Partnership Contracts Research Articles

Identifying the Type of a Contract to Transfer Health Services to Charities in Teaching Hospitals of Shahid Beheshti University of Medical Sciences in Tehran, Iran

Background: One of the most important issues in the health system is to provide the necessary resources to present health services. To increase the role of charities and facilitate public participation in the treatment area and to develop hospital units, the cooperation between charity organizations and public hospitals must be highlighted. Objectives: This study aimed at identifying the type of contract for the transfer of health services to charities in the teaching hospitals of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Methods: This study was conducted in hospitals of Shahid Beheshti University of Medical Sciences in 2019. The statistical population of the study consisted of 411 people, including managers, chiefs, and deputies, contracting experts, hospital social workers, managers and lawyers of the university, trustees, and managers, and charity experts. The research sample consisted of 330 people who were selected using a stratified random sampling method. SPSS version 18 and AMOS software were used to analyze the data. Results: By identifying the selection criteria of a charity to operate in the hospital, identifying the contract model, identifying the share of capital and current costs, and selecting the type of department in the contract with path coefficients of 0.78, 0.72, 0.68, 0.73, and 0.73, respectively, it can be ensured that the costs of an inpatient ward were supplied by the charity during the contract term. Conclusion: The study showed that the partnership contract model is the most appropriate type of contract in the transfer of health services to charities.

Impact on cardiac surgery volume of a comprehensive partnership with Integrated Health Solutions.

The New Brunswick Heart Centre (NBHC) entered a contractual partnership with Integrated Health Solutions (IHS) to help address increasing wait times in the province of New Brunswick. Team leaders were identified from each of the target areas, including surgeons, anesthesiologists, nurses (operating room, intensive care unit [ICU] and postoperative ward), access coordinators and administrators. The methodology used was based on Lean principles and involved exercises by stakeholders aimed at identifying opportunities for improvement. A weekly dashboard was created to monitor and facilitate improvement efforts. No additional hospital beds or operating room theatres were added during the study period. After 2 years, the annual number of cardiac surgical interventions increased from 788 to 873, representing a 10.8% increase in capacity. The best median wait time for patients decreased from 52 to 35 days (35% reduction). The best 90th percentile wait time decreased from 126 to 98 days (22% reduction). The overall increase in capacity could be explained in part by the significant increase in fast tracking from the ICU to the ward (> 2-fold) or bypassing the ICU altogether (4-fold increase reaching 13%). Despite these successes, challenges persist as the number of OR cancellations remained around 7.5% of all cases, mainly because of limited ICU resources. The NBHC-IHS partnership on this project has resulted in excellent engagement by stakeholders and promoted team cohesiveness. Furthermore, it has allowed significant reorganization and realignment of efforts to limit wait times and maximize overall capacity.

The Partnership of Beneficial Owner (Rabb al-Mal) with Managing Trustee (Mudarib) in Business

Passive partnership contract (mudarabah) occupies a prominent place in the jurisprudence of Islamic financial transactions, and Islamic jurisprudence has surrounded it with provisions, controls and conditions that guarantee its performance of its role. If some of these terms and conditions are violated, this may lead to invalidation of the mudarabah or its being corrupted. Among the conditions stipulated by jurists for the validity of Passive partnership contract is that the beneficial owner not to interfere in performance of its contract except in a manner that guarantees adherence to the controls and restrictions agreed upon by the owner of the money with the managing trustee, including that the owner of the money delivers the capital to the mudarib. This study aims to explain the rule of stipulating that the money owner be involved in performing the work, himself or his representative, as well as the rule of his participation in the work without stipulating that in the contract. The study concluded that it is permissible for the owner of the money or his representative to work with the mudarib, and that this does not affect the validity of the contract unless it leads to restricting the work and preventing the mudarib from disposing of Passive partnership contract.

متطلبات تفعیل الشراکة (PPP) بین القطاع العام والخاص مدخلًا لإصلاح التعلیم قبل الجامعی

الملخص العربى : يعد التوجه نحو خصخصة الخدمات العامة جزءا من إطار عام للإصلاح، يهدف إلى التقليل من حجم النفقات العامة في المجتمع، وإتاحة التنوع من الجهات المقدمة للخدمات، وتحقيق الأهداف العامة من خلال مشارکة القطاع الخاص في تحقيقها، وقيام الدولة بمنحه بعض الصلاحيات لتقديم بعض الخدمات وفقا لضوابط وحدود معينة. ويهدف البحث إلى التوصل إلى تصور مقترح لتفعيل الشراکة (PPP) بين القطاع العام والخاص لإصلاح التعليم قبل الجامعي، وذلک من خلال التعرف على الإطار المفاهيمي لإصلاح التعليم، ومفهوم نظام الشراکة بين القطاع العام والخاص (PPP)، وأهدافه وخصائصه، ومزاياه، ودواعي اللجوء إليه، والتطرق إلى بعض ملامح تجارب الدول في مجال الشراکة بين القطاع العام والخاص (PPP)، وأهم نماذجه. منهج البحث اعتمد البحث على المنهج الوصفي. نتائج البحث توصل البحث إلى تصور مقترح لتفعيل الشراکة (PPP) بين القطاع العام والخاص لإصلاح التعليم قبل الجامعي، وتمثلت أهم آليات تفعيل الشراکة بين القطاع العام والخاص في التعليم قبل الجامعي، في الآتي: - إضافة تشريعية فيما يخص المتابعة والرقابة والمساءلة وإسنادها على مشروعات الشراکة التعليمية بين القطاعين العام والخاص، وإسنادها لجهة سيادية محايدة، تستطيع من خلال القانون أن تتابع وتراقب وتحاسب جميع الأطراف في عقود الشراکة، وذلک بداية من طرح المشروع مرورا بتنفيذه وتشغيله، وحتى انتهاء المدة وتسليمه للجهة الإدارية بالحالة المتفق عليها في عقد الشراکة. - ضررة وجود دعم سياسي قوي للشراکة بين القطاع العام والخاص فهذا الدعم، يشجع المستثمر المحلى أو الأجنبي، على الدخول في مشروعات شراکة مع القطاع العام، حيث أن دعم القيادات السياسية لتلک المشروعات يبعث بالثقة والاطمئنان في نفوس المستثمرين. -العمل على توفير قاعدة بيانات سليمة يمکن الاعتماد عليها والوثوق بها تمکن من التخطيط الجيد لمشروعات الشراکة وتحديد الاحتياجات وإدراجها في الخطة الاستثمارية. الملخص الانجليزى : The Direction towards privatization of public services is considered part from public framework for reformation, it's aimed at reducing the public expendure in society. It also gives chance for diversity of services and achieving public goals through private participation, in addition to granting certain Prowers from country to provide some services according to special limits. This research aims to making suggested framework for activating public private partnership (PPP) to reform pre-university education through recognizing the conceptual frame of education reform, concept of public private partnership system and its aims, characteristics and mentioning some of experiments of countries in the field of public private partnership. Search methodology: The research depended on descriptive method. The results of research The research resulted in suggested framework for activating public private partnership for reforming pre-university education. - The most important mechanisms of activating public private partnership in pre-university education are: 1) Monitoring and accountability for educational partnership projects between public and private sectors, which can monitor and accountability from the law and control all the parties of partnership contracts from the beginning of project to the implementation and operation. 2) Necessity of political support for public-private partnership in which this support encourage political authorities for these projects. - working on availability of data base which we can depend on in good planning of partnership projects and determining the needs and putting them in investment plan.

Ensuring Adaptation While Seeking Efficiency: Tiered Outsourcing and Skip-Level Supplier Ties in the Airbus A350 Program

When outsourcing design tasks, firms want their suppliers to be both efficient and adaptive. Whereas efficiency is necessary to reap economic gains from outsourcing, adaptation is required to deal with interdependencies as the design evolves. Achieving both objectives simultaneously, however, is difficult because procurement contracts require a trade-off between providing incentives for efficiency and facilitating adaptation. In the presence of formal contracts that provide strong incentives for efficiency, ensuring adaptation thus requires effective relational contracts between the buyer and the supplier. But because the focus of prior research has been on dyadic buyer–supplier relationships, it is unclear how the efficiency–adaptation trade-off can be mitigated in the multitier supplier systems that are common in many industries. Addressing this gap, we argue that in hierarchical supplier systems, relational contracts between contractual partners become more important, but at the same time harder to establish, than in single-tier supplier systems. An in-depth case study of the adaptive frictions that arose in the Airbus A350 program allows us to illustrate this challenge of tiered outsourcing. Moreover, we show how Airbus came to resolve the frictions by leveraging skip-level ties—direct informal contacts to lower-level suppliers with which no contractual relationship existed, thus replacing the archetypal notion of a supplier hierarchy by a more complex relationship structure. We discuss the boundary conditions of our findings and suggest propositions for the emergence of skip-level ties in tiered outsourcing.

The International Classification for Human Functioning, Disability and Health in e-Health of Bulgaria

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018 Issue In the last years in Bulgaria has been working hard to improve the information and communication environment through the National Science Program 'e-Health'. The links between the health of working people and the social and environmental determinants of public health are best identified by the WHO through the International Classification for Human Functioning, Disability and Health (ICF). In Bulgaria, about 650 occupational health services (OHSs) that use heterogeneous software products. Description of the Problem A targeted study of the ICF's capabilities opens the horizon to integrate social and environmental health factors in an increasingly aging and morbid workforce, with people with disabilities, and with electronic access to social and medical services. The creation of an electronic system for dynamic monitoring of any change in human functioning health of workers and their determinants, allows the OHS, the organs of workability expertise to make the right decisions in work placement. Results A scientific toolkit has been developed for the introduction of the ICF Module for updating the electronic health integrated dossier for all STMs with a view to applying the common methodology of EUROSTAT, EC, Directorate-General F5 for the consolidation of occupational disease data and other health problems in functioning, disability and health to working people. Lessons The ICF module supports both the company's occupational health and safety policy, the OHS, and the implementation of a higher class electronic network, a challenge that inevitably faces the digitalisation of every European country. The module contributes to the extension and refinement of information. Data will be provided on priority risk factors that have harmed workers' health. Key messages The ICF module creates opportunities for rapid and correct measures to ensure good occupational health. The ICF module creates opportunities for rapid and correct measures people with disabilities in a changing demographic and health environment.

Design of a mechanism for access to various sources of data on health of workers

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018 Issue Comprehensive occupational health records can be put into practice by linking multiple clinical applications, all of which need to be tailored to the requirements of specific conditions and specifications. Description of the Problem Sharing health records between distributed entities and meaningful analysis of these records requires the use of a systematic approach regarding clinical (semantic) data structures. These data should be based on a single Reference Model so that the equivalent clinical information is correctly and uniquely presented. Results Two reference models (Archetypes) related to occupational health record have been created, respectively one for the health of the working people and one for the working environment and working conditions. The models are based on openEHR. The freely available Archetype editor software was used to create the archetype. The model and hierarchical structure of the occupational health record are constructed using the XML standard. Lessons Archetypes are effective pre-coordinated combinations of hierarchies that are coordinated across the subject area to ensure semantic interoperability, consistency and data quality. The use of standardized archetypes provides an interoperable way of presenting and sharing data between different types of information systems and the specifications used. Key messages The use of standardized archetypes provides an interoperable way of presenting and sharing data. Shared data is between different types of information systems and specifications used.

The European campaign to fight musculoskeletal disorders - the need for eHealth

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018. Background The focus of the European Health and Safety Agency's 2020-2022 campaign is on the prevention of work-related musculoskeletal disorders (MSD). In the employment of medical professionals, they are common. The introduction of eHealth in Bulgaria supports the processes of information, monitoring and prevention. Methods An adapted Neck Injury Index (NII) questionnaire was developed by: Vernon, H. & Mior, S. (1991) to determine specific injuries in the cervical spine, administered to 251 healthcare professionals from a large medical establishment. Results A study of the relationship between gender and the answers given in the ten sections of the questionnaire revealed a statistically significant difference in the answers for 'headache', 'driving' and 'sleeping' with p = 0.005, p < 0.001 and p = 0.020 respectively. 74.6% of men and 63.7% of women gave negative answers for headache, no driving pain, with men leading by 92.3% and a lower proportion of women than 56.1%, and without any sleep disturbances. 94.9% of men and 68.9% of women surveyed. The relationship between the profession and the medical profession indicating symptoms of neck damage, statistical significance was confirmed except in the above sections and also in 'lifting weights' (p = 0.009) and 'reading' with p = 0.002. As 65.3% of physicians, 51.9% of healthcare professionals and 56.5% of paramedics have no complaints of additional neck pain when lifting weights. A significant correlation was also found between mild injury rate (10 to 28%) and work experience over 10 years in 53.5% of those working in the hospital (p = 0.031). Conclusions The multifactorial influence of gender, position, and special length of service in the surveyed health care professionals did not cause symptoms indicating specific changes in the neck. Key messages It is important to establish a database through the introduction of eHealth with an information system. Identification changes in health and the presence of MSD in working nurses.

Improvement of the module for occupational diseases in the structure of occupational health record

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018 Issue Occupational health is closely linked to public health and health system. In Bulgaria there are many software products related to the registration and reporting of occupational health. Description of the Problem It is necessary to study all the determinants of occupational health, including the risks of diseases and accidents in the occupational environment, social and individual factors. The establishment of electronic systems for registering and monitoring both the health status of each worker and the possible hazards in the work environment is associated with the introduction and use of the occupational health record of each worker. Results The methodology for improving the module for occupational diseases in the structure of the occupational health record in Bulgaria has been developed. The classifications are in compliance with the legislation in the country and the requirements of the developing Eurostat methodology for European statistics on occupational diseases are applied. The occupational health record will serve both employers and physicians working in Occupational Health Services. Lessons The occupational disease module in the structure of the occupational health record will contribute to the statistical comparability of occupational disease data at regional and national level. Not only will the registration of the harmful factors of the working environment and the diseases related to the work process, but also the introduction of timely measures to ensure good occupational and public health. Key messages Through the occupational disease module, the structure of the occupational health record introduces the possibility of taking adequate measures to ensure good occupational health. The occupational health record will serve both employers and physicians working in Occupational Health Services.

Public-private Partnerships for Medicine Provision: an alternative to the combat to the covid-19 pandemic

This work aims to verify how the Public-private Partnership contracts can be used as a tool for the policy makers to provide infrastructure in health services, specially seeking to fight the coronavirus pandemic, like the construction of hospitals and health centers, plus research and development of vaccines and medicine. An analysis of PPP cases already currently working in Brazil was conducted, based on the empiric literature. The PPPs arise as a feasible alternative of investments in this sector, particularly in a fragile moment of public accounts, in addition to the need of healthcare improvements throughout the country. Besides being more efficient, this kind of contract also attenuate the pressure on the public accounts since it is financed by private investments.

Impact of Endogenous Risk Factors on Risk Cost in PPP Projects in Saudi Arabia

The formation of the Public-Private Partnership (PPP) contracts is based on the grounds that the construction, progress, operation, and investment of a project must be allocated to a private organization under a contract. The risks associated with PPP projects are usually associated with resource improvement and development as well as the long-term operation of the project. It is known that cost and time overruns are among the obvious risks faced by a project during the development phase. Cost and time overruns are major sources of monetary risk. The risk and its impact may vary at different phases during the life cycle of a PPP project. In traditional procurement, all of the monetary risks are covered by the public sector. Most of the projects delivered under traditional procurement involve a price confirmation to indicate standard cost risks. This paper aims to investigate the impact of endogenous factors on budget overrun in PPP projects in Saudi Arabia. The paper briefly illustrates the content regarding the PPP risk evaluating systems and explains the association between risk occurrences and cost overrun in the Kingdom of Saudi Arabia (KSA). The paper concludes with recommendations for future research.

Models Of Public -Private Partnership Contracts PPP In The Tourism Sector (Selected Countries) With A Special Reference To Iraq

Models Of Public -Private Partnership Contracts PPP In The Tourism Sector (Selected Countries) With A Special Reference To Iraq

Malaysian regulators' ranking of PPP contract governance skills

PurposeThe purpose of this study is to explore the skills required by regulatory agencies for effective governance of public-private partnership (PPP) contracts from the perspective of Malaysian regulators. There is a growing literature indicating that there is poor public sector expertise in managing PPP projects.Design/methodology/approachThe study, being an exploratory one, relied on a questionnaire survey of the Malaysian PPP unit (UKAS) and five Malaysian regulatory agencies responsible for regulating service delivery across a number of sectors.FindingsThe results of the exploratory factor analysis returned six factor groupings, indicating that the most important skills are procurement, auditing and forensic accounting, lifecycle costing, sector-specific, negotiation analysis and performance management. It was also found that academic qualifications, profession, years of experience and the regulatory agency had no mediating effect on the rankings.Practical implicationsThe findings show that infrastructure regulation training programs should be tailored to reflect regional and country-specific characteristics. This is because a similar study with a globalised set of respondents gave a different result from the current study.Originality/valueThere is a growing trend towards remunicipalisations and contract cancellations globally. This is the very outcome that regulatory agencies were created to prevent. Studies including government reports are increasingly pointing in the direction of poor skills set among public sector staff managing PPPs. This lack of capacity has resulted in poor oversight, which now threatens the sustainability of service provision.

The trust-control nexus in public private partnership (PPP) contracts

This study examines the trust-control nexus in the context of public private partnership (PPP) contracts. It draws on the literature and the case of two UK school PPP contracts with varying degree of trust among the partners to illustrate the role of control in building competence trust and goodwill trust, and how trust in turn affects control. Prior to entering into the PPP contract, under a condition of high risk and low trust, reliance was placed on formal control to evaluate competence trust for the purpose of selecting a preferred bidder, whilst goodwill trust, which takes time to evolve, played no role in the selection process. During contract implementation, formal control formed the basis for demonstrating competence and nurturing goodwill trust. Trust subsequently determined the extent of reliance on formal control and informal control. In the case of School 1, high level of trust led to a reliance on informal control which enabled partners to focus resources on solving problems, whilst formal control operated in the background. In the case of School 2, low level of trust and perceived lack of transparency led to a demand for additional formal control. This study adds to the trust-control literature by shedding light on how trust relates to control, in the context of long-term PPP contracts which are difficult to specify in advance.

Testing a fine is a price in the lab

Recent research in experimental law and economics shows that the imposition of a fine, intended to deter some harmful behavior, may crowd out moral motivation: the behavior occurs more frequently even though a payment is charged to discourage it. In A Fine is a Price, Gneezy and Rustichini (2000) suggest that the payment may induce subjects to frame the intended prohibition as a permission in exchange for a price. Obviously, the effect if confirmed may impact almost any form of public regulation or contract drafting. May fines charged for plastic bags in fact increase usage? May penalty clauses in contracts increase the likelihood of breach?Our study tests this theory, distinguishing it from six alternative crowding-out mechanisms and from confounds in Gneezy and Rustichini’s original day-care study.In our experiment, subjects are offered a contract to perform a real effort task. Subjects are paid upon the acceptance of the contract. If they breach the contract, they keep their payment, but burden their partner with an additional workload. We vary our treatments by specifying different amounts that subject need to pay if they do not perform: T1 specifies no payment, T2 stipulates a low fine disproportional to the extra workload imposed, and T3 stipulates a proportional fine; the payments go to the contractual partner.We find the same mean performance level across all three treatments. However, splitting the sample according to the subjects’ social value orientation reveals a strong crowding-out effect in the pro-social group and an offsetting price effect for the pro-self players.Our last treatment, T4, aims to identify the mechanism behind this crowding out effect. In this treatment, the payment is made to the experimenter, instead of the contractual partner as under T2 and T3. In the absence of a transfer between the parties, T4 forces subjects to view the fine as a penalty, instead of an exchange. Results show that T4 crowds in the pro-social subjects’ compliance, providing causal evidence for the Fine-is-a-Price hypothesis.

Flexibility and Sharīʿah Compliance of Islamic Financial Contracts: An Evaluative Framework

Abstract Although the key distinguishing feature of Islamic finance is compliance with Sharīʿah, there is criticism from various quarters on the Sharīʿah compliance of its products. However, there is no objective way to assess the Sharīʿah compliance of Islamic financial contracts. This article develops a structured framework for analysing Sharīʿah compliance of Islamic financial contracts by deconstructing them and developing principles of evaluation based on concepts from Islamic legal theory. Other than providing a framework to assess Sharīʿah compliance of Islamic financial contracts, this article also alludes to an important issue regarding the contracts’ flexibility. Using concepts from Islamic legal theory, the article classifies different contractual stipulations according to their legal weight, and identifies how legal perspectives on the requirements of compliance can determine the flexibility of contracts. An evaluative framework is used to assess the Sharīʿah compliance of an actual muḍārabah (silent partnership) contract and finds it to be defective.

Development of normative-legislative provision of state-banking partnership in Ukraine

The analysis of the legal framework for regulating the development of public-private (state-banking) partnership in Ukraine is carried out. Attention is drawn to the fact that the problem of inconsistency of the relevant laws and regulations on the regulation of public-private partnership, which often contain different rules on the same issues in this field, and the mechanism of implementation of such projects, is quite problematic and of the highest priority for state regulation. is not unambiguous and unified.
 The priority plan of changes is outlined, which takes the following form: amending the legislation on public-private partnership for the purpose of its uniform application and interpretation; introduction of a unified procedure for all types of state-bank partnership agreements; development of an authorized state body responsible for the development of state-banking partnership in Ukraine; strengthening the functions of local self-government bodies in the sphere of state-banking partnership; a clear division of functions between the relevant public authorities regarding the implementation of state-bank partnership projects; introduction of a single model contract of public-private partnership.

Implementation of the H&M Global Framework Agreement in Cambodia: Producing Outcomes for Industrial Democracy Despite a Challenging Context?

Global Framework Agreements (GFAs) are expected to be a more effective instrument for safeguarding collective labour rights in global supply chains than the unilateral instruments of private regulation adopted previously. The direct involvement of global union federations as contractual partners has significant potential in this regard. However, the effects of GFAs in supply chains have so far been under-researched. Since the exercise of collective labour rights is often prevented or undermined in producer countries of the Global South, and global supply chains are characterized by unstable and volatile relationships between global brands and local suppliers, the effective local implementation of GFAs faces particular challenges. Against this background, this article provides a qualitative analysis of expert interviews to examine how the implementation of the GFA of the global fashion brand H&M in Cambodia has influenced power relations between key stakeholders in the Cambodian garment industry and to what extent the agreement contributes to promoting ‘industrial democracy’ in the H&M supply chain in Cambodia. Platform Work, Temporary Agency Work, Temporary Agency Work Directive, Atypical Employment

Dynamic organization model of automated negotiation for 3PL providers selection

To keep their competitive edge and improve customer satisfaction, it is popular for many companies to outsource their logistics to proper Third-Party Logistics (3PL) providers. The evaluation and selection of 3PL providers in their business processes are expected to be solved dynamically. In this paper, based on the theory of automated negotiation, a Dynamic Organization Model (DOM) was designed for an online E-commerce Platform (EP) from the perspective of companies outsourcing logistics. During the negotiation, the involved 3PL provider agents may autonomously make decisions upon both the negotiation context and the dynamic market arguments in an iterative manner, and both the basic attributes of 3PL providers and the historical cooperation data with them are considered. Through comprehensive evaluation and negotiation, the most suitable 3PL provider may be determined as the contractual partner. Finally, the effectiveness of DOM is testified by a case study instantiated with a coal company and several 3PL providers.

Legal foundations of medical profession partnerships

In der Berufsausübungsgemeinschaft werden nicht nur die Praxisräumlichkeiten, die Praxiseinrichtung und das nichtärztliche Personal von zwei oder mehreren Ärzten gemeinschaftlich genutzt, sondern es kann auch ärztliches Personal gemeinsam beschäftigt werden, und in der Regel laufen zudem sämtliche Einnahmen und Ausgaben gemeinschaftlich über die Praxis. Nach außen bildet die Berufsausübungsgemeinschaft eine rechtliche Einheit, was sich auch in der gemeinsamen Haftung der Gesellschafter niederschlägt. Zum Schutz dieser Einheit darf die Berufsausübungsgemeinschaft auch im Rahmen der Nachbesetzung der Zulassung eines ausscheidenden Gesellschafters über den Nachfolger mitbestimmen, wenn die Zulassung innerhalb der Berufsausübungsgemeinschaft nachbesetzt wird. Im Rahmen der Gestaltung des Gesellschaftsvertrages ist insgesamt große Sorgfalt und in vielerlei Hinsicht auch Vorsicht geboten. Zudem ist immer die individuelle Situation der Gesellschaft und der einzelnen Gesellschafter maßgeblich zu berücksichtigen. Auch die örtliche Versorgungssituation im Hinblick auf die Bedarfsplanung hat bedeutenden Einfluss, v. a. auf Regelungen zum Ausscheiden eines Gesellschafters. Die hier aufgezeigten Teilaspekte der Vertragsgestaltung und die jeweiligen Regelungsmöglichkeiten können angesichts der Komplexität der Materie hier nur einen kleinen Ausschnitt darstellen. Mit der Gestaltung eines ärztlichen Gesellschaftsvertrages sollte in Anbetracht der rechtlichen Schnittmengen aus Gesellschaftsrecht, ärztlichem Berufsrecht und ggf. Zulassungsrecht ein Rechtsanwalt beauftragt werden, der über die entsprechende Erfahrung und Expertise verfügt.