This ebook, delving into the institutional and procedural contingency shaping the evolution of managerial arrangements across Europe, contains four articles on national configurations, one comparative paper, and one conceptual contribution. The papers included in this ebook provide us with illustrative examples of the rich range of the variation in medical hybridization that is, and in some cases, is not going on within the hospitals across Europe. The 'managerialisation' in hospital care that has blurred the boundaries between medicine, management and clinical leadership exhibits a national character. The variety and complexity regarding this movement appears consider-able. There are top-down management reforms in some countries (UK, Italy, Norway and France) while elsewhere 'managerialisation' is an emergent and less clear-cut process (Germany, Poland). The worlds of hospital governance converge as a general tendency, but there is considerable contingency in the related physician-management encounter.