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Management Learning
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Rhetorics of Efficiency, Fashion and Politics

Hospital Mergers in Quebec

Elise Comtois

Canadian Health Services Research Foundation, Canada, elise.comtois{at}chsrf.ca

Jean-Louis Denis

University of Montreal, Canada, jean-louis.denis{at}umontreal.ca

Ann Langley

HEC Montreal, Canada, ann.langley{at}hec.ca

Drawing on a content analysis of discourse surrounding five sequential hospital merger decisions, this research examines the role of efficiency considerations, fashion and politics in stimulating the adoption of a managerial idea. The article analyses how different arguments come to be intertwined. It illustrates how rational and institutional arguments are used to legitimate political strategies while simultaneously constituting the apparatus of legitimation for others in a reciprocal process that contributes to the persistence of those same strategies. The article thus confirms the key role of politics, interests and agency in the evolution and constitution of institutions, and in the diffusion of managerial ideas.

Key Words: discourse analysis • hospital mergers • institutionalism • managerial ideas • politics

Management Learning, Vol. 35, No. 3, 303-320 (2004)
DOI: 10.1177/1350507604045608


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