The Corporate Organization of Hospital Work: Balancing Professional and Administrative Responsibilities
Stoeckle, John D.
Reiser, Stanley J.
Annals of Internal Medicine. 1992 Mar 1; 116(5): 407-413.
The development of the hospital into a corporation has influenced the care of patients and the work of the professional staff. As a corporate enterprise, the modern hospital has a private agenda aimed at increasing growth and efficiency with an emphasis on technical services, professionals as employees, and patients as customers. These changes have resulted in a decrease in trustee and professional authority and an increase in administrative control. This shift in the control structure has continued in response to the need for accounting and regulation of services and in response to demands for increased growth and efficiency made by an increasingly competitive market environment. Strategies for the reorganization of hospital staff aimed at improving both inpatient and outpatient care are reviewed. The reorganization of the institution and staff, using either a staff group-practice corporation or an administrative staff model, is proposed. Clinicians have new responsibilities for developing collective arrangements for instituional governance, for allocating institutional resources, for providing public accountability regarding the use of these resources, and for defining the missions of care.
Accountability; Administrators; Biomedical Technologies; Economics; Employment; Environment; Ethics; Goals; Health; Health Care; Health Care Delivery; Health Facilities; Health Personnel; Hospitals; Institutional Ethics; Institutional Policies; Medicine; Patients; Physicians; Professional Ethics; Professional Patient Relationship; Proprietary Health Facilities; Public Participation; Regulation; Responsibilities; Sociology; Sociology of Medicine; Standards; Values;
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