Clark Green

Fall 2011

Medical Associates-Middleboro

Case Study Assignment

Case Overview:

Founded in 1951 and led by Dr. James R. Fairchild, a board-certified internist, Medical
Associates is a physician group practice that expanded slowly and added other specialties in
1963. It has continued to expand over the years, and began to provide specialty and sub-specialty
medical and surgical care in 1972. Medical Associates has also grown into a large tax paying
medical group of forty physicians and two separate location in Middleboro and the eastern edge
of Jasper which opened in 1972 and 1985 respectively. The practice was originally a single
specialty practice but now has several specialties and sub-specialties in addition to ambulatory
surgical services due to Dr. Fairchild advocating on behalf of multi-specialty medical care.
Medical Associates provides services in cardiology, ENT, gastroenterology, general surgery,
internal medicine, OB/GYN, orthopedic surgery, pediatrics, thoracic surgery, and urology.
However, the practice struggles to provide an adequate amount of lab and imaging services. The
board is battling many issues that are time sensitive and need to be fixed as quickly as possible
such as staffing and insurances for example. They will need to remedy the situations before they
become too hard to control and manage. A SWOT analysis of the organization, chart is attached
at the end of this document, will be conducted to determine the strengths, weaknesses,
opportunities and threats of the Medical Associates practice in the hopes of fixing the problems.
Next, the organizations stakeholders must be identified in addition to identifying all of the
problems within the organization. Finally, recommendations on the best solutions for the
organization will be given after an analysis of alternative solution is conducted.

Much like many other organizations, Medical Associates has many different strengths,
weaknesses, opportunities and threats. The threats and weaknesses of Medical Associates can be
overcome according to how well they take advantage of their opportunities and utilize their
strengths. One of the strengths. New physicians are hired on a two year contract with a fixed
salary and benefits. After the completion of their two year term, they can then choose to either
buy a share of Medical Associates and become stakeholders, or terminate their relationships with
the practice entirely. Over the course of the past 5 years, Medical Associates staff has changed
dramatically within the organization. As registered nurses retire or resign, they have been
replaced with medical assistants. On five recent occasions, when a Registered Nurse assigned to
a senior physician resigned, the senior physician demanded that the registered nurse assigned to a
staff physician (non-shareholder) be reassigned to him or her and that the new Medical Assistant
be hired to fill the vacancy with the new staff physician. This ad hoc system of job switching has
caused a great deal of internal turmoil between the senior and junior physicians and has lead to
the subsequent resignation of two Registered Nurses who did not want to be reassigned. Another
issue of long term concern involves the financial structure of the corporation. At a recent Board
retreat, a consultant furnished a recommendation that the corporation retain more of its annual
earnings before sharing earnings with the shareholders. This report was very controversial. Dr.
Eason, the Medical Director, has recently informed the Board of his growing concern over
managed care practices in the area. For the last seven years, Medical Associates physicians have
been retained by Swift Health Plan, Swift would have to terminate its relationship with Medical
Associates and employ their own physicians in this area. While Dr. Eason has identified this as
a growing issue, he has offered no solution.