Since health care is changing dramatically right now, hospital and health system CEOs had better be adapting or they will cease to be effective which equates to dying. We have to take advantage of the changes that are happening now as well as those on the horizon. Today's change is rapid, it's volatile and it's uncertain. So, in order to thrive going forward according to Chief Executive magazine, we have to be able to detect external change no matter how complex or uncertain; we have to be prepared to change course even if it means moving away from key people and core competencies; we will have to move fast; we have to turn experts into leaders and not the other way around and we have to get our boards to accept fluctuations in our financials without losing confidence in our direction. Each of the preceding new capabilities are tall orders for CEOs, but necessary ones. At WMHS, we have been involved in dramatic and dynamic change for the last several years with no relief in sight. But, at the same time it is exciting as we adapt to the changes that are upon us as well as those that aren't fully envisioned, yet necessary in order to be successful.