Introduction

The stories that follow come from Seattle Children’s Hospital (SCH) and other organizations that have engaged Joan Wellman & Associates (JWA Consulting) as consultants over the last 15 years: The Everett Clinic in Everett, Washington; Nemours Children’s Health System in Florida and Delaware; and Seattle Cancer Care Alliance. These organizations vary widely in size and complexity from standalone hospitals (SCH) to multi-institutional systems (Nemours). These organizations also have very different physician models including a primarily academic model (Seattle Children’s Hospital), an employed physician model (Nemours), and a physician-owned model (Everett Clinic).