Reading the three assigned chapters and listenting to the presentations was very beneficial and useful.  Most of my experience has been a military clinics and hospitals and it is very interesting to have insight on how civilian facilities run.  On the military side profitability and productivity are measured and definitely have value, but we definitely have differing objectives to take into consideration.  All of our providers are members of the Air Force either as military members, civilians or contractors.  The military members have an obligation to fulfill before they can consider separating and joining civilian facility.  The difficulty we are having is keeping our providers beyond their military obligation and hiring civilians and contractors at competitive salaries.  The high deployment rate and lack of competitive salary poses a challenge. Recently, the Air Force has made great strides in staying competitive in the open market.