This chapter applies Max Weber's concept of formal rationality to modern hospitals. Weber ([1922] 1978:85) defined formal rationality as the purposeful calculation of the most efficient means and procedures to realise goals. Formal rationality is the type of thinking and logical deduction that people use to determine what is most important in particular situations and the most effectual method they should use for reaching desired goals. Tradition, sentimentality, outmoded customs, piety and various other types of potentially less effective ways of doing things are discarded in favour of the most efficient action that can be calculated to achieve the ultimate outcome: what some call the "bottom line'.