Richard L. Johnson

Hospital governance in a competitive environment

The modern hospital has evolved through three phases since 1900. Between 1900 and 1950, hospitals were in a charitable era and from 1950 to 1990, they were in a technological era developing a comprehensive range of clinical services. From 1990 to well into the 21st century, hospitals will be in an economic era where decision making will shift from the boardroom to the administrative suite. Clinical and management viewpoints will be blended in order to successfully compete in the new environment.

Revisiting "the wobbly three legged stool".

Examination of both the similarities and dissimilarities of the use of the corporate organizational model in the typical hospital has led to the conclusion that the model can, at best, be only a loose fit.

The entrepreneurial physician.

This article draws on the experience of interviews of hundreds of physicians in the last few years. Those at mid-career have deep concerns about what lies ahead for them. A character, Dr. Charles Evans, has been created to describe some of the major possibilities being thought about and explored by physicians who believe their profession is now changing in ways they never had anticipated.

Public trust: Reclaiming or preserving?

The public trusts hospitals for their diagnostic and therapeutic capabilities, while resentful of the high costs of care. A comprehensive national health care program will increase the publics distrust of health care when its goals are not met. It is more desirable to incrementally add benefits in a national program beginning with a catastrophic coverage program to assure the publics trust.

The power broker--prototype of the hospital chief executive?

To some people power brokers manipulate because they lack a solid grounding in management. Power brokering is not an equation of manipulation or management; rather it is the application of solid management techniques combined with a deep understanding of how people behave as human beings.