Berenson Robert A, Ginsburg Paul B, May Jessica H
Urban Institute, Washington, DC, USA.
Health Aff (Millwood). 2007 Jan-Feb;26(1):w31-43. doi: 10.1377/hlthaff.26.1.w31. Epub 2006 Dec 5.
Because many services performed in hospitals can safely and conveniently be performed in ambulatory settings, physicians have become owners of entities directly competing with hospitals for patients in a new medical arms race. Hospitals and medical staff physicians face growing tensions as a result of physicians' growing reluctance to take emergency department call and the consequences of hospitalists replacing physicians in the care of inpatients. Although there are increasing expectations that health system challenges will lead hospitals and physicians to collaborate, in many markets the willingness and ability for hospitals and physicians to work together is actually eroding.
由于许多在医院进行的服务能够在门诊环境中安全且便捷地开展,在这场新的医疗竞争中,医生已成为与医院直接争夺患者的实体机构的所有者。由于医生越来越不愿意承担急诊科值班任务,以及住院医师取代医生负责住院患者护理所带来的后果,医院和医务人员之间的关系日益紧张。尽管人们越来越期望卫生系统面临的挑战将促使医院和医生进行合作,但在许多市场中,医院和医生合作的意愿和能力实际上正在受到削弱。