Case Analysis:

Need to determine the problems in the company, management and communications. Following a decision making process to come up with a list of possible solution and then pick the best one. Following concepts and theories in Public Administrations.

The board of physicians of the Green River County Hospital convened for their monthly meeting to discuss cases and hospital business. The big issue at hand was the proposal to turn over management of the hospital to a private contractor, namely Four Corners Health Partners (FCHP). It was a small outfit that had started buying up health facilities in the Colorado Plateau region but was quickly expanding into other areas of the country. For public health care institutions, FCHP was now offering consulting services and in this case actual management of the county hospital. The county commission had asked the board of physicians for its recommendations. The Director of Medical Staff, Dr. Melvin Wood called the meeting to order. The first item on our agenda is preparing a response to the county commissions inquiry. They want our perspective on the contract as proposed by FCHP for management of this hospital. Who would like to speak first. Several doctors raised their hands, but the director recognized Dr. Sophia Kopper, the senior physician on staff. Most of us here have already heard from colleagues and friends who work in facilities owned or managed by FCHP. The picture isnt pretty. FCHP does appear to deliver on its mission of lowering costs but it does so at the expense of patient care. The people Ive talked to are frankly too scared to come out in the open and voice their

concerns for fear of losing their jobs. My own independent research has revealed that FCHP has been involved in numerous scandals. Their public relations and lobbying efforts appear to be extremely effective in squelching complaints before they come to the publics attention. I think this outfit is unethical. We should tell the county commissioners that we unequivocally oppose this deal. Sophia, theyre talking about closing this hospital. We may not have any alternative, said Dr. Wood. Mel, do you know if the county commission has explored other companies? asked Dr. Kopper. No, I dont. Lets face it though, we are in a sparsely populated part of the country and I doubt that many companies would want to operate here. Dr. Kopper did not respond. Her eyes glanced around at the other physicians. Finally, Dr. Wood asked if anyone was in favor of recommending approval of the contract. Only Dr. Kopper responded. Mel, we have all met informally before coming here. All of us are in agreement that as our representative, you should write a strong memo saying that we are unanimous in our objection to signing a contract with FCHP. I so move. Several physicians simultaneously seconded the motion. We have a motion on the floor. All those in favor say Aye. Dr. Wood was met with a resounding chorus of voices. All those opposed say Nay. The room was silent. All right, Ill prepare a memo and forward it to the commission.

Later that day, Dr. Wood had lunch with the hospital administrator and a representative from FCHP. When the administrator left to visit the restroom, the FCHP representative said to Dr. Wood, Im aware that your staff physicians have some reservations about our company. I can assure you Dr. Wood that any problems we may have had in other jurisdictions have been just growing pangs. Were a good company. Your administrator is eligible for retirement and I doubt that he will make the move to FCHP should we get the contract. For somebody like you, however, I believe you will find an opportunity to come and grow with our company. You already have management experience and we like what we see. Im sure that we could come to some arrangement about a significant increase in salary not to mention stock options. Keep that in mind while you write the report. Dr. Wood was thankful that at just that moment, the hospital administrator came back to the table. Later that day, Dr. Wood looked over the accounting books and agreed with the county budget office that the hospital could not continue under the current financial arrangements. As he wrote the letter to the county commissioners, he deliberately softened the objections of the Green River County Hospital Board of Physicians.