When multiple medical staff models coexist, who is accountable to whom and for what?

Almost every hospital employs physicians and expects to employ more in the future. Many hospitals have established service lines, and some of these have morphed into service line comanagement arrangements. Many hospitals have turned to more traditional business arrangements, such as exclusive and nonexclusive physician contracts, and employ medical directors and other physician executives. At the same time, the traditional department-based medical staff has not gone away. When these models coexist in the same medical staff, it can be hard to determine who is accountable to whom and for what.

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