The new academic health center hybrids: part business, part academic.

Academic health centers have flourished since the 1960s and even managed to survive the shift toward prospective payment. But in their current quest to expand the number of managed care patients and compete with the private sector, they often must price services below cost and reduce the number of faculty members and other personnel. Unless their prices are competitive, managed care companies will not do business with them.

In-house recruiters: on the inside looking out.

Few smaller hospitals or managed care companies have in-house physician recruiting departments. Their low hiring volume simply doesn't support such an operation. But most health systems and large managed care organizations say they literally couldn't afford to be without an internal system for the recruitment of physician executives and other health care professionals.

Herding stats: the quality measurement dilemma.

All over the country, millions of research dollars are being spent to devise an effective way of measuring quality that could be standardized in health care, and hospitals and managed care companies are experimenting with a variety of quality tools, trying to document what they now can only perceive as improvement. Experts are divided on what works best, but all applaud and embrace the efforts. In this special report, several of them discuss their views on what works, and what doesn't work, in the exploding field of health care quality measurement.

Fighting fire with fire: physicians blazing new paths to autonomy.

Thousands of physicians around the country have stopped complaining about being burned by the system and have started reengineering their destinies. They're building super IPAs, forming and operating HMOs, and joining unions to represent their rights in a growing grassroots physician effort to regain control. These physicians have thumbed their noses at managed care companies they say have drastically cut reimbursements, arbitrarily dropped them from panels, dictated utilization, and cost them patients.

Lonely at the top and loving it: physicians as CEOs.

As little as five years ago, most hospital board members scoffed at the idea of hiring physicians as chief executive officers or chief operating officers. Physicians, they maintained, belonged at the bedside, not in the board room. For the most part, physicians didn't take issue with this thinking.