Objectives.To identify the barriers, facilitators, and potential better practices to achieving physician-system alignment. Methods.Interviews using a semi-structured, open-ended protocol were conducted during a total of 18 site visits, each usually 2 days in length, covering multiple topics of physician group-system alignment. Interviews were conducted with members of the target physician group, key leaders of the health care system, and representatives of physicians not in the target group. The summary of the interviews for each of the site visits was analyzed to determine barriers, facilitators, and better practices for achieving more effective relationships between physician groups and health care systems. Results.A number of barriers to more effective relationships between physician groups and health systems were identified. Barriers related to environment, culture, and information systems were most prevalent. Other major general areas of barriers encountered were physician leadership, group-system relationship, compensation and productivity, care management practices, group strategy, and accountability. Examples of practices that may help to resolve some of these issues were also identified. Conclusions.Physician-system relationships can and do cause problems for improving health care. The evidence from the conducted site visits suggests that specific strategies may help improve these relationships but more research is needed in order assess the actual impact of these strategies.
[1]
S M Shortell,et al.
Physicians as double agents: maintaining trust in an era of multiple accountabilities.
,
1998,
JAMA.
[2]
S L Walston,et al.
Just how integrated are integrated delivery systems? Results from a national survey.
,
2001,
Health care management review.
[3]
Stephen M. Shortell,et al.
Remaking Health Care in America: The Evolution of Organized Delivery Systems
,
2000
.
[4]
Stephen M. Shortell,et al.
Remaking Health Care in America: Building Organized Delivery Systems
,
1996
.
[5]
Diego Boerchi,et al.
Trust in the balance; Building successful organizations on results, integrity and concern
,
1999
.
[6]
L. Emanuel,et al.
What Is Accountability in Health Care?
,
1996,
Annals of Internal Medicine.
[7]
S. Shortell,et al.
The effect of hospital control strategies on physician satisfaction and physician-hospital conflict.
,
1990,
Health services research.
[8]
L R Burns,et al.
Physicians and Organizations: Strange Bedfellows or a Marriage Made in Heaven?
,
1998,
Frontiers of health services management.
[9]
L. Burns.
Polarity management: the key challenge for integrated health systems.
,
1999,
Journal of healthcare management / American College of Healthcare Executives.
[10]
Colin Camerer,et al.
Not So Different After All: A Cross-Discipline View Of Trust
,
1998
.