Medicine and management. Bridging the cultural gaps.

: Cost-effective health care requires the informed and intensive collaboration of medicine and management. Unfortunately, the two cultures tend to view the health care enterprise very differently. To physicians, the essence is individual physician-patient encounters, patient hospital days, nurse-patient contact hours, diagnoses, and procedures. To managers, the $1 trillion-plus colossus called health care is a challenge to corporate practices of finance, accounting, organization, planning, and personnel. The efforts of these two cultures to face medicine's dilemmas can result in conflict and confrontation--or in collaboration and synthesis.