Use the Psychsocial Systems Model as this will be the model you will use to analyze this case.

follow the guideline as listed : 1. Introduction 2. Leadership Assessment 3. The Contextual Factors in the Case 4. The Required System 5. The Emergent System 6. The Gap 7. Recommendations 

1. What is the quality of the work produced?

Case Study 1 What Just Happened? By Zulma M. Berrios It is the end of a busy Thursday at the office. Denise, the office manager, storms into Dr. Thomas's office, clearly upset. Denise relates to Dr. Thomas that she received a voice mail from Garnet, the billing and collections specialist, who has given an ultimatum: either remove her from handling Dr. Blandon's claims or she would resign. Denise retrieves Garnet's voice message for Dr. Thomas to hear. "I don't want to work for Dr. Blandon. Don't make me be in charge of his claims and collections! Nobody told me I had to work for him. He does not understand what I'm doing; this is too much. What is he expecting? I'm okay with Dr. Thomas and Dr. Williams's accounts, but you either outsource Dr. Blandon's accounts, or I'll resign." The office is a single specialty practice managed by two physicians (Drs. Thomas and Williams). Most of the office staff, including Denise and Garnet, have been working together at the practice for over 10 years. Garnet is one of the most valuable employees. The practice enjoys an average of 30 days A/R cycle and a 90% collections rate, mainly because of Garnet's certification in medical coding, her experience in the field, and knowledge of the physician's clinical practice and claims experience. Garnet is dedicated, organized, and loyal to the practice. Her attention to detail and need for structure sometimes makes her a bit inflexible and resistant to the notion of change and the exploration of alternate ways of doing things. In order to maximize the use of the expensive office space, Drs. Thomas and Williams have entered into an agreement with a third physician, Dr. Blandon, for the use of space, equipment, and personnel, and sharing of office expenses. Dr. Blandon has been working in the office for the last 4 weeks. His addition to the practice required rearranging the office space, hiring new personnel, and redistributing work assignments. Denise has been busy with all the arrangements required to bring Dr. Blandon on board. In addition to all her daily duties as manager, Denise was in charge of ordering new equipment; interviewing, hiring, and training new personnel; as well as bidding and contracting for the leasehold improvements. Although Denise has substantial freedom to carry out her duties, Drs. Thomas and Williams make the decisions regarding salaries, bonuses, promotions, and major operational changes. With Dr. Blandon's addition, Garnet is now responsible for the billing and collections for the three physicians. Since Garnet has Fridays off and Dr. Williams is out of town, Dr. Thomas asked Denise to call Garnet and give her the opportunity to vent her frustration and to reassure her that the doctors will meet with her. Dr. Thomas doesn't want Garnet to be consumed with her dissatisfaction over the weekend. Denise calls Garnet from Dr. Thomas's office relating, "Garnet, I just heard your voice-mail message. I'm sorry I could not answer your phone call. I was in the middle of a meeting with the contractors that will make the leasehold improvements. I want to talk with you and give you the opportunity to explain your concerns. You know you can always come to me with your concerns." Garnet, responding so loudly Dr. Thomas could hear her from across her desk, "That is one of the problems, you are so busy that there has been no time to talk. It has been 4 weeks since Dr. Blandon started working here, and no one has talked to me about what I need to do. I have this volume of work dropped on my lap that I was not expecting. On top of that, Dr. Blandon is constantly double-checking my work. Doesn't he know that I have more than 15 years of experience! Not only does he double-check my work, he also expects a high level of collections every week. Doesn't he understand the billing and collection cycle? I don't appreciate that he is looking over my shoulder all the time. I don't want to be in charge of his claims and collections. I'm not used to have work pile up. I don't want to be working overtime. You either outsource Dr. Blandon's collections, or I'll resign." Denise continued to listen to Garnet's complaints, trying to calm her down, and promised that Garnet would speak with Drs. Thomas and Williams first thing Monday morning. Although still upset, Garnet agreed to meet with the doctors on Monday. Dr. Thomas asked, "What just happened?" Denise replied, "I'm as surprised as you are. I didn't know this was happening. I have been busy with the arrangements to bring Dr. Blandon on board. I didn't notice any changes that would alert me that something was bothering her. As you heard, she is expecting to meet with you and Dr. Williams on Monday. I'm confident we can reach a solution."