Economic, social and political life in Bulgaria are in a period of profound democratic reform, which inevitably has its influence on the health care system. The political stability, the micro and macroeconomic development on a regional level, as well as in the country as a whole determine the nature of changes in Bulgarian health care system.

A health reform without an adequate management approach is inconceivable. The essentials for an effective advance require the liquidation of the stereotypes of old management thinking, adopting professional attitude and style on every level of management activity. We still pay a high price for poor management decisions in the past such as the prohibition of private medical practice, the ambition for a total dispensarization, the unbalanced productivity of medical manpower, etc.

Today Bulgaria lives in the air of a timely management "boom". Commercialism, nonconceptual and unsystematic training, political ambition give birth of a whole army of pseudo-health managers. A comprehensive identification with the economic, sociological, psychological, informational aspects of the theory and practice of management is necessary in the future. Much more the university graduate and postgraduate education included most of the elements of modern management science. The problem is elimination of totalitarian dogma, systematization of knowledge, qualification and requalification of professionals within national and international management education programs.