Formal and Informal Authority of Hospital Directors

Describes and contrasts the perceptions of formal and informal authority of hospital directors of two different kinds of organizations: hospitals that are part of public multi‐hospital organizations (PMOs) and independent hospitals. Indicates that all the directors perceive their informal authority to be greater than their formal authority. However, there is a gap in the perception of formal and informal authority by directors of the two types of hospital. Directors of independent hospitals perceive themselves to have more formal and informal authority than do their colleagues at hospitals that are part of PMOs. Both structural and personal explanations for these findings are given. In addition, discusses the implications for policy making of the source of authority, informal, and formal authority in the transition to autonomous semi‐independent hospitals in a changing environment.