The Managed Service Restructuring (MSR) strategy requires an examination of alternate restructuring options including realignment, increased promotion, managed divestiture and community involvement before a service termination. A community-based hospital, with a reasonable market share and stiff competition, attempts to develop new business by reaching out beyond its primary market with a specialized service. The administrator had come up through the ranks at the hospital and had started as an accounting clerk. The MSR technique was successfully applied at Doctors because both the objectives and the management structure were modified. The physician-partners were shown the hospital’s financial statements and projections and learned to understand the business side of hospital management. The medical staff finally came to the conclusion that a new management approach was needed and sought a partner that could infuse needed capital and bring in up-to-date management.