Abstract
Regardless of the speed of the evolution from a MSO to a PSO, it is inevitable. During the course of this evolution, hospital management must be certain that individual clinicians and the PSO as a whole perform technical services that are integrated into the hospital's overall effort to achieve its goals. Although nonclinician managers cannot deliver clinical services or independently judge quality, they can obtain the expert advice and technical assistance needed to understand individual and aggregate PSO practice. Doing so allows managers to not only meet their ethical and legal responsibilities but also implement continuous quality improvement in the hospital, an activity of critical importance in the 1990s.
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