Lessons from Mergers: Voices of Experience

Health Progress, May/Jun 2001 by Wendeln, Elizabeth

Lessons from Mergers: Voices of Experience Nancy Linenkugel Health Administration Press, 2000, 176 pp., $35 (paperback)

IN THE PREFACE OF THE CANDID AND refreshing book "Lessons from Mergers: Voices of Experience," Nancy Linenkugel acknowledges that her own opportunity to gather firsthand experience interviews compelled her to make this wisdom available to others. The subtitle gives the main content of the book and is the focus of the author's doctoral dissertation.

The setting for the interviews is the health care ministry, an area certainly experiencing mergers and various types of joint ventures. Linenkugel notes that between 1994 and 1999, 3,997 health care facilities were involved in mergers-more than half the number of hospitals in the United States. The highest rate of activity occurred in 1996. The up side and down side of mergers can be traced throughout the conversations of the many people who participated in the book's interviews.

The voices of experience include executives, board members, department managers, physicians, employees, patients, and community representatives. The knowledge gathered is so extensive that it could be applied to mergers in general, not just the health care field.

In organizing the myriad conversations, the author gleans insights on why organizations merge, what they hope to accomplish, how the fit and the governance structures emerge, how merged organizations handle employees and their perceptions, and how to evaluate outcomes. In the mergers studied, business fit and culture fit were not enough to guarantee that mergers could achieve the desired goals. Factors of timing, motivation, and leadership, among others, contributed to success or distress. Linenkugel draws the interest of the reader without offering definitive answers. She lets the voices of those with experience speak for themselves,

After the introductory chapter, each of the remaining chapters is organized in a somewhat similar fashion. Critical factors are offered in a concise manner followed by many and diverse voices. The author intersperses paragraphs highlighting collective thoughts and providing insights. At the end of each chapter, a section titled "Clues and Hallmarks" asks questions of the readers in an probing manner, such as "Did you detect anything that indicates . . .?" This call to take time for reflection gives readers pause to discover their own insights. Contributors to the book are candid and practical. They speak from firsthand experience in their particular role in the health care ministry and offer their thoughts both before and after a merger. The resulting success, the eventual failure, or the state of financial struggle that ensued is noted in each instance.

The final chapter offers a succinct summary in the form of tables comparing elements that contribute to successful mergers and those elements that cause less-than-successful mergers. The author then offers some words of advice she has gathered. These closing pages make the book a treasure of summary wisdom.

This book could be considered by health care system leaders who are preparing for some type of consolidation, joint venture, or merger. CEOs might use this book with staff to foresee experiences of staff, physicians, and community leaders. Although some of the comments are predictable, the questions at the end of each chapter could guide a small group in preparing for what to expect and how they might develop processes for participation in their respective groups. Taking time to learn from the voices of those who have preceded us adds to our own wisdom and eases the path for others.

Elizabeth Wendeln, SCN Director of Parish Leadership Diocese of Lexington, KY and Member of the Stewardship Board of Trustees-CHI