The Physician’s Changing Hospital Role

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Abstract
Although the hospital was not invented by doctors, and they might have devised quite another kind of organization if they had had the option, it has been their creature for a long span of recent history. Especially in the United States, with its tradition of voluntary private hospitals whose independence is limited only by the need to adhere to certain minimum legal and professional codes, the physician has enjoyed a highly autonomous role in the hospital organization. This autonomy has been laden with power to direct the course of the organization; explicit authority has been immense, and implicit authority perhaps even more potent. It is important to recognize that the doctor's ability to produce desired effects in organizational life has been joined to a flourishing negative capability—a freedom from—for escaping many of the ordinary demands of that life. In a curious sense, any doctor who is not a full-time department head in a teaching hospital has been a "guest" of the organization, much as the othe...

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