7. The Dynamics of Indecision

“Deliberate often. Decide once.”

—Latin proverb

In 1996, a merger took place between the Beth Israel and the Deaconess hospitals, two large and well-respected health-care institutions in Boston, Massachusetts. The merged entity brought together more than 1,000 highly accomplished physicians and had revenues of nearly $1 billion. Senior executives at the newly formed Beth Israel Deaconess Medical Center (BIDMC) hailed the merger as a “good fit” and cited the potential for “tens of millions of dollars” in cost savings.1 Not everyone remained convinced that the deal would pan out. The Boston Globe commented, “The concept is attractive; the reality may be a bit messy.”2

The early years of the marriage did not go smoothly, ...

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