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    Devin Fillman

    Project Summary The Gastroenterology (GI) clinic and ambulatory surgery center (ASC) will be known as the practice for this document. The practice is in a medical office building (MOB) of a community hospital in Oregon. Nine shareholders, in various stages of their careers, must reach a consensus and plan.

    The practice shareholders struggle to make big decisions about the landscape and growth of their practice. The practice has a history of difficulty in establishing and implementing big decisions. Big decisions, in this case, are defined, as decisions that are either large in scope or high cost that require consensus amongst all shareholders. Once made further, big decisions need the management team to provide decision making data, to facilitate the decision-making process, and implement the decision.

     Example of a big decision that the practice has made in the past is: 

    • Leasing additional space in the hospital-owned building on campus. The clinic leased extra space in the current structure and then withdrew the lease fifteen months later when the shareholders became concerned about the overhead associated with the additional space. 

    Example of a big decision that the practice has been unable to make is: 

    • To move some or all the practice to a site away from the hospital campus. The practice is unable to provide certain ancillary services due to the land use agreement associated with the condo they currently occupy and own. The practice shareholders have discussed moving at least part of the practice away from the hospital campus to provide ancillary services. While sites explored were not executed, the conversation continues without a decision.

     The main issue that is shared by all the big decisions is a lack of data. In both cases; there is a lack of information needed to make a data-driven decision. In these cases, feelings (usually in the form of fear) rather than facts (which are missing in these cases) drive the decision-making or grind it to a halt. It is common for practices making decisions of this magnitude where several stakeholders are involved.  

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    Devin Fillman



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