Editorial.(Editorial)

The term "healthcare reform" carries connotations that instill both resolve and reluctance in the hearts of Americans. No one will argue that reform is unnecessary, just as no one will keep quiet when a reform plan is brought forward. Voicing support or dissent is an American right after all, and this right is exercised more during uncertain times.

Whether the Obama Administration's healthcare reform plan passes or stalls, the healthcare reform movement throughout history communicates an important message: The ideal solution is often elusive, but that fact should not deter the pursuit of the ideal. This is a fundamental tenet in healthcare--from leadership to management, from research to teaching and policymaking, from quality improvement to revenue generation, from customer satisfaction to physician and employee retention, and every point in between. Examples of this quest for improvement are presented in this issue.

The recipient of the 2009 ACHE Gold Medal Award is our interviewee. Mark Neaman, a pioneer in the electronic medical record movement, discusses the value of a systems approach to operations. He also advocates the adaptation of approaches that have proven to work well in other industries.

In the Physician Relations column, Ken Cohn, Bruce Bethancourt, and Maire Simington offer a three-pronged physician retention strategy. Based on the well-received implementation of a physician on-boarding program in one hospital, the strategy emphasizes co-mentoring, listening to feedback, and involvement. Trends columnist Walter Vernon provides a list of organizations that can guide healthcare facilities in their decision to improve environmental performance.

The first-place winning essays of the 2009 ACHE Richard I. Stull Student Essay Competition in Healthcare Management are showcased in this issue. The undergraduate essay winner, Allison Clemmons, weighs the question of whether altruism or a legal market is the answer to easing the shortage of donated organs for transplantation. The graduate essay winner, Keila Rooney, explores the trends in healthcare marketing, specifically Internet-enabled strategies. Both essays submit recommendations for healthcare executives.

Factors that cause a hospital to declare bankruptcy are the focus of the article by Amy Yarbrough Landry and Robert Landry. Findings from this study are especially relevant given the current recession and decreases in reimbursements.

Lastly, in their article, William Nelson and colleagues explore ethics from the viewpoint of healthcare leaders. The study concludes that more tools are needed to assist healthcare executives in navigating myriad ethical situations.

As this issue illustrates, lessons learned from past failures and successes, analyses of trends and resources, and expert advice can give us all an advantage over our challenges.

Kyle L. Grazier, DrPH

Editor

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