Growth, Power Structure and Leadership Functions in the Hospital Organization

Abstract

The accelerated development of medical technology, the increase of diagnostic and therapeutic methods, and the still continuing process of specialization within the medical professions are responsible for the statistical evidence of increased capital investment for the organization of medical care. As a consequence of the economies of scale, new hospitals built in the last decade are very large and some small hospitals have been closed or merged. It may be fruitful to examine the socisl effects of this process of concentration in the field of medicare, which has been generated by mainly economic considerations. This article will deal with one aspect of the problem. It tries to connect the quantitative changes in hospital organization that are obvious to everyone, with qualitative changes in the organizational character, its social structure, its labour relations, and its relationship with tile patients; changes that are not always immediately visible and thus seldom foreseen. Administrative action, therefore, fails to take them sufficiently into account. In fact, the development of an organization's structure on a larger scale is influenced by