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Most physician organizations have yet to reach a state of stability.
Whether hospital-based or independent, IPA or management services model, many face governance issues, poor financial results and unsatisfactory performance of operating systems. Often the economic incentives for physician providers are misaligned with the factors which drive the organization's finances. In the best performing organizations, compensation to the physician and other providers is closely tied to the organizations' overall financial performance. Often a material portion of compensation is at risk until financial results are known. Economies of scale are attained by physicians practicing together in groups of four to six.