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To create thriving practices and organizations, we must resist the “us vs. them” narrative and pursue real collaboration. Here's what that looks like.

Fam Pract Manag. 2025;32(6):17-21

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial relationships.

“Building trust and transparency between practicing physicians and administrators has the potential to .... result in improved working relationships, healthier workplaces, increased personal and organizational resilience, and improved patient-physician experiences.”

— Paul DeChant, MD, MBA1

Imagine working in a thriving clinical environment where physicians and administrators function as a cohesive team, each understanding, respecting, and supporting the other's needs and roles to advance the mission of the practice. Too often, however, the pressures of health care create an environment of friction and misalignment. Increased patient complexity, rapid technological advances, productivity demands, financial pressures, and staff shortages can derail even the best physician-administrator teams, fueling a narrative that “they don't understand us,” which can negatively affect patient care, efficiency, and professional satisfaction.

The risks from poor physician-administrator collaboration are greater than ever, as 76% of family physicians now work in employed practice settings.2 Physicians who feel unheard may resist organizational changes, while administrators who feel pressured to cut costs or increase efficiency may unintentionally undermine physician morale. The truth is that the success of one is linked to the success of the other. Collaboration isn't just a “nice to have;” it's the foundation of effective and sustainable patient care.3

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