Mintzberg et l'hopital
Barbara Bigelow and Margarete Arndt Coeditors
THE FORUM
Health Care Manage Rev, 2001, 26(1), 56–92 © 2001 Aspen Publishers, Inc.
This FORUM features two articles by Henry Mintzberg and Sholom Glouberman, commentaries by Tom D’Aunno and Peter Weil, and the authors’ response to the commentaries. It makes for a stimulating sequence, indeed! In their first article, Glouberman and Mintzberg take a broad view of the health care system and identify four aspects—care, cure, control, and community—that function to a large part independently and under different mindsets. They see that as one reason why it is so “enormously difficult” to control the overall system. In their second article, the authors focus on how closer coordination of the four quadrants could be achieved. Mintzberg and Glouberman refer to “curtains” that inhibit communication and collaboration between members of licensed professions and alternative providers. But, as became evident to us from articles presented at this year’s Academy of Management meeting, there are curtains between the formal professions as well (for example, between physicians and nurses), making the transfer of knowledge difficult even among people who collaborate closely in the care of each patient. Both Tom D’Aunno and Peter Weil agree with the authors that much separation remains among the participants in the health care system. Both also provide further insight. For example, D’Aunno points to a considerable body of research that empirically confirms arguments made by Mintzberg and Glouberman while adding nuances that go beyond the suggestions made in the articles. Weil’s comments focus on the role of management and attempts by hospitals to achieve higher integration between management and clinicians, as well as between the organization and its community. He also makes a case that management should be seen as a profession. The issues raised in these fine articles and commentaries are not only extremely important,