The manager and the merger: adjusting to functioning in a blended organization.

Once a cottage industry consisting of many scattered providers, health care has become an industry of large organizations and multi-institutional systems. Various organizational combinations continue to occur, especially in the form of mergers, affiliations, and the creation and expansion of health care systems. In the midst of this ongoing dramatic change, the role of the individual manager remains essentially unchanged in concept, but the arena in which that role is pursued is rapidly changing. Areas of responsibility are becoming broader, the groups overseen by individual managers are becoming larger, and many of the older "principles" of management are being tested and strained. Today's health care manager is learning that survival and success depend more than ever on flexibility and adaptability.