Organizational Power and Conflict regarding the Hospital—Physician Relationship: Symbolic or Substantive?

1997 ◽  
Vol 10 (1-2) ◽  
pp. 91-106 ◽  
Author(s):  
P. A. Rivers ◽  
B. Woodard ◽  
G. Munchus
Keyword(s):  
Power Relationship ◽  
Hospital Physician ◽  
Organizational Power ◽  
Professional Groups ◽  
Level Manager ◽  
Professional Employees ◽  
Physician Relationship ◽  
Executive Level ◽  
Professional Bureaucracy ◽  
Machine Bureaucracy

The purpose of this paper is to provide a critical review of organizational power and conflict regarding the hospital—physician relationship. The issue of power being symbolic and/or substantive is discussed. The classification (Mintzberg Model) of organizations as simple structures, machine bureaucracies, professional bureaucracies, divisionalized forms and adhocracies are reviewed. Also, the issue of whether the perceived autonomy that professional employees enjoy increases the likelihood that an executive level manager in a professional bureaucracy (hospital entity) will devote substantial attention to influencing symbolic outcomes as opposed to substantive outcomes in a machine bureaucracy is discussed. In conclusion, conflicts between hospitals and physicians can be resolved in two ways: (1) by avoiding controversial decisions that might threaten the powers and prerogatives of professional groups; and (2) by agreeing to decisions that hold something for everyone involved in the hospital—physician power relationship.

The Hospital-Physician Relationship

2007 ◽  
Vol 457 ◽  
pp. 78-86
Author(s):  
Sanaz Hariri ◽  
Ann L Prestipino ◽  
Harry E Rubash
Keyword(s):  
Hospital Physician ◽  
Physician Relationship

The Evolving Role of Third Parties in the Hospital—Physician Relationship

2007 ◽  
Vol 22 (6) ◽  
pp. 402-409 ◽  
Author(s):  
Lawton R. Burns ◽  
David B. Nash ◽  
Douglas R. Wholey
Keyword(s):  
Third Parties ◽  
Hospital Physician ◽  
Physician Relationship

A Proposal on Developing a 360° Agile Organizational Structure by Superimposing Matrix Organizational Structure with Cross-functional Teams

2020 ◽  
Vol 45 (3) ◽  
pp. 270-294
Author(s):  
Kiruba Nagini R. ◽  
S. Uma Devi ◽  
Sayed Mohamed
Keyword(s):  
Organizational Structure ◽  
Simple Structure ◽  
Organizational Structures ◽  
Advantages And Disadvantages ◽  
Hr Practices ◽  
Business Opportunities ◽  
The Matrix ◽  
Functional Teams ◽  
Professional Bureaucracy ◽  
Machine Bureaucracy

With the growing business opportunities and expanding boundaries, the organizational structure of the companies is becoming highly dynamic with several levels flattened out and branching out horizontally, instead of being vertical. With agility required in all fast-evolving organizations, it is essential to check out for the suitability of the modern organizational structures prevalent, being classified by Mintzberg as ‘entrepreneurial or simple structure, machine bureaucracy, professional bureaucracy, divisional form, and adhocracy or innovative’ (Mintzberg, 1980; Lunenburg, 2012). In this article, we propose a 360° Agile organizational structure which is a hybrid of the matrix organizational structure superimposed with cross-functional teams (CFTs). This article discusses the possibilities of forming smaller teams without compromising the incidence of the essential ‘skills– talents–competencies’, necessary for every single project, thereby superimposing the matrix organizational structure and the CFTs. This article also discusses the advantages and disadvantages of this proposed organizational structure. A possible cross-check with regard to the scalability issues has also been made with the Scaled Agile Framework (SAFe®) agile HR practices.

The Algocracy as a new ideal type for government organizations: Predictive policing in Berlin as an empirical case

2020 ◽  
pp. 1-16
Author(s):  
Lukas Lorenz ◽  
Albert Meijer ◽  
Tino Schuppan
Keyword(s):  
Max Weber ◽  
Ideal Type ◽  
Ideal Types ◽  
Predictive Policing ◽  
The Public ◽  
Government Organizations ◽  
Government Bureaucracy ◽  
Decision Making Processes ◽  
Professional Bureaucracy ◽  
Machine Bureaucracy

Motivated by the classic work of Max Weber, this study develops an ideal type to study the transformation of government bureaucracy in the ‘age of algorithms’. We present the new ideal type – the algocracy – and position this vis-à-vis three other ideal types (machine bureaucracy, professional bureaucracy, infocracy). We show that while the infocracy uses technology to improve the machine bureaucracy, the algocracy automates the professional bureaucracy. By reducing and quantifying the uncertainty of decision-making processes in organizations the algocracy rationalizes the exercise of rational-legal authority in the professional bureaucracy. To test the value of the ideal type, we use it to analyze the introduction of a predictive policing system in the Berlin Police. Our empirical analysis confirms the value of the algocracy as a lens to study empirical practices: the study highlights how the KrimPro system conditions professional assessments and centralizes control over complex police processes. This research therefore positions the algocracy in the heart of discussions about the future of the public sector and presents an agenda for further research.

Vertical Integration of Hospitals and Physicians: Economic Theory and Empirical Evidence on Spending and Quality

2017 ◽  
Vol 75 (4) ◽  
pp. 399-433 ◽  
Author(s):  
Brady Post ◽  
Tom Buchmueller ◽  
Andrew M. Ryan
Keyword(s):  
Economic Theory ◽  
Literature Review ◽  
Vertical Integration ◽  
Institutional Economics ◽  
Empirical Support ◽  
Future Research ◽  
Hospital Physician ◽  
Growing Body ◽  
Physician Relationship ◽  
Vertical Foreclosure

Hospital–physician vertical integration is on the rise. While increased efficiencies may be possible, emerging research raises concerns about anticompetitive behavior, spending increases, and uncertain effects on quality. In this review, we bring together several of the key theories of vertical integration that exist in the neoclassical and institutional economics literatures and apply these theories to the hospital–physician relationship. We also conduct a literature review of the effects of vertical integration on prices, spending, and quality in the growing body of evidence ( n = 15) to evaluate which of these frameworks have the strongest empirical support. We find some support for vertical foreclosure as a framework for explaining the observed results. We suggest a conceptual model and identify directions for future research. Based on our analysis, we conclude that vertical integration poses a threat to the affordability of health services and merits special attention from policymakers and antitrust authorities.

The Hospital-Physician Relationship

2016 ◽  
Author(s):  
John D. Blum ◽  
Shawn R. Mathis ◽  
Paul J. Voss
Keyword(s):  
Hospital Physician ◽  
Physician Relationship

Tools and Resources: Web Sites of Interest

2001 ◽  
Vol 6 (2) ◽  
pp. 6-8
Author(s):  
Christopher R. Brigham
Keyword(s):  
Informed Consent ◽  
Physical Examination ◽  
Functional Status ◽  
Web Sites ◽  
Satisfaction Survey ◽  
High Quality ◽  
Diagnostic Studies ◽  
Physician Relationship ◽  
Complete History

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, explains that independent medical evaluations (IMEs) are not the same as impairment evaluations, and the evaluation must be designed to provide the data to answer the questions asked by the requesting client. This article continues discussions from the September/October issue of The Guides Newsletter and examines what occurs after the examinee arrives in the physician's office. First are orientation and obtaining informed consent, and the examinee must understand that there is no patient–physician relationship and the physician will not provide treatment bur rather will send a report to the client who requested the IME. Many physicians ask the examinee to complete a questionnaire and a series of pain inventories before the interview. Typical elements of a complete history are shown in a table. An equally detailed physical examination follows a meticulous history, and standardized forms for reporting these findings are useful. Pain and functional status inventories may supplement the evaluation, and the examining physician examines radiographic and diagnostic studies. The physician informs the interviewee when the evaluation is complete and, without discussing the findings, asks the examinee to complete a satisfaction survey and reviews the latter to identify and rectify any issues before the examinee leaves. A future article will discuss high-quality IME reports.

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