Physicians and the Organizational Evolution of Medicine
Burchell, R. Clay
White, Robert E.
Smith, Howard L.
Piland, Neill F.
JAMA. 1988 Aug 12; 260(6): 826-831.
Today doctors care for patients within increasingly complex medical organizations. The rise of investor-owned health care corporations, prepayment schemes, expanding group practices, and other factors are challenging the physician's traditional control over the delivery of medical care, resulting in growing contention between practitioners and organizations. Burchell, et al., describe organizational evolution in medicine, the antecedents to conflict, and a profile of the conflict itself. They then review the strengths and limitations of four strategies for resolving physician-organization tensions. A fifth strategy, expanded physician involvement in organization and management issues, is the approach the authors recommend that doctors adopt. They see it as the most realistic way to cope with the transformation of medicine into an "organizational phenomenon." (KIE abstract)
Administrators; Autonomy; Communication; Conflict of Interest; Doctors; Economics; Evolution; Health; Health Care; Health Care Delivery; Health Maintenance Organizations; Hospitals; Incentives; Industry; Medicine; Organizational Policies; Organizations; Patient Care; Patients; Physician's Role; Physicians; Proprietary Hospitals; Remuneration; Review; Social Dominance;
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