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How Do We Improve Collaboration between Physicians and Hospital Administrators?

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An Opinion Poll for Doctors, FAs and Patients

By Jennifer Tomasik MS [Principal: www.CFAR.com]

“It is the long history of humankind (and animal kind, too) those who learned to collaborate and improvise most effectively have prevailed.”

– Charles Darwin

Beyond institutional mergers and joint ventures, collaboration in healthcare is being driven by other factors; there is a need to move from a healthcare system driven by volume and characterized by fragmentation, waste, high cost, and inconsistent quality to a system where care is coordinated, costs are lower, and quality is higher.

Merger Mania

Merger mania in the 1990’s was driven by similar concerns, including the fear of for-profit competition and the rise of managed care. The results of this earlier round of mergers were unexpected. The 1990s ‘consolidation fever’ raised hospital prices by at least 5%, and did not measurably improve quality.[i] Hospitals purchased physician practices without a great deal of thought about expectations and mutual accountability, and many of those relationships failed—usually with significant financial implications.

Of Savvy Healthcare Leaders

Fearful of history repeating itself, savvy healthcare leaders are thinking differently about how to develop the collaborative relationships they need to succeed today. They see Accountable Care Organizations [ACOs] and Global Payments—where institutions will take on greater risk for the cost and quality of the services a patient requires—as an opportunity to get clear about how they can best position themselves across the full continuum of care. They believe potentials gains are not likely to show up simply as a result of mergers and acquisitions or consolidation per se. Rather than just integrating the bottom lines of their institutions, they are focused on ensuring that those individuals and teams who actually care for patients can productively collaborate with each other, and that they understand the clear and compelling rationale for why that collaboration is necessary.

Nowhere is this relationship more important than between hospital administrators and the medical staff.

What is “Collaboration” Anyway?

Merriam-Webster defines collaboration as “to work jointly with others or together especially in an intellectual endeavor.” While true, we find this definition insufficient for our purposes. Our colleagues at The Rhythm of Business, a consulting firm focused exclusively on collaboration, provide a more productive way to think about collaboration:

“Collaboration is a purposeful, strategic way of working that leverages the resources of each party for the benefit of all by coordinating activities and communicating information within an environment of trust and transparency.”

We add to this definition one additional, yet critical dimension. Collaboration also means working with, and through, differences. Any highly functioning team will, by its very nature, have differences – team members are ideally bringing innovative ideas that compete for “idea space” at the table.

Effective collaboration requires that teams not only value differences, but in fact encourage them to be surfaced. Viewed in this way, collaboration is not an event or an idea. It’s not “agreeing to get along.” Effective collaboration is an ongoing, systematic, strategic process. It is also, we believe, a business imperative – and nowhere more so than in healthcare.


Given the often difficult nature of relationships between hospital administrators and medical staff, how do you improve collaboration to increase productivity and performance?

NOTE: [i] Vogt, William B and Robert Town. “How has hospital consolidation affected the price and quality of hospital care?” Robert Wood Johnson Foundation: Policy Brief No. 9. 2006.


And so, how do we improve collaboration between Physicians and Hospital Administrators?

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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About the Author

Jennifer Tomasik, Principal,  leads CFAR’s Health and Hospital Systems practice. She works with her clients to solve complex strategic and organizational challenges. Her approach to consulting emphasizes communication and collaboration, supported by a blend of quantitative and qualitative analytics. Jennifer has worked in the health care sector for nearly 15 years, with expertise in public health, clinical quality measurement, strategic management, and organizational change. Her clients include some of the most prestigious hospitals, health systems and academic medical centers in the country. She has a Master’s in Health Policy and Management from the Harvard School of Public Health.

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3 Responses

  1. Managing the Hospital-Physician Relationship

    Driven by changes in Medicare reimbursement policy and regulation and electronic health records, hospitals are examining their relationships with physicians and revisiting the benefits as well as the risks associated with physician recruitment and employment.


    This is a “hot” industry topic. Thanks for posting.



  2. We’ve been down this path before …

    Before 1980, the hospital-physician relationship was a relatively straight path to travel. Physicians had their own practices, were the gatekeeper to patient referrals and were in the hospital every day seeing their patients. In turn, hospitals made sure that the physician’s every request was taken care of. If a physician said “jump,” the hospital and staff would say “how high?”

    Physicians had tremendous influence on the hospital and were effectively in the driver’s seat while the hospital embraced a “physician as customer” culture. In the 1980’s however, a new trend emerged that changed this culture forever. Essentially, the path changed and with that a shift in influence. The payor was now in the driver’s seat, with the hospital and the physicians as co-passengers along for the ride.

    The fork in the road for hospitals is evident: Do we continue down the path of valuable “Physician as Customer” or turn down the path of expendable commodity “Physician as a Commodity?”

    Carolyn Merriman
    [Founder and Partner]


  3. Good points

    Jennifer – Indeed, there is an increasing concern that doctors are finding it more difficult to connect with other doctors to coordinate care.


    Doctors can be in the clinic, on rounds, in the OR, in the lab, or many other areas. Then, it is talk, talk and talk.

    Well done.



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