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In the 1990s, the turbulent environment continued to exert pressure on the management of cost, access, and quality of healthcare provision. To strengthen financial and market positions, mergers and acquisitions became popular strategies along with the reengineering of internal structures. Since this trend of restructuring and reengineering, an understanding of the value of middle managers has been misplaced. Their importance in strategic formulation and implementation has largely been overlooked. They have been perceived as intermediaries that slow organizational efficiency without adding much measurable value. Some researchers have since challenged the accuracy of this assumption and the helpfulness of removing middle managers. They have reexamined the role of middle managers and discovered that they are key agents of change. Middle managers make significant contributions across the healthcare organization in their roles of entrepreneur, communicator, therapist, and stabilizer.
Mari K. Embertson (Sat,) studied this question.