Shake, don't rattle, roles. With financial pressures afoot, health systems look to change management structure.

As pressure builds on hospitals, some are taking an extreme approach to reorganization by totally revamping their management. At the University of Chicago Medical Center, David Hefner, left, was part of such a overhaul, which included eliminating his job as president. "I just think we could go to any of these healthcare enterprises and do some of the kind of recombining of functions and reduce executive management."