Abstract
Within ten years, the French public hospital system's organization experienced several structural reforms. New managerial concepts coming from the industrial for-profit field spread into the public hospital sector, and outcome-oriented rationales replaced the unconditional answer to the population's health needs. Three main reforms have been implemented to take measures dedicated at improving public hospitals' performance regarding their financing, management and quality policies.
Those measures have had dramatic repercussions on hospital culture: organizing medical services to generate the highest profits often hardly matches professionals' devotion to their duty to patients. As a consequence, public hospitals often fail to federate different professional bodies under a common philosophy and to spread shared values that will give a meaning to structures' mission and corresponding organization. Seeking performance is not about following a unique, standardized model. Each business field has its own specificities, and performance-seeking processes have to be adapted to suit those specificities and optimize each organizational model to get the best out of structures' processes.
