Table 1 Advantages and disadvantages of the personnel partnership of medical centres with general hospitals.

Advantages for the medical centre	Advantages for the general hospital
Reducing competition Obtaining new customers when specific consulting services take place only in the medical centre (e.g., radiology, pathology, psycho-oncology, etc.) Access to “normal” patient collectives (e.g., for purposes of research or further training of assistant physicians) Obtaining physicians in further training in the smaller hospital who may in future as office-based specialists refer patients to the two hospitals Performance of particular interventions in the smaller hospital which are not profitable in the medical centre on the basis of its more expensive cost structure (e.g., outpatient interventions) Performance of certain operations in the medical centre which would lead to organisational and financial difficulties in the smaller hospital (e.g., surgery of ovarian cancer)	Connection with a larger hospital for strategic direction and planning security use of niches easier in the cooperation since the entire specialist field is covered Linkage with and use of existing structures (e.g., certified cancer centres, urogynaecological centres, etc.) Occupation of medical positions possibly easier through the more “attractive” larger hospital since, as a rule a higher grade of further training possibilities and initiative competition are in existence Expansion of certain surgical interventions
Disadvantages for the medical centre	Disadvantages for the general hospital
Splitting of attention and working time of the head physician	possibly restrictions of the operation spectrum possibly reduction of case mix and case mix index