⦁Changing traditional medial service to innovative medical service front line service methodWhile traditional general hospitals are unlikely to disappear anytime soon, a new approach-a commitment to clinical service lines as an organizing paradigm, much as many corporations organize themselves by business unit-is becoming a necessity for many such organizations. Specializing in a few service lines allows hospitals to build a critical mass of patients in select areas and to enjoy economies of skill and scale. In some doctor and nurse past service experience, hospitals that make the leap to a service-line orientation become more productive, improve their quality of care, recruit physicians more effectively, and build market share. By developing a focused service-line strategy, hospitals can also limit their investment in nonpriority areas, with savings to be found in areas ranging from marketing to new technologies. Some hospitals may even choose to take facilities off-line if they are unlikely to reach minimum effective scale in any individual service or combination of service areas. The transition to service lines is about much more than introducing a new vocabulary or high-level concepts into business planning and strategy. Full implementation of a service-line approach requires real changes in organizational structure, incentive plans, physician relationships, and business development, as well as in many support functions, including IT and human resources. To make wise decisions about which service lines to emphasize, hospitals must have a deep understanding of their own economics and competitive environments. Furthermore, running a hospital with a service-line orientation requires new approaches for recruiting the clinical staff, for aligning its interests with those of the hospital, and for measuring success. Hospitals that succeed-whether or not they are nonprofit institutions-can reap tremendous quality, cost, and service benefits and avoid turning themselves into specialty hospitals, closing their emergency rooms, or lowering the level of care they offer their communities. They will become far more effective competitors as well. Three portraits few medical service organizations have captured the full potential of a service-line transformation. Issues complicating the transition include: the effort required to reorient a hospital's structures and systems, the leadership commitment needed to shepherd the change process, the difficulty of assembling the high-quality data needed to support good decision making, and the risk aversion of many staff members and physicians. Patience is also necessary-many changes won't yield results for months or even years.