After a meteoric rise through the late 1980s and early 1990s, PSS began to stumble badly, beginning with a difficult IPO in 1994 and culminating in a terminated acquisition offer in 2000. Having seen even its last hope--a face-saving merger--evaporate, PSS' senior managers had no choice but to try to turn the company around on their own. That's what they've done for the past eighteen months, with a strategy focusing on better financial controls, on the one hand, and a rededication to customer service, on the other.

Just a few years ago, Tenet was overshadowed nearly to invisibility by the Columbia/HCA juggernaut. Now it has reversed roles, and suppliers have come courting. But instead of playing by traditional group purchasing rules, Tenet hopes to make its mark by going in the opposite direction from everyone else, shaking up a stagnant industry.