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Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"

David Hughes

International Journal of Health Policy and Management, Volume: 13, Issue: 1

Swansea University Author: David Hughes

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DOI (Published version): 10.34172/ijhpm.8651

Abstract

Ubels and van Raaij provide a valuable account of the operation of novel hospital/medical specialist enterprise (MSE) contracts in a Dutch healthcare system shaped by market reform. However, their analytical distinction between the separate domains of contractual and relational governance frames the...

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Published in: International Journal of Health Policy and Management
ISSN: 2322-5939
Published: Kerman University of Medical Sciences 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68153
first_indexed 2024-11-03T14:13:55Z
last_indexed 2025-01-09T20:32:47Z
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spelling 2025-01-09T12:45:44.6040409 v2 68153 2024-11-03 Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands" f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2024-11-03 Ubels and van Raaij provide a valuable account of the operation of novel hospital/medical specialist enterprise (MSE) contracts in a Dutch healthcare system shaped by market reform. However, their analytical distinction between the separate domains of contractual and relational governance frames the contractual domain more narrowly than does the relational contract theory widely deployed in socio-legal studies. The authors’ conclusion that contract plays little or no part in governing relations between hospitals and MSEs leads them to underplay a wider realm of contractual practices that develop in the shadow of the written contract. Apparent non-use of contracts in favour of shared planning, compromise and extra-legal solutions only takes the form it does because of the potential application of the available legal framework. Larger qualitative field studies involving a more extensive combination of interviews and observations may be needed to gain fuller insights into the relational dimensions of the contracting process. Journal Article International Journal of Health Policy and Management 13 1 Kerman University of Medical Sciences 2322-5939 Netherlands; Hospitals; Medical Specialist Enterprises; Physician Reimbursemen; Relational Contracting; Organisational Governance 13 11 2024 2024-11-13 10.34172/ijhpm.8651 Commentary COLLEGE NANME COLLEGE CODE Swansea University Not Required 2025-01-09T12:45:44.6040409 2024-11-03T14:06:07.5469826 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health David Hughes 1
title Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
spellingShingle Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
David Hughes
title_short Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
title_full Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
title_fullStr Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
title_full_unstemmed Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
title_sort Can’t Contracting Be Relational? Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands"
author_id_str_mv f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author David Hughes
author2 David Hughes
format Journal article
container_title International Journal of Health Policy and Management
container_volume 13
container_issue 1
publishDate 2024
institution Swansea University
issn 2322-5939
doi_str_mv 10.34172/ijhpm.8651
publisher Kerman University of Medical Sciences
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description Ubels and van Raaij provide a valuable account of the operation of novel hospital/medical specialist enterprise (MSE) contracts in a Dutch healthcare system shaped by market reform. However, their analytical distinction between the separate domains of contractual and relational governance frames the contractual domain more narrowly than does the relational contract theory widely deployed in socio-legal studies. The authors’ conclusion that contract plays little or no part in governing relations between hospitals and MSEs leads them to underplay a wider realm of contractual practices that develop in the shadow of the written contract. Apparent non-use of contracts in favour of shared planning, compromise and extra-legal solutions only takes the form it does because of the potential application of the available legal framework. Larger qualitative field studies involving a more extensive combination of interviews and observations may be needed to gain fuller insights into the relational dimensions of the contracting process.
published_date 2024-11-13T14:45:14Z
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