Unlikely Entrepreneurs

Book excerpt: In Unlikely Entrepreneurs, Barbra Mann Wall looks at the development of religious hospitals in the late nineteenth and early twentieth centuries and the entrepreneurial influence Catholic sisters held in this process. When immigrant nuns came to the United States in the late nineteenth century, they encountered a market economy that structured the way they developed their hospitals. Sisters enthusiastically engaged in the market as entrepreneurs, but they used a set of tools and understanding that were counter to the market. Their entrepreneurship was not to expand earnings but rather to advance Catholic spirituality. Wall places the development of Catholic hospital systems (located in Illinois, Indiana, Minnesota, Texas, and Utah) owned and operated by Catholic sisters within the larger social, economic, and medical history of the time. In the modern health care climate, with the influences of corporations, federal laws, spiraling costs, managed care, and medical practices that rely less on human judgments and more on technological innovations, the "modern" hospital reflects a dim memory of the past. This book will inform future debates on who will provide health care as the sisters depart, how costs will be met, who will receive care, and who will be denied access to health services.