Richard Gunderman,  M.D., a  professor of radiology, pediatrics, medical education, philosophy, liberal arts, and philanthropy, and vice-chair of the Radiology Department at Indiana University in Bloomington, describes how hospital-physician relationships can go bad.

Becker’s Hospital Review reports on  “six of the most influential things in any hospital-physician relationship and how they can go awry — as inferred by Dr. Gunderman.”

1. Financial support. “When EHRs and billing and coding systems are costly, physician practices have few places to turn. If physicians feel forced to rely on the hospital for financial support and muscled into relationships with hospitals, the relationship can hold resentment and turn sour.”

2. Job security and compensation. “When physicians feel their job security and pay is being toyed with or held over their heads, this undermines confidence and can push physicians to feel beholden to hospital administration.”

3. Decision-making.  “Dr. Gunderman says the best way to discourage a physician is to refer to such their decisions as ‘anecdotal, idiosyncratic, or simply insufficiently evidence-based.’ Hospital administrators are wise to avoid this.”

4. Productivity expectations. “Physicians are not factory workers. Increasing or  establishing exorbitant caseload expectations can wreak havoc. ”

5. Authority. “If physicians actually possess limited control over their work, they may fall victim to ‘learned helplessness,’ which Dr. Gunderman defines as a sense that physicians cannot meaningfully influence healthcare.”

6. Priorities. “Physicians don’t do the work they do for the benefit of the hospital — they do what they do for the patient….When priorities get mixed and hospital interests supersede patient interests, the entire healthcare model gets warped.”