Realising integrative care by delegation: The hospital physician

Hospital managers are constantly confronted with capacity and continuity problems that tempt them to investigate the possibility of further job differentiation. In The Netherlands, the hospital physician represents a new breed of physicians who are not oriented towards a medical specialism but towards a patient domain. The hospital physician represents a controversial kind of job differentiation that is expected to stimulate more continuity. This case study shows how medical specialists themselves are starting to address the fragmentation caused by specialization. According to the professionals involved, the hospital physician constitutes a solution that does not threaten their professional values. They report a number of ways in which this job type can contribute to solving the problems reported. However, concerns have been raised about the risks of developing these new jobs without changing the existing professional and work structures.