Effects of Competition, Regulation, and Corporatization on Hospital-Physician Relationships

Recent changes in the hospital operating environment and physician-supply patterns have begun to erode the historical separation between hospital management-governance and physicians. We examine alternative mechanisms whereby physicians are integrated into the hospital's management-policNmaking structure and test a number of hxpotheses related to the conditions under which various forms of integration occur. Because regulatory intensity, physician competition, and hospital corporatization enhance managerial power vis-a-vis physicians so that there is greater balance, they are hypothesized to result in more integrated hospital-physician relationships. Results of multivariate analyses of a sample of 1, 981 general, short-term hospitals provide general support for our hypotheses regarding the effects of regulation and physician competition; however, the degree and type of hospital-physician integration are shown to varY by the ownership of the corporate organization with which the hospital is affiliated.