“Because management deals mostly with the status quo and leadership deals mostly with change, in the next century we are going to have to try to become much more skilled at creating leaders.”

– John Kotter

Late in the last century, there was a large investment on developing health care managers. I was part of that generation of M.B.A.s trained in a health care administration curriculum of operations and human resource management, accounting and finance, information technology, economics and health care organization. In those days, there were separate organizational hierarchies for hospital administration and the organized medical staff. The role of management was to optimize revenues and reduce costs and keep the medical staff happy in order to maintain the flow of referrals and admissions.

However, with recent changes in health care, and the shift from volume to...

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