM
Shortell
S M
SM
D003625:Data Collection; D003659:Decision Making, Organizational; D006739:Hospital Administration; D006777:Hospitals, Proprietary / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration; D006788:Hospitals, Voluntary / Q000458:organization & administration; D006801:Humans; D007325:Institutional Practice / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D009096:Multi-Institutional Systems / Q000458:organization & administration*; D010067:Ownership / Q000706:statistics & numerical data; D014481:United States