This study`s objective is to identify the success critical factors in hospital management and to propose a management model based on the best practices in the market. It was presumed that many of these factors would be related to the challenges faced by the hospital in the market, to the strategies adopted, to the way these strategies are implemented and to the management technologies used. So, a literature review was made and the field questions were created focusing on these topics. In the field, five Rio de Janeiro metropolitan area private hospitals were studied. All of them have the surgeries as one of their main activities, despite of doing many other procedures. So, the doctors are one of their main clients, as far as they need the hospital structure to make their surgeries come to true. The results reveal a spacefull market, a lack of professional management as well as informal strategies. In the end, a hospital management model is proposed. This model may help the hospitals to make themselves ready to the market professionalization that must come soon.