Health care organizations exist in complex and interacting environments, to state the obvious. Administrators understand how current economic trends affect the financials of the health care organization via various routes, such as reimbursement rates, amount of charity care, and pressures on wages. Similarly, demographic trends predict the characteristics of future patients and providers.
A recent, but less acknowledged, environmental factor is the polarized and politicized social context within which health care organizations operate. Over the past few years, findings from medical science have been politicized with polarized opinions repeated in news and on social media. Science, as a basis for decision-making, has often taken a back seat to less informed stances. Within this polarized and politicized sociocultural environment, hospitals are facing unique and unprecedented challenges.
Hospitals or health systems with publicly elected boards of directors appear vulnerable in a new way. A recent article in the Washington Post (Craig, 2022) describes efforts in Sarasota, Florida, by one antivaccine group to fill seats on the hospital's board. If a slate of antivaccine, or antiscience, directors is elected, the consequences could be diverse and profound. How can a safety net hospital remain a quality health care provider if a political agenda influences treatment options? What would be the implications for social justice and health care equity? What might be the financial implications for the health care organizations, as well as for the populations served? The questions feel endless.
Again, to state the obvious, the overturn of Roe v. Wade has created a tumultuous health care environment. News reports have described the scramble providers have had to find a niche so they might provide medically necessary care. A plethora of strategy research avenues deserve attention. For example, what strategies are effective in protecting health care providers and the community for which a health care organization has some degree of responsibility? How can health care organizations effectively implement these strategies in such a politicized environment?
Strategy has always been about understanding the organization's environment. Early organizational strategy research focused on developing typologies of strategies (e.g., Ginn & Young, 1992; Zajac & Shortell, 1989). Since that flurry of health care administration strategy research, environmental turbulence now includes sociocultural shifts, accessibility of news via social and traditional channels, and globalization of supply chains. What research exists that might help hospital administrators navigate the complexities of balancing community involvement with holding true to the organization's mission and values? Health Care Management Research seeks current research about strategy that might be useful, helpful, directive, or otherwise supportive of health care administrators who are navigating their polarized and politicized community environment.
L. Michele Issel
Editor Emerita
Cheryl Rathert
Larry Hearld
Co-Editors-in-Chief
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