Adapting to the age of competition: a paradigm for voluntary hospitals

The difference between voluntary hospitals that successfully change themselves from charitable into competitive institutions and those that don't is the way the hospitals' leaders view their institutions. The concept of the hospital as an institution that provides services to those in need differs from the concept of the hospital as an institution that offers services to customers. This fundamental conflict may be why many voluntary hospitals find it difficult to benefit from modern management methods that work well in commercial enterprises. For hospitals wanting to make themselves more competitive, the author recommends introducing the customer/client concept at middle management levels of the organization.