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Most physicians practice within an institutional setting--typically a hospital, but it may be a medical school, a clinic, or another type of health care institution. The physician may not be an employee of the institution but is still subject to the rules of the institution. These rules may increase the duty and the legal liability of the physician toward his or her patients. Violation of these rules may also imperil the physician's right to practice at the institution. Conversely, the institution owes the physician some duty of fairness in the application of its rules. Many physicians have challenged the prerogatives of hospital medical staff committees and institutional administrators.

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