Why is the dual pyramid form of organization very nearly unique to health care organizations?

Consider other forms of organizations. Can healthcare change?

Traditional 20^th century organizations

• 20^th Century Structure
• Bureaucratic
• Multi-leveled
• Organized with the expectation that senior management will manage
• Characterized by policies and procedures that create many complicated internal interdependencies

21^st Century Structure

• Non-bureaucratic, fewer rules and employees
• Limited to fewer levels
• Organized with the expectation that management will lead, lower-level employees will manage
• Characterized by policies and procedures that produce minimal interdependencies to serve patients and staff.