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by John Kallas, Rosemary Batt and Eileen Appelbaum
A central problem in contemporary employment relations has been the fragmentation of work and dismantling of internal employment systems that historically provided stable jobs and income security. This process is occurring in hospital systems as they attempt to cut costs and improve care quality by shifting services out of costly hospitals and into a wide range of outpatient centers. While these strategies may benefit patients, the implications for workers and their unions are worrisome as decentralization