The book "Institutional Change and Healthcare Organizations: From Professional Dominance to Managed Care" by W. Richard Scott, Martin Ruef, Peter J. Mendel, and Carol A. Caronna, published in 2000, provides a comprehensive historical and sociological analysis of the transformation of healthcare systems in the San Francisco Bay Area. The authors explore the shift from professional dominance to managed care, driven by the "buyers' revolt" in the 1980s, where insurers, governments, and employers became frustrated with the inefficiencies and variability of services under professional control. The book introduces concepts and tools for measuring organizational, institutional, financial, and environmental integration, making it a valuable resource for healthcare systems seeking to understand and analyze their own integration processes. It covers three historical periods: the era of professional dominance (1945-1965), the era of federal involvement (1966-1982) with Medicare and Medicaid, and the era of managerial control and price competition (1983-present). The authors document the profound institutional changes, including new governance structures, discontinuous logics, new actors, and blurred boundaries. They highlight the destabilization of the healthcare system, questioning how the stable, professionally dominated system broke down and how new actors gained legitimacy. The book also discusses the fragmented governance structures, reduced coherence of organizational boundaries, and confusion among practitioners and patients. While the book provides a detailed analysis of organizational changes, it does not fully explain the reasons for the collapse of professional dominance and the subsequent era of fragmentation. The authors' use of commercial and political terms like "health maintenance organizations" and "integrated healthcare systems" is criticized for reifying these concepts without critical examination. Despite this, the book offers valuable insights into the dynamics of organizational change and institutional ecology, making it a significant contribution to the field of sociology and healthcare policy.The book "Institutional Change and Healthcare Organizations: From Professional Dominance to Managed Care" by W. Richard Scott, Martin Ruef, Peter J. Mendel, and Carol A. Caronna, published in 2000, provides a comprehensive historical and sociological analysis of the transformation of healthcare systems in the San Francisco Bay Area. The authors explore the shift from professional dominance to managed care, driven by the "buyers' revolt" in the 1980s, where insurers, governments, and employers became frustrated with the inefficiencies and variability of services under professional control. The book introduces concepts and tools for measuring organizational, institutional, financial, and environmental integration, making it a valuable resource for healthcare systems seeking to understand and analyze their own integration processes. It covers three historical periods: the era of professional dominance (1945-1965), the era of federal involvement (1966-1982) with Medicare and Medicaid, and the era of managerial control and price competition (1983-present). The authors document the profound institutional changes, including new governance structures, discontinuous logics, new actors, and blurred boundaries. They highlight the destabilization of the healthcare system, questioning how the stable, professionally dominated system broke down and how new actors gained legitimacy. The book also discusses the fragmented governance structures, reduced coherence of organizational boundaries, and confusion among practitioners and patients. While the book provides a detailed analysis of organizational changes, it does not fully explain the reasons for the collapse of professional dominance and the subsequent era of fragmentation. The authors' use of commercial and political terms like "health maintenance organizations" and "integrated healthcare systems" is criticized for reifying these concepts without critical examination. Despite this, the book offers valuable insights into the dynamics of organizational change and institutional ecology, making it a significant contribution to the field of sociology and healthcare policy.