ABSTRACT
The type of a structure that manages a hospital or health system has a form equivalent to the nature and scope of the institution. Seldom is this “sized” to accommodate a private practice. Transition comes from a variety of departments and may be a process that is not only far reaching, but also overreaching. An example is often evident in purchasing. The private practice may have an account at Costco™* that it has used for office supplies and the hospital buys through a buying group (group purchasing organization (GPO)). The Costco pricing may be cheaper on some items than what the hospital has been able to achieve in its professionally staffed purchasing function. Also, Costco acts as an inventory support function for the private office. It always has a stock of whatever is needed. If a practice runs out of something, there is always a trip to Costco. This keeps inventory low, and logic would dictate that the practice would buy from the most cost-effective source. This may not fit the process as it is managed in a health system that has very precise and, maybe, automated purchasing function that is linked to bookkeeping and accounting functions. Not only is the process changed, but there is now a need to warehouse supplies, and there may be increased supply costs.
