Mergers of Teaching Hospitals in Boston, New York and Northern California
John A. Kastor, MD
Softcover, 504 pages
University of Maryland Press / UMP
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Mergers of Teaching Hospitals in Boston, New York, and Northern California investigates the recent drop in funding for teaching hospitals and the subsequent mergers of some of the nation's top medical schools and teaching hospitals with both for-profit and not-for-profit hospitals.
The case studies contained within this book rely on an impressive amount of research.
Notably, instead of citing only published articles and books, the author includes information from numerous, extensive personal interviews with key participants in the various mergers.
With this research the author not only presents to the reader a picture of why these mergers came about, but also investigates how the organizations have fared since joining together.
The mergers are analyzed and compared in order to identify various methods of merger formation as well as ways in which other newly formed hospitals might accomplish a variety of important goals. Offering a spectacular account of some of the mergers that occurred in the health care field at the close of the twentieth century, these stories provide insight into academia's relationship with teaching hospitals and the challenges involved in bringing prestigious and powerful medical institutions together. This book will particularly appeal to professionals and academics interested in medicine, business, and organizational studies. John Kastor is with the School of Medicine at the University of Maryland. (information provided by the publisher)
From the New England Journal of Medicine, November 28, 2002: "Mergers and acquisitions are now such common subjects of discussion in our newspapers, on television, and in the country's larger law firms that they are hardly news any longer. The aim of a merger is to make something greater or stronger than the sum of its parts. What is newsworthy is that they may fail or be contested in the courts, and what is worrisome is that the world of business is littered with failed mergers. So it should come as no surprise that in the world of corporate medicine we have our own mergers to discuss or decry. In the hospital world of the 1990s, strength was often believed to derive from alliances that could drive better bargains in a changing world of reimbursements for medical services... In this detailed and very well written book, John Kastor dissects for us three important mergers of the mid- and late 1990s that involved six of the country's leading academic hospitals, which were closely allied to five distinguished medical schools. The details, and of course the people, differed, but each group believed that they could continue to do what they already did so well if they teamed up with a main competitor so as to face a hostile new world with greater strength... Kastor, a cardiologist of note, a faculty member at Harvard and the University of Pennsylvania, and for 11 years chair of medicine at the University of Maryland, was, as this book amply demonstrates, born to be an investigative journalist. He interviewed 237 faculty members and administrators, some more than once, and with great clarity tells the story of the three mergers in two chapters each... In the first chapter pertaining to each merger, he briefly describes the history of each hospital and medical school and then discusses the hospitals' leaders and the increasing pressures they faced in a rapidly changing and highly uncertain medical marketplace... In a final chapter Kastor considers the contrasts among the three quite different merger arrangements and points to some of the lessons we might learn... The story of the three mergers that Kastor tells in such rich detail is not yet a work of history, nor does it pretend to be... Although it may be much too early to write such a history, at least two conclusions may be drawn. One, a theme of ever-increasing importance, relates to the differences and the similarities between a business enterprise and a university and its hospitals... A second point implicit throughout these case histories is the importance of people not only with good will and good intentions, but also with vision and with the leadership skills necessary to carry out partnerships among dedicated faculty members from different traditions, different cultures, different loyalties, and (as in the California case) from public and private universities. As complicated as the economics, the geography, or the traditions may be, all those who contemplate such mergers ought to have a sign on their desk that says, "It's the people, stupid." Gert H. Brieger, M.D., Ph.D., New England Journal of Medicine.
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