August 2, 1971

Doctors in Hospitals: Medical Staff Organization and Hospital Performance

Author Affiliations

Cedars-Sinai Medical Center Los Angeles


by Milton I. Roemer and Jay W. Friedman, 322 pp, $12.50, Baltimore and London: Johns Hopkins Press, 1971.

JAMA. 1971;217(5):700. doi:10.1001/jama.1971.03190050156028

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When current debates about delivery of health services are resolved, the complex task of implementing the broad policy decisions reached will require assessment of each component of presently existing health services. These include medical practice and hospital performance, which intersect primarily through the medical staff organization. This book attempts to relate the varieties of medical staff structures to the hospital performance in providing direct care to patients (as well as a miscellany of community health services). Performance is conceived as "what the hospital as a social organization does."

In order to put such a study in perspective, the authors describe in several excellent introductory chapters the development of the modern hospital and its organized medical staff, the conflicts that divide them, and the social pressures and external controls that affect the institutions in which physicians work.

No single study method can probe hospital-based medical practice as well as the diverse