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Few industries are buffeted from as many strong forces as healthcare. The industry is highly regulated, thus dramatically increasing costs and sometimes even interfering with the ability to deliver healthcare. New drugs, treatments, and medical technologies are so common that keeping track of them can be overwhelming, and incorporating them into patient care or administration can be costly and complicated. On the social side, different groups have different opinions on any given topic and often the right thing to do depends on your point of view. Third party payers add another level of complexity, and competition adds yet another layer of difficulty as organizations seek to grow patient volume by positioning themselves as distinguished in terms of cost, quality, accessibility, and quality of patient experience.

Few industries are buffeted from as many strong forces as healthcare. The industry is highly regulated, thus dramatically increasing costs and sometimes even interfering with the ability to deliver healthcare. New drugs, treatments, and medical technologies are so common that keeping track of them can be overwhelming, and incorporating them into patient care or administration can be costly and complicated. On the social side, different groups have different opinions on any given topic and often the right thing to do depends on your point of view. Third party payers add another level of complexity, and competition adds yet another layer of difficulty as organizations seek to grow patient volume by positioning themselves as distinguished in terms of cost, quality, accessibility, and quality of patient experience.

Entrepreneurs bring together the various stakeholders necessary to create new products and services; however, stakeholders face a high level of uncertainty when determining whether to invest their resources in the venture. This paper draws from signaling theory and stakeholder theory to explain how firms that have reputations for outstanding treatment of stakeholders send a signal to potential resource investors that reduces the uncertainty they perceive to be associated with the venture. Perceived uncertainty is reduced because of an enhanced ability to acquire necessary resources, a smaller probability that unexpected events will occur, an increased ability to plan for changes that do occur in the external environment, and the possibility that the strong stakeholder network itself may be a source of sustainable competitive advantage for the firm. While these ideas are applicable to entrepreneurial ventures at many stages, the context examined herein is firms that are preparing for an initial public offering because they have had sufficient time to establish reputations.

Organizational democracy is frequently associated with increased employee involvement and satisfaction, higher levels of innovation, increased stakeholder commitment, and, ultimately, enhanced organizational performance. However, democratic processes can also absorb significant time and other organizational resources and bog down decisions, which may lead to reduced efficiency. This article summarizes the pros and cons of organizational democracy. It also introduces and integrates ideas from the three other articles in this special forum. In the end, we conclude that although the economic arguments for organizational democracy may be mixed, increased stakeholder participation in value creation and organizational governance can benefit both society and corporations. In fact, the corporation itself may be envisioned as a system of self-governance and the voluntary cooperation of stakeholders.

The weakening of the traditional management hierarchy, the hollowing out of corporations, and an increasing management emphasis on boundarylessness have created a new mind set concerning external stakeholders. Increasingly, organizations are moving beyond traditional stakeholder management techniques to partnering tactics that lead to the achievement of common goals. In spite of these trends, there has been very little effort in the management literature to tie stakeholder management and partnering tactics. This article demonstrates how successful partnerships with stakeholders create such valued benefits as increased product success rates, increased manufacturing efficiency, the development of distinctive competencies arising from partnerships with local communities or government agencies, reduced unfavorable litigation, reduced levels of negative publicity, and favorable regulatory policies.

The stakeholder perspective is an alternative way of understanding how companies and people create value and trade with each other. Freeman, Harrison and Zyglidopoulos discuss the foundation concepts and implementation of stakeholder management as well as the advantages this approach provides to firms and their managers. They present a number of tools that managers can use to implement stakeholder thinking, better understand stakeholders and create value with and for them. The Element concludes by discussing how managers can create stakeholder oriented control systems and by examining some of the important stakeholder-related issues that are worthy of future scholarly and managerial attention