Report of the Ninth Duke University Medical Center Private Sector Conference

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Abstract
Relations between American hospitals and their medical staffs, increasingly troubled because of conflicting imperatives that society has imposed through its major agent of change — the federal government — will grow worse before they stand much chance of general improvement. Creation of a Medicare payment mechanism that essentially places a hospital at financial risk for the behavior of its medical staff is the latest government action to upset these relations, but other forces are also placing strains on the collaboration between institutional and individual providers of care, including a growing supply of physicians, an increasing inclination by hospital medical staffs . . .

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