Merging, De-Merging, And Emerging at Deaconess Billings Clinic. (Health Care Organizational Structure)‪.‬

BY THE SPRING OF 1995, almost everyone worried that the merger two years earlier, forming the Deaconess Billings Clinic (DBC), was a mistake. Administrators from the community-owned not-for-profit hospital, Deaconess Medical Center, were aggravated with "those physicians" who demanded to be treated as equal partners, yet weren't prepared to understand the business of operating this complex health care organization. And physicians from the for-profit physician-owned Billings Clinic across the street were distraught at being treated as if the hospital had "purchased" their services with the clinic. Ninth Avenue, which separated the two Billings, Montana health care facilities, appeared to be getting wider every day. This mutual antagonism surprised everyone, because, for two years before the merger, representatives from both sides discussed "every conceivable" financial, legal, and operational issue and had co-developed a mission and values statement to guide the organization into the future. They further agreed not only that the merger would profit both institutions, but that it would enable them to better serve the community. But like many others going through this process, what no one recognized was that they had overlooked a critical issue- the cultural differences between the clinic and hospital that threatened to rip apart the newly merged organization.