Hariri Sanaz, Prestipino Ann L, Rubash Harry E
Massachusetts General Hospital, Boston, MA 02114-2696, USA.
Clin Orthop Relat Res. 2007 Apr;457:78-86. doi: 10.1097/BLO.0b013e31803372a7.
The traditional hospital-physician relationship in the United States was an implicit symbiotic collaboration sheltered by financial success. The health care economic challenges of the 1980s and 1990s unmasked the weaknesses of this relationship as hospitals and doctors often found themselves in direct competition in the struggle to maintain revenue. We recount and examine the history of the largely implicit American hospital-physician relationship and propose a means of establishing formal, explicit hospital-physician collaborations focused on delivering quality patient care and ensuring economic viability for both parties. We present the process of planning a joint hospital-physician ambulatory surgery center (ASC) at a not-for-profit academic institution as an example of a collaboration to negotiate a model embraced by both parties. However, the ultimate success of this new center, as measured in quality of patient care and economic viability, has yet to be determined.
在美国，传统的医院与医生的关系是一种隐含的共生合作关系，受到经济成功的庇护。20世纪80年代和90年代的医疗保健经济挑战揭示了这种关系的弱点，因为医院和医生在维持收入的斗争中常常发现彼此处于直接竞争状态。我们回顾并审视了美国医院与医生之间这种很大程度上隐含的关系的历史，并提出了一种建立正式、明确的医院与医生合作关系的方法，这种合作关系专注于提供高质量的患者护理，并确保双方的经济可行性。我们以一家非营利性学术机构规划联合医院与医生门诊手术中心（ASC）的过程为例，说明为协商双方都能接受的模式而进行的合作。然而，这个新中心在患者护理质量和经济可行性方面的最终成功还有待确定。
