The changes in healthcare delivery that hospitals and health systems seek in today's market cannot be accomplished without the cooperation of physicians. Conversely, many physicians find that they need relationships with hospitals to guarantee patient volume and income. Physician-hospital alignment is the phrase used to describe the ideal state of physicians in lockstep with strategic goals. But achieving alignment is complex. The trend of employing physicians continues, yet employment does not necessarily lead to integration. Whether employed or independent, and regardless of specialty, physicians must see value in collaborating with acute care hospitals. Executives and physician leaders need one another to counter declining reimbursements and the other challenges facing the industry. HealthLeaders Media recently joined with five executives for an in-depth, three-hour conversation on governance, compensation, culture change, and accountability.