Abstract
Health care is well along in its steady change from a cottage industry of scattered providers to an industry of larger 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 it is applied is rapidly changing. Areas of responsibility are becoming broader, staffs are becoming larger for individual managers, 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.