Carilion Clinic, formerly known as Carilion Health System, is a Roanoke, Virginia-based tax-exempt integrated health care organization that provides quality care for nearly one million Virginians. Carilion owns and operates seven hospitals in the western part of Virginia as well as Jefferson College of Health Sciences and a joint venture medical school and research institute with Virginia Tech. The system consists of hospitals, primary and specialty physician practices, pharmacies, health clubs and other complementary services. Carilion Clinic is also home to the region’s only Level 1 Trauma Center at Carilion Roanoke Memorial Hospital. The system has more than 12,100 employees with 685 physicians covering more than 70 specialties. Carilion originated with Roanoke Memorial Hospital, founded in 1899 and located at the base of Mill Mountain in southwest Roanoke. The hospital expanded into related health care services and the acquisition of other hospitals beginning in the mid 1900’s. Most prominent was the acquisition of the competing Community Hospital of Roanoke Valley in downtown Roanoke. The deal took several years to complete because of anti-trust concerns by the United States Department of Justice that two of the three major hospitals in the Roanoke Valley would now be under the same ownership. In the early 1990s, Roanoke Memorial adopted the name Carilion for its consolidated health care business. In 2006, Carilions management warned that trends in the health care sector threatened to undermine the organizations financial position. In response, Carilion announced plans for a significant business reorganization that would change its emphasis from running hospitals to hiring more doctors in a larger number of medical specialties, with a primary goal of better coordination of patient care and an emphasis on medical education and research.