While debate in the health care literature continues with respect to the role of marketing, many industries are adopting a broadened perspective which recognizes the comprehensive role which marketing may assume at a variety of levels within the organization: marketing as culture, marketing as strategy, and marketing as tactics. A national study of general service hospitals suggests that, in many hospitals, the marketing function is indeed transcending its functional boundaries through enculturation of a marketing orientation, involvement in the strategic process of the organization, and expansion of tactical marketing activities. Hospitals which adopt and support this broadened role of marketing are witnessing a positive effect on performance.