QUESTIONS TO DEBATE Chapter 2, Instructor’s Manual

1. How do stakeholders’ needs differ? By age—old people versus young people? By income—rich versus poor? By role— buyers versus providers? By geography—Jackson, Mississippi, versus Jackson, Michigan? © 2006 by John R. Griffith and Kenneth R. White

2. The chapter adopts a specific theory of operations and a set of values for a well- managed HCO. There are other theories, such as “3 legged stool” (stakeholders are the board, management, and medical staff), “satisficing” (meeting all stakeholders’ minimum, as opposed to optimum, needs), and “profit maximization” (totally or partially excluding the values of both IOM and Healthy People initiatives). How would these theories change operations in a hospital, and would the change be better or worse? © 2006 by John R. Griffith and Kenneth R. White

3.How does an HCO hear its stakeholders? How does it resolve conflicting stakeholder views? What would happen if only some stakeholders owned an HCO, and others were simply users or buyers of service? © 2006 by John R. Griffith and Kenneth R. White

4. Must an HCO always have three component systems—governance, clinical, and support? What would happen if it didn’t? Are there ways to have a system without owning a system? How can an HCO decide what it should own? © 2006 by John R. Griffith and Kenneth R. White

5. What is the manager’s role in HCOs? How is the role different from the folk tradition of managerial roles (like Donald Trump on the television show The Apprentice or the “boss” in popular literature)? Why has this difference developed? © 2006 by John R. Griffith and Kenneth R. White