It is the structure hospitals, universities, and acr counting firms tend most often to favor. Most impor tant, because it relies for its operating tasks on trained professionals-skilled people who must be given considerable control over their own work the organization surrenders a good deal of its power not only to the professionals themselves but also to the associations and institutions that select and train them in the first place. As a result, the structure emerges as very decentralized, power over many de cisions, both operating and strategic flows all the way down the hierarchy to the professionals of the operating core. For them this is the most democratic structure of all. Because the operating procedures, although com are rather standardized-taking out appendix in a hospital, teaching the American Motors case in a business school, doing an audit in an account ing firm-each professional can work independently of his or her colleagues, with the assurance that much of the necessary coordination will be effected automatically through standardization of skills. Thus a colleague of mine observed a five-hour oper heart operation in which the surgeon and anesthe- ologist never exchanged a single word