Mergers of Teaching Hospitals in Boston, New York, and Northern California

John A. Kastor
A fascintating look at the difficulties involved in merging health-care institutions


If a teaching hospital loses funding, what is the next option?

Mergers of Teaching Hospitals in Boston, New York, and Northern California investigates the recent mergers of six of the nation's most respected teaching hospitals. The author explains the reasons why these institutions decided to change their governance and the factors that have allowed two of them to continue to operate while forcing the third to dissolve after only 23 months of operation.

The case studies contained within this book rely on an impressive amount of research. Notably, instead of citing only published articles and books, the author includes information from numerous, extensive personal interviews with key participants in the various mergers. With this research the author not only presents to the reader a picture of why these mergers came about, but also investigates how the organizations have fared since joining together. The mergers are analyzed and compared in order to identify various methods of merger formation as well as ways in which other newly formed hospitals might accomplish a variety of important goals.

Offering a spectacular account of some of the mergers that occurred in the health care field at the close of the twentieth century, these stories provide insight into academia's relationship with teaching hospitals and the challenges involved in bringing prestigious and powerful medical institutions together. The institutions discussed are Partners, the corporation which includes the Massachusetts General Hospital and the Brigham and Women's Hospital, New York-Presbyterian Hospital, the union of the New York and Presbyterian hospitals in New York City, and the UCSF Stanford, the merged teaching hospitals of the University of California, San Francisco and Stanford. This book will particularly appeal to professionals and academics interested in medicine, business, and organizational studies.

John Kastor is Professor of Medicine at the University of Maryland School of Medicine. From 1984 to 1997, he was Theodore E. Woodward Professor of Medicine and Chairman of the Department of Medicine at Maryland and Chief of the Medical Service at the University of Maryland Hospital. Dr. Kastor is also the author of Arrhythmias.

Praise / Awards

  • "This is a fascinating history, a 'must read' for members of these institutions, anyone contemplating such mergers elsewhere, and officials charged with enforcing anti-trust laws."
    --Alain C. Enthoven, Marriner S. Eccles Professor of Public and Private Management (Emeritus), Graduate School of Business, Stanford University
  • "Extremely well researched and highly accurate in outstanding piece of scholarship...should be required reading for all deans and hospital and medical center directors."
    --Antonio M. Gotto, Jr., M.D., D.Phil., Cornell University Medical College
  • "A fascinating glimpse into the marital difficulties encountered in three prominent teaching hospital mergers. Kastor tells us a great deal about the underlying values and forms of academic medicine in his careful examination of these case studies in the difficulties inherent in the mingling of institutional cultures."
    --Charles Rosenberg, Professor of the History and Sociology of Science, Department of the History of Science, Harvard University
  • "[This] book should be required reading for those in academic medicine and should be used in case studies of various business schools."
    --Guy McKhann, M.D., Professor of Neurology and Neuroscience, Johns Hopkins University
  • "John Kastor penetrates the mysteries and mythologies surrounding the mergers and unmergers of some of America's most important teaching hospitals. In a scholarly, lucid, and incisive manner, he identifies the cultures, costs, and environmental issues which make a difference."
    --Kenneth I. Shine, M.D., President, National Institute of Medicine
  • "In this 'thick description' of three extremely important mergers of university hospitals, Dr. John Kastor gives a balanced voice to all participants but pulls no punches in his appraisal of what happened and why."
    --Victor R. Fuchs, Henry J. Kaiser Jr. Professor Emeritus, Stanford University
  • "This beautifully researched and written book describes the conditions that led to mergers of some the the U.S.A.'s top teaching hospitals. . . ."
    --American Journal of Cardiology
  • "Like a social anthropologist, Kastor aggregated all of his minute, detailed observations across three different sites to form some powerful, well-grounded conclusions regarding hospital mergers. This is both a refreshing and welcome change. . ."
    --Rob Burns, Health Affairs, Volume 21, No. 1
  • "In this detailed and very well written book, John Kastor dissects for us three important mergers of the mid- and late 1990s that involved six of the country's leading academic hospitals, which were closely allied to five distinguished medical schools. The details, and of course the people, differed, but each group believed that they could continue to do what they already did so well if they teamed up with a main competitor so as to face a hostile new world with greater strength. . . . [Kastor] was, as this book amply demonstrates, born to be an investigative journalist. . . . Suffice it to say that in many places the story is a gripping one."
    --Gert H. Brieger, M.D., Ph.D., New England Journal of Medicine, Vol. 47, No. 22 (November 28, 2002)
  • ". . . a very important book. It is meticulously researched, balanced in its analyses, and exceptionally well written. It is a timely volume that will appeal to all academics and professionals interested in medicine and medical administration, as viewed from the perspective of this unprecedented epoch in American health care history."
    --Pascal James Imperato, Pharos, Spring 2002

Look Inside

Product Details

  • 6 x 9.
  • 504pp.
  • 3 tables.
Available for sale worldwide

  • Paper
  • 2003
  • Available
  • 978-0-472-08935-2

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  • $44.95 U.S.

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