DONNA SOLLENBERGER AND ALAN ZUCKERMAN, in their respective articles, have presented their readers with an interesting point-counterpoint underscoring the juxtaposition between research and theory and practical application. On the one hand, Zuckerman presents us with the results of his research and field experience suggesting a disconnect between the practitioner's perceived state of the art of healthcare and the ten best in healthcare planning. He goes further to argue that a yawning chasm exists between the best practices in healthcare and the state of the art in outside of healthcare. In the course of this discussion he addresses four stages in the evolution of and suggests that most healthcare institutions have not evolved past stage two and that stage-four organizations tend to operate outside of healthcare. Stage three is defined as strategic and stage-four is characterized by aspects of some or all of the following five qualities: 1. systematic, ongoing data gathering, leading to use of knowledge management practices; 2. encouragement of innovation and creativity in approaches; 3. more bottom-up than top-down planning; 4. evolving, flexible, continuously improving processes; and 5. a shift from static to dynamic planning. Zuckermaris points are well taken. The process of planning, including its death at one point, has been the focus of extensive research and writing over time. The concept of evolution in the process has also been well studied. Gluck, Kaufman, and Walleck (1980) 25 years ago described four phases in the evolution of planning. Phase I is defined as basic financial planning designed for operational control and to meet the budget. For many companies with strong leadership and singular focus, this level of sophistication may serve the organization well. As companies and markets become larger and more complex, they tend to migrate to more effective processes to accommodate that level of complexity. Phase II is then defined as forecast-based planning and recognizes the need for more effective for growth. When rapid change becomes the hallmark of an industry, forecasting contributes less value to the decision-making process and a new focus predominates the process. Labeled Phase III, this focus is defined as externally oriented planning that forces management to think strategically. At this stage of an organization's evolution, the complexity of its business and the markets in which it operates dictate that alternative paths be considered and that difficult choices be made. Unfortunately, these issues become compounded when the right hand doesn't fully appreciate, or communicate in advance, the effects decisions will have on the left hand. As this realization sets in, the process evolves to an even higher plane. Phase IV is defined as strategic management, and when effectively integrated into the organization, Phase IV allows management to create the future. The words of Gluck and colleagues are illustrative here: Phase IV joins and management in a single process. Only a few companies that we studied are clearly managed strategically, and all of them are multinational, diversified manufacturing corporations. The challenge of for the needs of hundreds of different and rapidly evolving businesses, serving thousands of products/markets in dozens of distinct national environments, has pushed them to generate sophisticated, uniquely effective techniques. However, it is not so much technique that sets these organizations apart, but rather the thoroughness with which management links to operational decision making. This is largely accomplished by three mechanisms: 1. …