Bill Hurt, the new CEO of Hillside Hospital, knew that the forecast was grim. The hospital's service volumes and market share were dropping precipitously. The direct causes of the problems were numerous, but an indirect cause-and major barrier to addressing the declines-lay in the poor relationship between Hillside's management and its physicians. To engage the physicians in problem-solving, he considered a consultant's suggestion: turning the clinical planning process over to the physicians, with management involved only at their request. This approach was risky but Bill thought sometimes you got power by giving it up.

Dr. John Niff, co-chair of the Medical Advisory Panel (MAP) to Hillside Hospital, waited for his colleagues to join him to review the recommendations for The New Hillside Hospital that the panel had developed over the past six months. When Bill Hurst, Hillside's CEO, had first suggested creating a committee of doctors (the MAP) to develop recommendations for clinical programs at the hospital, Niff was skeptical. But as the clinicians worked together to identify problems and set priorities, they developed their management skills as well as a greater appreciation for the challenges facing the hospital. Trust between management and physicians grew as the hospital implemented some of the panel's recommendations. Although the MAP's list of recommendations had not yet been formally accepted by the Board, all participants reflected on the benefits already gained through this process.