Medical Staff Organizations: A Persistent Anomaly

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Abstract
Medical staff organizations (MSOs) originated to reconcile hospitals' hierarchical management structure with the professional autonomy demanded by physicians. MSOs' primary purpose is to hold physicians collectively accountable for patient safety and clinical performance. However, in an era of declining hospital activity, most physicians no longer understand this. More often, they view the MSO as a political body whose purpose is to foster physicians' interests with the hospital's administration and board of trustees. In many hospitals, it is difficult to determine whether the MSO is the key to clinical improvement or the biggest barrier.