ABSTRACT
Over the course of eight decades the practice grew exponentially as it evolved into a world-class medical facility. On the cusp of the twenty-…rst century, however, Virginia Mason was in trouble. In 1998, for the …rst time ever, Virginia Mason lost money for the year and then suered an additional loss the following year. is trend was disturbing enough by itself, but in the context of the sharply competitive medical marketplace in Seattle, the results were alarming. Virginia Mason was a not-for-pro…t system with a 336-bed acute care hospital , 445 doctors, and multiple clinics located throughout the Puget Sound area. In a city with two larger competitors, Virginia Mason was medium-sized and relatively undercapitalized. e fact that many medical centers throughout the country were facing similar …nancial di¤culties-in part due to the siege of ill-conceived forms of managed care-was little consolation.
