Abstract
This article explores the first vision of modern hospital management as it was advanced by the American Hospital Association in the early 1900s and compares it with the reality of daily practice at the time. The findings show a wide gap between vision and reality. They also show that many of the issues faced by hospital administrators a hundred years ago remain relevant today. They include the tension between adoption of new technology and the cost of hospital care, advocacy for business practices from the private sector, and the administrator's responsibility in the area of quality of care.
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