This chapter examines the hybridity of hospitals’ organizational meaning structures and the resulting hybridity of hospital managers, who sit at the interplay between organization and communication. Hybrid practices polarize hospital managers between clinical management and general management priorities. This chapter focuses on management communication implications of hospitals’ unique and enduring paradoxical characteristics: conflicting missions, interaction of multiple professions, multiple external stakeholders, and an ambiguous and complex external environment. These characteristics are illustrated with excerpts from hospital employee interviews and discussions. Hospitals’ essential structure is based in communication in these domains. Illustrations reveal that the organizational uniqueness of hospitals lies in the communicational implications of their social structures. Finally, a conceptual framework for hospital management communication is offered that provides tools for examining paradox through hybridity to prevent impasse and provide agency, conceptualizing hospital-unique characteristics as intersecting communication paradox domains.