In order to fully obtain the potential benefit of employed physicians, hospitals need to do the hard work necessary to strengthen their employed physicians into a cohesive group that shares the hospital’s values and strategies, and develops the skills to lead the way in fulfilling those strategies. One of the great difficulties most healthcare organizations encounter in trying to simultaneously improve quality, productivity, and effi¬ciency is the organizational gap between a management structure that delivers the full infrastructure for hospital care and the physicians who are instrumental in the use of that infrastructure.

Today’s physician often feels overburdened, under-appreciated, and under-compensated, as well as profoundly frustrated with increasingly complex and bureaucratic regulatory and reimbursement processes. For the vast majority of physicians the hospital has evolved from being “a home away from home” to a commodity, and a relatively dispens¬able commodity at that. In this context, alignment sufficient to allow collaborative work on shared professional challenges is critical to build—but hard to find.