After working in American healthcare for 11 years, I feel confident saying that it is, as a whole, one of the most badly managed sectors in the entire economy. Every healthcare organization I have worked for – public and private – has been grossly mismanaged. The few competent managers there are either get passed over for promotion or driven out all together. I don't pretend to know why healthcare management is so uniquely bad, but I suspect a lot of it has to do with The Joint Commission.