A growing, profitable internal medicine practice of 10 physicians, 2 physician assistants, a physical therapist, and a massage therapist is located in a city of 150,000 people. The clinical personnel are mostly from the majority group in the area and consider themselves openminded, altruistic, and culturally aware. The administrative support staff is representative of the makeup of the patient population—mostly minority groups in the local community. The patient population is growing and becoming more diverse from those newly arrived in the city. The practice is currently facing several challenges.

DISCUSSION QUESTIONS 

1. The practice manager wants to have the local hospital expert on cultural competency come talk to the staff. The administrative support staff does not feel that they need training. How should the practice manager proceed?

2. The practice needs to hire a new administrative assistant to work with the front desk staff. The practice wishes to hire someone from the local minority community rather than an equally qualified individual from another state. How should the practice manager proceed? Justify the rationale for this recommendation.

3. With the recent growth, the practice is considering relocating its office to another, larger office facility. Several options are being discussed. Should they relocate to a more affluent area of the city that that is less diverse? Or should they stay in the same neighborhood, even if it is less profitable? What are the pros and cons of staying in this neighborhood versus moving to another area? If the rent is higher in the more diverse area, is that enough to justify not moving there? Or is diversity responsiveness a “cost of doing business?” How should the practice manager proceed?

4. The practice wants to maintain its good standing in the community. What initiatives could it undertake to remain connected to its local patient population?

5. The practice manager wants to complete a strategic plan as a guiding framework for the organization for the next five years.

From whom should she get input to help shape this plan? Should cultural competency initiatives be included in this plan?