A large Midwestern tertiary care hospital asked SSB to help it develop a new physician alignment strategy. Although the organization had an extensive medical directorships organized by service line, physicians felt that they were not appropriately represented or included in administration decision-making. SSB interviewed physician leadership from all major service lines and worked closely with Administration to develop a series of physician alignment initiatives, addressing all of the major issues and concerns raised by physicians, including the hospital's overall physician relations philosophy, hospital-physician communications, the primary care network strategy, the regional referral network, growth strategies for all the service lines, information technology planning, and a new organization structure.