The Characteristics of an Effective Physician–Hospital Working Relationship: An Exploratory Study

Abstract

The working relationship between a private practice physician, whose medical practice was acquired by a health system, and the health system that sponsored the medical practices was studied using a dyadic perspective and drawing from agency theory to identify those characteristics that are present in an effective working relationship. In-depth interviews with currently employed physicians and those whose contracts were terminated within the last 3 years were used to identify why some working relationships failed and others succeeded. Hospital administrators and practice managers that provided the support services to the acquired medical practices were also interviewed for their assessment of the working relationship. As a result of the research, a model for developing an effective working relationship is presented to be considered as a framework for developing future working relationships. Based upon the data, this study posits that the physicians and the hospitals can have a more effective working relationship if specific characteristics are evident before, during, and after the contract is signed. Understanding the factors that contribute to an effective working relationship can help in designing contracts with physicians and better utilize resources at the physician private practice level, as well as at the hospital level.