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Organisations and firms are formed by people and entrepreneurs. Firms can become sick just as people do. Not all firms live forever. This paper examines the emergence of "sick" institutions. Organisations can become unhealthy when there is a mismatch between goods and services they produce and the external environment in which they operate. Survival and fitness of an organisation depend on its ability to respond and adapt cost-effectively to the changing environment. Entrepreneurship, n-Achievement and productivity of individuals are critical to an organisation's health. A thorough diagnostic framework of symptoms of organisational ills is required before prescribing any therapy, to bring about a healthy organisation. The future belongs to healthy firms, with adaptable strategies and resources that optimally fit the changing environment.