“Today’s hospital is the community’s center of health care and advanced medical technology. It is also the most complex human institution around, with a profusion of services and healthcare professionals which nobody dreamed of even fifty years ago.”
Drucker, Peter. Toward the Next Economics. Boston: Harvard Business Review Press, 1981.
In that era:
Hospitals were cost-plus
Hospitals did not employ physicians
Hospitals were not taking risk like insurance companies
Those conditions have long-since disappeared
Reimbursement trends are negative (in real terms)
New forms of competition appear on almost a daily basis (e.g. United Healthcare, Amazon)
The focus of health care has expanded to include chronic care
As a result, leaders must select one (or many) complementary strategic paths for their increasing complex entities.