Physician-hospital integration in a community hospital: a case study.

Over the past 20 years, the hospital environment and physicians' relationships with hospitals have changed dramatically. Hough has presented a concise description of this relational evolution. He describes hospitals during the period 1900 to 1975 as physicians' workshops; 1976 to 1985, hospitals were physicians' competitors; 1986 to 1995, hospitals have been and will be physicians' suitors; and, from 1996 on, Hough sees hospitals as physicians' partners. At St. Joseph Health System, we have already taken strong moves toward the final scenario envisioned by Hough. In this article, the author describes the historical underpinnings and the methodologies of the system's planning and implementation processes for new arrangements with staff and community physicians.