Peer-to-Peer Leadership

9Implications for Organization Design

I once worked in a large hospital system in the southeastern part of the United States when it was forced to respond to the threat of managed healthcare—a phenomenon that swept healthcare in the United States during the 1990s. The hospital system’s response was to merge with a rival hospital in another part of the city. The merger, billed as “a merger of equals,” was an extremely difficult undertaking, and the two institutions eventually de-merged. One remarkable lesson I learned from the experience can be found in the “story of the turkeys.”

In the midst of the largest of cost-cutting initiatives, a decision was made to eliminate the traditional distribution of holiday turkeys to every employee. Because ...