The integration of medical specialists in hospitals. Dutch hospitals and medical specialists on the road to joint regulation

Medical specialists have-notwithstanding governmental policy-acquired a firmly established position in policy-making in Dutch hospitals. In all general hospitals the Executive Board and the Staff Executive frequently and systematically negotiate their interests. Three conclusions may be drawn on the basis of the research reported on in this article. In the first place, it is the primary objective of the medical staff executive to protect the interests of the medical domain against managerial dominance. In the second place, developments suggest that the parties are slowly but surely switching to the joint regulation of overlapping interests. Finally, the trend towards joint regulation is an enormous challenge for medical staff governance.