If It Is Complex, Let It Be Complex – Dealing With Institutional Complexity in Hospitals; Comment on “Dual Agency in Hospitals: What Strategies Do Managers and Physicians Apply to Reconcile Dilemmas Between Clinical and Economic Considerations?”

Document Type : Commentary


1 School of Business, University of Skövde, Skövde, Sweden

2 Faculty of Theology, Diaconal & Leadership, VID Specialized University, Oslo, Norway


Waitzberg and colleagues identified strategies that managers and physicians in hospitals apply to reconcile dilemmas between clinical and economic considerations. Contributions that actually acknowledge the institutional complexity of hospitals and describe how to deal with it are rare. This comment explains the reason behind the institutional complexity in healthcare organizations and argues that institutional complexity is a good foundation for a wellfunctioning and sustainable healthcare, as long as we are able to deal with this complexity. This point underscores the importance of their contribution. However, even if the identified strategies on how to reconcile and balance different, competing demands are important, they are not easy to apply in practice. First, the strategies require frequent and high-quality interaction between different actors adhering to different institutional logics. Second, even when the strategies are applied successfully, it is difficult to make them sustainable since they rest on a fragile balance between competing logics. However, these are important avenues for future research for researchers who want to follow the route of Waitzberg and colleagues.


  • epublished Author Accepted Version: February 22, 2022
  • epublished Final Version: March 9, 2022
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Volume 11, Issue 10
October 2022
Pages 2346-2348
  • Receive Date: 08 November 2021
  • Revise Date: 17 February 2022
  • Accept Date: 21 February 2022
  • First Publish Date: 22 February 2022