The evolving role of third parties in the hospital physician relationship.

Hospital-physician relationships (HPRs) are a key concern for both parties. Hospital interest has been driven historically by the desire for the physician's clinical business, the need to combat managed care, and now the threats posed by single specialty hospitals, medical device vendors, and consumerism. Physician interest has been driven by fears of managed care and desires for new sources of revenue. The dyadic relationships between hospitals and physicians are thus motivated and influenced by the role of third parties. This article analyzes the history of HPRs and the succession of third parties. The analysis illustrates that the role of third parties has shifted from a unifying one to one that divides hospitals and physicians. This shift presents both opportunities and problems.