Ms. Thompson, Chief of Health Information Management (HIM), said to Vice President Arthur Phillips and Human Resource Director Carl Miller, "There are no two ways about it, we're going to have to raise the pay of our HIM directors by at least 10%. With Don Williams leaving us and going to River City Medical Center of Miami Valley for a lot more money, we're going to have to pay more than we're now paying to fill that spot. Of the nine hospitals in this city, our HIM directors are by far the lowest paid." Carl Miller responded, "Since we discussed this a week ago, I personally surveyed every hospital compensation manager in town. We're not the lowest paying of the nine in southwest Ohio. In fact, we're the third highest paying." Ms. Thompson shook her head. "That doesn't seem right," she remarked. "Some of our people take on additional projects at other hospitals and they've told me the hourly rates they're receiving for that extra work. They even mentioned they'd provide pay stubs to prove it." Arthur inquired, "A week ago you mentioned you were going to present some of those pay stubs from other hospitals. Did you receive them?" What does this case say about the supply of the particular skill in the area? And what might come of Dr. Gable's arguments if the realities of supply were different?

1. Do you believe that the interorganizational "bumping" of pay rates, if indeed a fact, constitutes professional behavior? Why or why not?
2. Because it might be reasonably suggested that the nurse anesthetists in the area are acting together, at least in a loosely organized way, one might be tempted to suggest that the area's nine hospitals of southwest Ohio get together and establish fair and consistent pay rates for this occupation. What hazards are inherent in this approach, and in what sense has one of the case's participants already ventured into hazardous territory?
3. How would you suggest that Arthur and Carl proceed in their consideration of Dr. Gable's request?