1. Issel, L. Michele PhD, RN, Editor-in-Chief

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Italy, Slovenia, South Korea, Taiwan, Canada, and the United States are represented in this issue of Health Care Management Review (HCMR). The articles reveal that health care systems and organizations are responsive to local laws, resources, cultures, and health care needs. You will notice that the international authors have provided some description of the health care system of their nation. However, this is not required of the authors from the United States. You will also notice in the international submissions that the concepts, theories, and citations are predominantly of scholars and journals from the United States. The reverse is not true; non-English journals are not cited by English-speaking authors. Also, it has become clear to me that the pressure on international scholars to publish in journals from the United States is surprisingly strong.

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These realities of international submissions have given me pause to consider the extent to which my decisions about manuscripts, including the types of revisions requested, are influenced by my own ethnocentrism and the pressures I experience to practice ideological imperialism. For better or worse, journals from the United States are perceived as the "gold standard." This may be an artifact of history, the dominance of Anglophone top-tier journals, or a process of legitimization within our discipline. It is the latter that is most worrisome to me. Arguably, the nearly exclusive reliance on knowledge and theories from the United States and the Western cultures diminishes the discipline of health care administration.


Language poses a more visible challenge. Writing well in a foreign language is extremely difficult, and here, I speak from personal experience, having published in a Spanish-language journal. When an article is submitted to HCMR, it must be in nearly perfect English and written in an academic style. Less than these and reviewers struggle to understand the manuscript, with subsequent unsure footing upon which to critique the concepts and methodology. Unfortunately, HCMR has limited resources to offer international authors in terms of editing potentially significant manuscripts. My best advise to authors is to pay for editing from a native English speaker and work with that person during the editing process. It will become a true learning experience. Again, I am speaking from experience.


As I receive and review the international submissions, I have gained deep appreciation for both the pressures and challenges that globalization of knowledge presents for authors, reviewers, editors, and practitioners. The challenges are ideologically substantive, not just linguistic. I optimistically believe that health care administration scholars and practitioners from all cultures and nations have something unique to contribute. It will take courage for authors, reviewers, and editors, not to mention practitioners, to be receptive to potentially unfamiliar approaches to understanding how to better create and manage health care systems and organizations. I look forward to finding a path toward integration and inclusion that allows scholars to explore and exploit (in a truly positive sense) diversity for generating new knowledge and tools for health care management.


L. Michele Issel, PhD, RN