This paper reports the results of a field study of six medical project teams that worked together in meetings over a seven-week period to develop plans to improve customer service within a hospital. Half the teams used a group support system (GSS), while the other half used traditional processes that were the habitual norms for this organization. In the teams using traditional project team processes, the leaders defined the teams’ project goal, directed discussions, recorded and controlled the teams’ notes, assigned tasks to team members, and prepared and presented the teams’ report. In the GSS teams, the leaders faced leadership challenges or abdicated, regular members participated to a greater extent, the project goal emerged from team discussion, and the teams’ notes were open and widely distributed. In short, processes in the GSS teams were more participatory and democratic. At first, teams found the GSS-based meeting processes very uncomfortable and returned to traditional verbal discussion-based processes. Once they returned to these traditional processes, however, they found them uncomfortable and moved back to include more electronic communication-based processes. Participants’ attitudes (satisfaction, perceived effectiveness, and cohesiveness) were initially lower in GSS teams, but gradually increased, until they equaled those of the traditional teams. There were significant differences in overall project outcomes: traditional teams developed conservative projects that met the unstated project agenda perceived by the team leaders. In contrast, GSS teams developed projects more closely aligned to the interests of team members.