title: A bitter struggle for integration survival.
abstract: The state of California created the El Camino Hospital District in 1961, one of 77 such districts created as a way to fund rural hospitals. During the 1990s, hospital administrators began to look for ways to streamline operations and cut costs to remain competitive. In 1992, the hospital District Board voted to turn over El Camino's management to a nonprofit company, believing the hospital could form business partnerships with doctors. The District created a private, nonprofit corporation, approved the appointment of volunteers and physicians to the board, and instructed the board to develop on alliance with other physicians. It became evident that several philosophies were at work regarding the healthcare system. In 1995, the District attempted to void the 1992 agreements and take back the hospital. Legal investigations were initiated. Meanwhile, reimbursement rates were decreasing and the hospital's 600 doctors were dissatisfied. Legal struggles continue, public controversy and physician anger are ongoing, and the Santa Clara County District Attorney's office has begun an audit of records. Camino Healthcare, despite all the ongoing difficulties, continues to provide excellent care to patients and the community.
authors.affiliation: Camino Healthcare, Mountain View, CA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Wright
mesh_terms: D001291:Attitude of Health Personnel; D002140:California; D019033:Delivery of Health Care, Integrated / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006759:Hospital-Physician Joint Ventures / Q000458:organization & administration*; D018578:Hospital-Physician Relations; D006780:Hospitals, Rural / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D008505:Medical Staff, Hospital / Q000523:psychology