in need of renewal rather than reconciliation: why we cannot be satisfied with hospital management’s status quo; comment on “dual agency in hospitals: what strategies do managers and physicians apply to reconcile dilemmas between clinical and economic considerations?”

Activity-based payment systems enforce israeli and german hospital professionals to continuously balance clinical and economic considerations. as argued this status quo is unsatisfactory due to two reasons. first, professional hybridity in hospital management is restricted to the physician versus manager dichotomy rather than a multifaceted-identity framework. second, by depending mostly on serendipity rather than hospital professionals’ organizational leeway applied reconciliation strategies seem extremely temporarily and brittle. as concluded, alternative models of hospital funding and organization such as global budgets are urgently needed. in addition, hospital professionals have to be empowered to make effectively us from their hybrid identities.