While catching up on my professional reading, two articles in very different journals caught my attention. One article was fascinating because it reported on testing the predictive value of three theories of provider behavior (Bonetti et al, 2006). The other article was a thought-provoking discussion of integrating East-West philosophical approaches into the practice of mindful management (Weick & Putman, 2006). The two articles could be viewed as representing left and right brain approaches, which may be why I found myself attempting to reconcile the slight cognitive dissonance I experienced at being intrigued by these radically different articles.
The article of Bonetti et al. (2006) on the amount of variance explained by the behavioral theories tested made me aware, almost for the first time, of how little experimental research has been done on health administration. I am fully aware of the logistical and ethical issues that are daunting barriers, but I cannot help but wonder whether that is an excuse to continue to do more of the same descriptive research that has become our stock and trade. Without experimental studies, or at least sophisticated and rigorous quasi-experimental evaluation research, health administration and management practice remains based on well-substantiated conjecture. The few experimental studies that have been done, such as the RAND Health Insurance Experiment (Newhouse, 1993), stand out as exceptions that have carried considerable weight over the years. Various health administration problems are amenable to experimentation and to newer experimental methodologies such as cluster randomized clinical trials. As Editor-in-Chief, I have not received any manuscripts purporting to be cause-and-effect research. The few manuscripts submitted on project implementation have been poorly designed, with little or no consideration of applying Cook and Campbell (1979) to a rigorous evaluation of the project. This is unfortunate because the myriad changes and innovations in health care organizations present possible natural experiments to be ethically exploited using rigorous evaluation methodologies.
The article of Weick and Putman (2006) touched the other side of my brain, with its creative attention to integrating the Eastern and Western thinking. Their article reminded me that more than cause-and-effect knowledge is necessary to have health care organizations that are healthy, wise, and effective. The myriad changes facing and made by health care administrators require thoughtful, mindful actions. Mindfulness, in my experience as Editor-in-Chief, is a particularly rare concept in the health administration discourse. However, creative solutions to health administration problems can emerge from a state of openness, reflectivity, and awareness and provide a means by which to translate idiosyncratic experiences into valuable expert knowledge.
Health Care Management Review seeks to disseminate knowledge from both sides, both experimentally based insights and mindfully generated knowledge, in an ongoing effort to contribute to the improving our health care systems by tapping the potential synergy of the right and left brain approaches.
L. Michele Issel, PhD, RN
Editor-in-Chief
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