Hospital-physician informed consent: new use for an old doctrine.

The relationship between hospitals and physicians has changed dramatically in recent years because of the increasingly competitive healthcare environment. Many healthcare executives have struggled to find a balance between collaborating and competing with the new breed of physicians. A relationship familiar to the healthcare leader may provide a useful framework for effectively addressing physician relations in today's healthcare setting. The physician-patient relationship experienced tensions similar to those facing the hospital-physician relationship, and informed consent arose to establish clear expectations between physicians and patients. Healthcare leaders might consider adopting an informed-consent philosophy in their physician relations. Four basic components of informed consent govern the physician-patient context: (1) an assessment of the situation, (2) an explanation of the treatment, (3) an exploration of the alternatives, and (4) a documentation of any agreement. These four components can be adapted to the hospital-physician context to foster productive partnerships in today's healthcare landscape.