ABSTRACT
Until recently hospitals, clinics and other health care organizations (HCOs) were considered so different from business or work organizations in mission, accountability, and productivity that many wondered if they really should be considered work organizations. Things have changed dramatically, so that today many health care organizations now proudly proclaim that they are “in the business of providing health care.” HCOs have worked diligently to become more businesslike in their operation particularly in an era when health care cost containment is a national priority. Nevertheless, there remain unique differences between the worlds of for-profit corporations and HCOs. Comparing a high tech manufacturing corporation with a high tech academic medical center illustrates this point. Typically, the high tech manufacturing organization might have a structure that is lean and responsive, and governed by leadership that is precise and predictable. And, typically, the high tech academic medical center will have a structure of loosely coupled units and division, and leadership that resembles the director's efforts in improvisation theater!
