title: How to improve hospital-physician relationships.
abstract: For healthcare organizations (HCOs), successfully partnering with physicians is the strategic imperative. A number of misperceptions and limiting beliefs compromise partnering initiatives. To pursue a more successful approach to partnering, it is important to understand some of the forces that are affecting the healthcare industry. The accelerating pace of change demands that healthcare leaders serve as change agents, evoking resentment from the majority of healthcare stakeholders. Demands for measured accountability and the shift of control from provider to consumer threaten the physician perception as "captain of the ship." Cultural differences between the expert culture of physicians and the affiliative culture of the HCO perpetuate feelings of distrust and compromise efforts to actualize interdependencies. Economic pressures and an unwillingness to make time to engage in dialog prevent the provider community from serving as a creative force in shaping its own future and restrict the ability to build the mutual trust that is necessary for the establishment of successful relationships. Measures that would enhance the likelihood of forming successful and lasting relationships include the following. Adopting an orchestration model would allow a flexible way to bring services to a community. It may be the only way to simultaneously integrate and specialize. Budgeting to reflect service-line functioning would allow the systematic integration of patient care throughput and provide a necessary metric for assessing clinical and operational performance. Segmenting the medical staff would allow the establishment of pluralistic relationships based on shared goals and values and allow change agents to lead to critical mass rather than consensus. Focusing on the customer would ensure relevance in the changing medical marketplace. Adopting a complexity science metaphor rather than continuing in a command-and-control, top-down organizational structure would enhance adaptability and help maximize human capital. Most importantly, forming relationships that center around shared purpose and values will lay the foundation for excellence and sustainability while restoring a sense of meaning, pride, and joy to the healthcare professions.
authors.affiliation: Kootenai Medical Center, Coeur d'Alene, Idaho, USA.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Bujak
mesh_terms: D002017:Budgets / Q000379:methods; D017598:Efficiency, Organizational; D004991:Ethics, Institutional; D004992:Ethics, Medical; D006748:Hospital Departments / Q000191:economics; D018578:Hospital-Physician Relations; D006801:Humans; D008505:Medical Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D017146:Models, Organizational; D015279:Organizational Culture; D009936:Organizational Innovation; D009937:Organizational Objectives; D017060:Patient Satisfaction; D017009:Professional Autonomy; D012945:Social Values; D035502:Trust; D014481:United States