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Organizational Behavior……
On a very bleak Monday morning in October, Dr Murray arrived at his office in San Marina General Hospital and for the first time that he could remember, he wished he could have stayed home. His entire weekend had been spoilt and he was still upset over a nasty row he had with the consultant from the UK who had been assigned to the government of San Marina. Dr Murray had enjoyed a reputation as an even-tempered man who disliked confrontation and he did not wish that to change. At the same time, he could not feel any remorse about the way he had acted. His only concern was to find a way to institute some damage control. John Murray is the Chief Medical Officer (CMO) for the small island state of San Marina, which has an area of approximately 75, 000 km2 and a population of 80,000. The island has one 150-bed public hospital with a simple organisation structure. There are two main wards – male and female for surgical and medical patients, and a small children’s ward. In addition to the hospital, the island’s health care delivery system includes the two government health centres offering primary health care and a few private practitioners offering a relatively comprehensive level of service. In his position as Chief Medical Officer, Dr Murray is the chief technical adviser to the Minister of Health, Education and Welfare and has overall responsibility for the island’s health policy. He is also the medical officer in charge of the hospital and his office is located in the hospital building where he performs some clinical duties in addition to supervising medical personnel. Along with his technical responsibilities, Dr Murray, by virtue of his status and position, exercises extensive moral authority in the hospital. The Matron of the hospital who is responsible for all nursing personnel – hospital and public health – is also the principal nursing officer and advisor to the Minister on nursing policies. But Matron hardly makes any policy or staffing decision before first referring the matter to the Chief Medical Officer. The same applies to all para-professionals or senior administrators in the hospital. For example, the Hospital Manager seeks his approval for all expenditure for medical supplies. As a former colonial state, San Marina continues to receive some technical assistance from the UK and so it was that Major John Sheffield, retired army surgeon with vast experience in several areas of medicine, was assigned to the island to assist the government in reviving laboratory services in the hospital and to help train laboratory technicians for this service. Since the retirement of the only qualified lab technician some three years earlier, the hospital has been relying on a privately owned laboratory to carry out the most basic lab tests and this was proving to be most unsatisfactory. From the outset, the Major’s presence in the hospital had been somewhat disquieting for several reasons. Within the context of the growing nationalism in the Caribbean region, expatriates were viewed with suspicion if not outright hostility. White expatriates with a military background posed a particular challenge to local staff who were accustomed to authority being exercised with an admixture of autocratic benevolence. Their tendency towards a ‘laid back’ approach to punctuality and the notion of ‘Caribbean time’ were anathema to the Major. On Friday, October 10, the Major had gone to the CMO’s office to complain about the lack of industry among the staff. He proceeded to give his advice on how he believed the hospital could be restructured so that the CMO would be relieved of some of his day-to-day administrative responsibilities. Without waiting for any reaction to his advice, the Major went on further to suggest that his own management skills could be more effectively utilised. Despite Dr. Murray’s attempt to control his emotions his response was less than courteous. He made it clear in no uncertain terms that after being in that position for over 30 years he did not wish to be told how to run ‘his’ hospital and that the Major would do well to stick to the task to which his government had assigned him. The Major, who up to that time had enjoyed an amicable relationship with the CMO, was quite unable to speak for some time, and when he regained his composure, he stalked out of the office without a word. Immediately, the CMO regretted his reaction. All weekend Dr Murray had gone over in his mind how he would mend the fence that had been broken and as he approached his office, he was preparing to eat humble pie and apologise to the Major. He was still musing when Matron, who was usually very calm, rushed towards him breathlessly. “Doctor!” she said, “we have a real crisis on our hands!” She told him that on Sunday night three children from an outlying district had been admitted to the ward with what appeared to be food poisoning. They were brought in by the community health aide who lived in the district. One registered nurse was on duty in the children’s ward but as the only resident medical officer was off duty, their only option would be to engage the services of a private practitioner who also worked in the hospital on a part-time basis. The children had been vomiting and there was a need for specimens to be collected and tested in the lab. Matron had called the Major to seek his assistance and he had arrived promptly. By early morning he had carried out some preliminary tests and on the basis of his knowledge and experience had taken full control of the situation. Assess the notion that the role of pharmacies in the 21st century is to dispense medication on demand by customers
1. What is the main purpose of this case study and briefly outline the overall problem to be solved.
2. Write a brief description of this case under discussion giving an outline of the main issues involved.

 
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