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Cover Story:
Dr. Partner
The Hospital Leader and the Powerful Physician: 7 Top Strategies for the New Relationship

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What is RSS?
Five Questions
Insiders Insight
Hospital Impact
Too Much Construction?
Many hospitals believe increased capacity will break up their patient logjams. But more beds may not be the answer.
Worth A Look
A new line of hospitalwear promises patients style, comfort—and a little backside coverage.

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A Continuum of Care
A Medicare demonstration project partners hospitals and retirement communities to improve care for the elderly—and increase profitability.
Armchair Finance
Money Talk
The 404 Plunge
So far, only a few health systems have tackled the labor-intensive internal controls section of Sarbox.

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Five-Minute Consult
A New Role for APNs?
Advanced practice nurses are encountering plenty of obstacles in their pursuit of full privileges.
Kid-Friendly EDs
Not sure whether your facility is child-proof? A few steps could help you find out.
More Than Maps
M.D. Anderson Cancer Center demystifies its maze of doorways and corridors.
Outsmarting Agencies
Unwilling and unable to bear the load of high agency labor costs, hospitals are looking for answers—and finding them—online.

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Behind the Wires
Family practice veteran William Davis promotes connectivity in a rural Minnesota setting.
DEAL!
An inside look at an IT contract.
Keep It Flowing
An automated tracking system helps a Pennsylvania hospital keep tabs on discharges and bed availability.
Reporter’s Desktop
The Quality Equation
EMR technology can help improve care delivery—if the patients cooperate.

What is RSS?
Benefit Plan Design
Out with the Old
Well done on your recent article, “So Long, ‘Mom and Pop’” (August 2006). As a recruiter, we grapple with physician groups who resist a more formal governance and leadership model. The paradigm for physician practice management has been shifting. The old rules about the acceptable level of leadership skills and operating systems are toast. The old model is all but DOA.
Right vs. Privilege
I agree with the premise of your June Fact File (“Economic Pressures on Hospitals”). The economic pressures on hospitals are already evident in many facilities around the country, with many of them operating in the red and shutting down. It is very sad that in the 21st century the United States is still grappling with an issue as basic as healthcare. Over the 41 years since implementation of the Medicare legislation, we have experimented with various healthcare delivery systems and subsystems only to see the majority of them fail, causing massive economic damage to all the patients and providers who participated. The excuses for failure are as diverse as is our economy. The entire health delivery system is too fragmented with no real direction and a lot of lip service from political experts who have no idea what it takes to operate the systems successfully. While most of our economists and leaders argue the finances, the basic issue remains unresolved. Is healthcare a right or is it a privilege? For those who can afford it or obtain coverage through a state or charity program, does it matter? Hill-Burton died many years ago, and our industry is facing a financing meltdown from indigent uninsured, lack of adequate compensation and increasing wages for staff. Moreover, physicians, nurses, physical therapists and pharmacists are giving up and looking at alternate careers that are more personally rewarding. A growing frustration exists for many frontline medical providers within the poor reimbursement system—complicated by the huge profits the insurance industry makes. The challenge our society will have over the next four to 10 years is to define how best to maintain the U.S. healthcare system so that it thrives. Unfortunately, I do not think the answer rests at a local or state level. Sooner or later our federal legislators have to recognize the problem and implement a regional-geoethnic federal healthcare financing system. My fear is that while the attempt will be made in good faith, the insurance industry will kill it due to loss of profits.

“It’s easier to get a fishing license online than an insurance application.”

“It’s like a good-driver discount.”

“Next year, I may be in the poorhouse. This year, we’re managing.”

Ask Your Doctor
The hospital CEO really has only one job that is critical. Keeping the cash flowing and the floors clean are part of the healthcare enterprise that falls under the CEO, of course. But the surest, fastest way for a CEO to get shown the door is to botch physician relations.
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