• Physicians and hospital authorities have a mutual responsibility to cooperate and work together in effectively maintaining patient care. 
• Although final authority for granting, denial, termination, or limitation of hospital staff privileges is vested in the governing board of the hospital, it is expected that the judgment of the organized medical staff will be relied upon in the evaluation of the professional competence, education, experience, and qualifications of all physicians, including the hospital-associated medical specialists. 
• Physicians having contractual or financial arrangements with hospitals should be members of the organized medical staff and responsible to it. They should be subject to the bylaws of the medical staff and conduct their professional activities according to the standards, rules and regulations adopted by it. 
• Hospital-associated medical specialists, as well as all members of the medical staff, are expected to contribute a reasonable amount of their time, without compensation, to participation in hospital staff committee activities for the purpose of improving patient care; providing continuing education for the benefit of the medical staff; and assisting in the training of physicians and allied health personnel. Physicians who provide teaching or other services in excess of those ordinarily expected of members of the attending staff are entitled to reasonable compensation therefore. 
• Hospitals are entitled to recover their reimbursable expenses, determined in accordance with recognized standard hospital cost-accounting principles, from the operation of departments in which hospital-associated medical specialists perform personally or supervise or direct the services provided patients. 
• The form of the contractual or financial arrangement between hospitals and hospital-associated physicians depends upon the facts and practical considerations existing in each situation. No single form of contractual or financial arrangement can be feasible for all of the arrangements that may be entered into between hospitals and hospital-associated physicians. The essential consideration is that whatever the arrangement, it is fair to the parties, promotes the interests of patients and supports the provision of high quality care and services. Arrangements should be avoided that are unrelated to the professional services, or time expended or to the skill, education, and professional expertise of the physician, and that result in disproportionate earnings. 
• Hospital-associated medical specialists are entitled to charge for the services they provide in accordance with the same standards of equity and fairness that apply to the charges of other physicians and for supervision of personnel under their direction. 
• There should be no duplication of charges to the patient where services are not actually provided by both the physician and the hospital. Each party should receive the compensation reasonably and equitably owing for services for which each is primarily responsible. Only one of the parties is entitled to the reasonable costs of assuring the accuracy and reliability of the procedures performed in such departments.
• Both hospitals and hospital-associated medical specialists have an obligation to serve the needs of patients and the medical staff. The primary responsibility for determining the services needed adequately to care for the needs of individual patients should be that of the attending physician subject to review by his peers.

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