When professionals listen to managers struggling with budgetary limits and when managers pay attention to professionals worrying about negative effects of performance-based payment systems on patient care, there is a process of integration that may strengthen organizational health. Sometimes, organizational health may also be promoted by disintegration. It means that competing values are encouraged, and tensions maintained in the organization. With the proliferation of New Public Management, effi- ciency has become the main criterion for priority setting in many health organizations. Such a development may have been necessary to cope with increasing healthcare expenditures. As a result, however, there has been a transition from individualized patient care to more standardized industrial service production, which has implied increasing value squeezes for health professionals and managers (48).