The landscape of Newtown was as pockmarked as a World War I battlefield. There were hulks of old medical juggernauts littered around, burned out practices, physician alliances, and such scattered beneath the thin veneer of public appearances and placid goodwill that the two competing health-care titans of Newtown (Eastern New Hope Healthcare and St. Everywhere General) hoped would lead to their ultimate dominance and triumph. The various boundary lines seemed to shift with each skirmish and the physicians in the community generally tried to play the neutrality flag while simultaneously holding the trump card of relocating their services to a competitor.

The pathology group served both masters, and occasionally labored under the delusion that they could somehow broker a peace deal, at least in their technology-intensive domain. Most recently, they have tried to craft a joint venture reference laboratory to serve all three entities’ interests. The latest sessions at the peace table had ended fairly brusquely with New Hope walking away with the intent to launch their own regional outreach reference laboratory unilaterally without participation of St. Everywhere, and only nominal medical director support from the pathology practice. The head of the pathology group, Dr. Algan, had recently been in a bit of a tiff with the New Hope CEO, and found no love for the manager of the new entity, United Consolidated Reference (UCR), considering him totally untrustworthy at worst, and fundamentally manipulative at best. The problem, however, was that both entities would need to derive their lifeblood, their specimen stream, from essentially the same marketplace of smaller regional hospitals scattered about the serviceable circumference of 150 miles. The pathology group was already receiving AP samples from these locations and UCR had their eyes squarely on the reference testing from these locations as well. Who would control the movement of this work loomed as the next likely battle in this repetitive cycle. But that was probably a ways off.