You are the new administrator of a primary care clinic in an academic medical center in a mid-Atlantic state. The clinic serves a large Medicaid and Children's Health Insurance Program (CHIP) population, as well as underinsured self-pay clients. The physicians, who are all employees, have come to you with a list of their top ten complaints. Led by Dr. Kidd, a smart, vocal pediatrician, all the physicians employed at the clinic are threatening to go elsewhere unless something can be done about their concerns, which are as follows: 1. The clinic is in a high-crime area and several employees have been mugged on their way to and from work. 2. Theft inside the clinic is rampant. Despite locks and keys, purses, medications, and supplies keep disappearing. 3. Patients come with problems ranging from preventative care to emergency conditions-yet they are all treated the same. Last year, a patient nearly died in the waiting room because they had to wait so long to be seen. 4. Patient information is in paper files, which are not always where they belong. Losing files is not uncommon, which leads to lost time in diagnosing and treating patients due to retesting. 5. The person/staff member/registration clerk at the registration desk takes unscheduled breaks and two-hour lunches, which slows everything. 6. We understand the building is old, but it does not have to be dirty. The janitor is absent most days and when there,, they will not clean. They sit in the parking lot and smoke. 7. We never know who to go to for assistance with clerical work. The nurses say it is not their job and the registration clerk laughs if we ask for assistance. We cannot take care of ordering supplies and scheduling vacations and take care of patients! 8. Our patient records are so disordered that, if we need to find someone in a hurry with an abnormal test result, we cannot find their chart to find the patient. This is dangerous! 9. The exam rooms must be cleaned between patients. Doctors should not do this, nurses will not do this. The janitor is out back smoking. Whose job is it? 10. Parking costs employees $15 per day - and that is at a cheap lot. You have to do something about the cost of parking!