“Dr. Griffith, Dr. Williams called and asked if you would join him on the golf course this afternoon,” Sandra the office manager said to Dr.Griffith.“Of course I’ll be there, I may have to cancel my afternoon patients.”Metro Renal is a reputable nephrology clinic in Urbana, IL headed by the Chief Medical officer of the group, Dr. Rosenberg. The grouphas two internists, Dr. James and Dr. Campbell, and it has also twonephrologists, Dr. Griffith and Dr. Rosenberg. Metro Renal Clinic was acquired last year by a well-known physician management company MRA, Metro Renal Associates. As a part of the acquisition, Dr.Rosenberg was chosen as the chief medical officer. Even though Dr.Rosenberg sees patients two days a week, he was offered a generous incentive from the management company to ensure that the practice is efficient and maintaining high returns.
Dr. Rosenberg has established a strict policy when it comes to scheduling and seeing patients which requires all physicians to be double booked. No cancellations are allowed except for family emergencies, in which case Dr. Rosenberg is to be notified directly. In order for Dr. Rosenberg to make sure the practice is running accordingly, he asked his scheduler, Tanya, to tell him everything that happened with other physicians in the group and their patients without anybody knowing.
Dr. Griffith and Sandra have been working together for four years and have a good personal relationship. Dr. Griffith is a renowned physician and his patients admire and respect him. No complaints were ever filed against him, and he gets the highest satisfaction scores. Dr.
Griffith didn’t think it was a big deal to cancel his afternoon patients and enjoy the nice weather with his friend on the golf course. Sandra agreed with him, since they can be rescheduled early next week instead.
Sandra went ahead and cancelled the afternoon schedule and didn’t mention anything to Dr. Rosenberg.
Tanya overheard the conversation between Dr. Griffith and Sandra and called Dr. Rosenberg to notify him.
The next day, Dr. Rosenberg showed up unexpectedly and asked Sandra to come to his office. He had prepared a written warning for violating his policy. He handed it to her and asked her to sign it. Sandra felt betrayed, but she didn’t know who could have done this to her. She told Dr. Rosenberg that he should communicate that with Dr. Griffith.
Dr. Rosenberg ignored her request and never discussed the subject with Dr. Griffith. Sandra notified Dr. Griffith of what happened, however, he wouldn’t comment on the subject either.
Dr. Griffith knew he violated the practice policy and didn’t want to have a heated conversation with Dr. Rosenberg.
Sandra called the regional manager and complained. The regional manager told Sandra not to worry about it, she would discuss it with Drs. Rosenberg and Griffith. However, the issue was never brought up in any meeting or ever addressed. Sandra has decided to leave the practice since she felt she was treated unfairly.
You are the regional manager. You were notified by Sandra that she is submitting her two weeks’ notice. She is a good manager and you don’t want to lose her. However, you don’t want to get involved in a heated conversation with the practicing physicians at the same time.
DISCUSSION QUESTIONS 

1. What are the facts of this case?
2. What are the management implications of this case?
3. What are the legal obligations the practice has to its employees and how do they apply to this case?
4. How would you address her letter of resignation? You want to keep Sandra and avoid confrontation with the physicians. Is that feasible?
5. Create a script for discussing this situation with Sandra.