ABSTRACT
Applying Porter's model of competitive forces to health care, stakeholder concepts are integrated to analyze the future of medical groups. Using both quantitative survey and qualitative observational data, competitors, physician suppliers, integrated systems new entrants, patient and managed care buyers, and hospitals substitutes are examined.
Subject(s)
Economic Competition/trends , Group Practice/economics , Health Care Sector/trends , Cooperative Behavior , Cost-Benefit Analysis , Forecasting , Health Care Coalitions/economics , Health Care Reform/economics , Health Maintenance Organizations/economics , Humans , Interinstitutional Relations , Investments/economics , Models, Economic , Power, Psychological , United StatesABSTRACT
The health care environment is complex and turbulent, and traditional governance forms face many challenges. As integrated delivery systems/networks are formed, governance structures must be responsive to both internal and external stakeholders. Both internal efficiencies and socially responsible actions are required of these relatively new organizational forms. To meet these needs, a two-tier governance structure is presented that consists of overarching and facilitating boards.
Subject(s)
Decision Making, Organizational , Delivery of Health Care, Integrated/organization & administration , Governing Board/organization & administration , Humans , Interinstitutional Relations , Models, Organizational , Organizational Innovation , United StatesABSTRACT
Physician executives need to negotiate effectively with a wide range of parties. In those negotiations, they should consider the relative importance of both substantive and relationship outcomes in selecting initial negotiation strategies. Of course, these strategies may or may not be successful, depending on the strategies used by the other party. Hence, the physician executive must consider the other party's strategy and how it and his or her initial strategy are likely to interact both before and during negotiations.
Subject(s)
Interprofessional Relations , Persuasive Communication , Physician Executives , Planning Techniques , Economic Competition , Humans , Models, Psychological , Problem Solving , United StatesABSTRACT
If physician executives are to be effective in confronting the environmental turbulence and uncertainty facing their organizations, they must effectively manage their stakeholders. This article extends the stakeholder approach described in the May-June 1989 issue of Physician Executive as a tool for the physician executive in the development of practical strategies to cope with turbulence and uncertainty. We suggest four generic strategies physician executives can use: involve supportive stakeholders, monitor marginal stakeholders, defend against nonsupportive stakeholders, and collaborate with mixed-blessing stakeholders. As an overarching strategy, a physician executive should try to change the organization's relationships with a stakeholder from a less favorable category to a more favorable one. The stakeholder can then be managed using the generic strategy most appropriate for the category.
Subject(s)
Decision Making, Organizational , Interprofessional Relations , Physician Executives , Power, Psychological , Humans , United StatesABSTRACT
If physician executives are to cope with the environmental turbulence and uncertainty facing their organizations, they must effectively manage their "stakeholders." The stakeholder approach helps integrate managerial concerns that are frequently treated separately, such as strategic management, marketing, human resource management, "organizational politics," and social responsibility. The stakeholder perspective enables medical managers to relate important issues to the development of strategies for handling potentially conflicting demands for effectiveness and efficiency from various stakeholders. Medical managers should minimally satisfy the needs of marginal stakeholders while they maximally satisfy the needs of key stakeholders. To identify key stakeholders, a physician executive should critically assess each stakeholder's potential to threaten the organization and its potential to cooperate. This assessment should account for such factors as the stakeholder's relative power, the specific context and history of the organization's relations with it, the specific issues under consideration, and other key stakeholders influencing the organization.
