New technology, bureaucracy, and construction of medical prices

Article Abstract:

This article presents an analysis of the social roots of medical service price inflation. The author argues that a struggle between hospital managers and physicians to control medical services has inflationary consequences. The author also contends that new technology acts as a strategic resource for managers in this struggle. Because the technology is new, few data exist for evaluating the demand for it and its medical and financial effects. Managers thus play a 'hypothetical game' and set prices through bureaucratic means that reflect their preferences for technology and help pay for the equipment. An empirical case study involving the purchase of nuclear magnetic resonance equipment in Omaha, Nebraska, supports and illustrates the argument. (Reprinted by permission of the publisher.)

Analysis, Finance, Physicians, Medical professions, Medical care, Cost of, Health care costs, Hospitals, Hospital administration, Medical technology

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The glorious failure

Article Abstract:

This article describes an organizational intervention that was considered highly successful on first sight and in the short term. However, after some time it emerged that the effects of this organizational intervention were surprisingly different from what had been planned and foreseen. A deeper analysis indicates the substantive effects of the basic assumptions (not always conscious) of management, foremen, workers, and the professional team conducting the intervention. The dynamics of influence of these assumptions and the possible overall implications for organizational interventions are discussed. (Reprinted by permission of the publisher.)

Case studies, Corporate culture, Organizational effectiveness, Organizational behavior

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