Hospitals' strategies for orchestrating selection of physician preference items

Kathleen Montgomery, Eugene Schneller

Research output: Contribution to journalReview articlepeer-review

71 Scopus citations


This article analyzes hospitals' strategies to shape physicians' behavior and counter suppliers' power in purchasing physician preference items. Two models of standardization are limitations on the range of manufacturers or products (the "formulary" model) and price ceilings for particular item categories (the "payment-cap" model), both requiring processes to define product equivalencies often with inadequate product comparison data. The formulary model is more difficult to implement because of physicians' resistance to top-down dictates. The payment-cap model is more feasible because it preserves physicians' choice while also restraining manufacturers' power. Hospitals may influence physicians' involvement through a process of orchestration that includes committing to improve clinical facilities, scheduling, and training and fostering a culture of mutual trust and respect.

Original languageEnglish (US)
Pages (from-to)307-335
Number of pages29
JournalMilbank Quarterly
Issue number2
StatePublished - Jun 2007


  • Physician preference items
  • Resource dependency
  • Standardization
  • Supply chain

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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