That was most evident when Swedish opened a new $30 million medical building, including a stand-alone emergency room, in February 2011 near the 128th Street SE exit of I-5.
Swedish's emergency room was just 10 miles from Providence Regional Medical Center Everett, where a $460 million medical tower with a spacious new emergency department was under construction.
No one would have predicted that these same two organizations would join in an unusual business partnership in February of last year.
If the public is looking for local examples of what's changed in the past year since the partnership was launched, it would be easy to overlook what didn't happen.
Before the partnership, Providence began planning to counter the opening of Swedish's new building by spending $4.6 million to install high-tech medical scanning equipment at its Mill Creek campus, said Preston Simmons, the newly named chief executive of Providence Regional Medical Center Everett.
So rather than spending money to compete, Providence will send patients who need medical scans to the Swedish building just off I-5 starting later this year.
"We can maximize the use of those high-cost services," Simmons said, instead using the money saved to provide other health care services.
The two organizations are working together in a number of other ways, he said.
Swedish is now managing the sleep lab at the Everett hospital's Pacific campus.
Swedish and Providence collaborated on a weight-loss surgery program that opened last year in Everett.
The Everett hospital will launch a program next year with Swedish's Neurosciences Institute in Seattle, Simmons said. It will mean more neurology services will be offered in Everett. It also will allow stroke patients at the Everett hospital to be evaluated by Swedish specialists in Seattle through live, computer-televised consultations.
Swedish and Providence will team up to see what improvements can be made to the Everett hospital's birthing center. With about 4,300 births last year, it ranked as the third busiest in the state, Simmons said.
Plans are under way to upgrade Providence Everett's emergency department designation to a Level 2 trauma center. Only three other hospitals, located in Spokane, Tacoma and near Vancouver, have that designation.
The change would allow more seriously ill or injured patients to remain in Everett rather than being transferred to Harborview Medical Center in Seattle, a regional trauma center serving patients in Washington, Alaska, Montana and Idaho.
The partnership between the two organizations next year should help better serve up to 50,000 children and adults in Snohomish County who are expected to get access to health care through the federal health care legislation known as the Affordable Care Act.
These changes are under way as the top leadership of the Everett hospital also has changed.
Last month, Simmons was named chief executive of the hospital and also was named as a member of the executive team supervising the affiliation between Providence and Swedish in northwest Washington. Collectively, the two organizations have 17,000 employees.
Simmons, 54, who lives in Snohomish, previously served as chief operating officer for Providence Everett.
He replaced Dave Brooks, who left in January to become chief executive for Ascension Health System in East Detroit. Brooks first came to the Everett hospital in 2004 as its chief operating officer. He was appointed the hospital's chief executive in 2007.
Sharon Salyer: 425-339-3486; firstname.lastname@example.org.
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