David Irwin, formerly Physician Superintendent, St George's Hospital, Morpeth

The Hospital-Physician Relationship

The traditional hospital-physician relationship in the United States was an implicit symbiotic collaboration sheltered by financial success. The health care economic challenges of the 1980s and 1990s unmasked the weaknesses of this relationship as hospitals and doctors often found themselves in direct competition in the struggle to maintain revenue. We recount and examine the history of the lar...

Physician-hospital integration without hospital employment.

Hospitals can use a full-service PSA to achieve physician-hospital integration without the downsides of an employed practice. Under a PSA, a hospital would serve as provider of service and responsible billing party. A PSA contractually obligates a group to defined responsibilities.

David Skae: Resident Asylum Physician; Scientific General Practitioner of Insanity

David Skae was resident physician of the Royal Edinburgh Asylum (hereafter REA) from 1846 to 1872. Despite a pioneering article about him by Frank Fish, Skae remains a liminal figure in the history of psychiatry. He is usually seen as an asylum-based practical medical instructor of more important figures such as Thomas Clouston. Although he lectured on insanity in the Edinburgh extra-academical...

David Oliver: Progress on dementia in hospital.

England’s health secretary, JeremyHunt, used a speech inMarch to rehash the long running prime minister’s challenge to raise standards of care for people with dementia. All Hunt really said about acute hospitals was that patients with “high dependency” would get consultant ward rounds twice a day and that some may have dementia—part of his “seven day services” crusade. This was a missed opportu...

Physician/hospital joint ventures in the wake of St. David's: reference material.