Case Study: Let it Pour
The problems that arise in the case study Let it Pour are primarily associated with the ethical dilemmas of health care in the Faith Community Hospital. As such issues as resuscitation versus the right to die gain more and more concern throughout the country, Faith Community Hospital is also experiencing tough times. This hardship mainly refers to different interpretations of the duties of doctors in the hospital, and different expectations from patients, from patients’ families and relatives, from board of directors, from different groups of personnel, and other groups of stakeholders. Each patient has unique concerns and requires individual treatment, and his or her families also want specific definite things. Forgetting that all hospitals, and Faith Community Hospital in particular, serve people and strive to promote health and well-being of citizens, many patients and patients’ families blame Faith Hospital’s doctors for rendering inappropriate medical services, or not rendering them at all in an appropriate manner. One of the causes of such inferences is that some doctors consider resuscitation immoral, while others’ motto is “do everything possible to save a patient.” Moreover, some doctors care about their patients so much that they do not require insurance coverage, while others “refuse to serve patients unless they confirm insurance coverage first.” This way not only the public relations of the hospital suffer, but authorities also are not quite satisfied with the performance of the personnel, without even knowing the details. However, this is only the first part of the problem. The second part consists in the financial difficulty the hospital experiences. Daily expenses have increased, while quantity of patients has decreased. And even though this is a non-profit oriented organization, this fact does not mean the hospital can relax and forget about expenses; costs minimization will always be an important issue in any organization, both for-profit and non-for-profit. 
In an attempt to find solutions to the above problems, the first thing that comes to my mind is to persuade the public and all stakeholder groups that despite the consequences on any medical service, Faith Community Hospital tries really hard to do everything possible to promote health and well-being. In other more harsh words, it would not be better without Faith Community Hospital, meaning that anything the hospital does serves for the better by definition. Period. The extent of success of separate cases does vary amongst patients, doctors, and illnesses. However, it should be made clear that some things medical doctors cannot modify, moreover if they can, they take enormous responsibility. In any case doctors help patients and improve their well being, but doctors are all different because they are humans just like others. And if an elderly person has suffered last years peacefully waiting his or her turn to pass away and not opposing the imminent, but rather wanting to see calm and quite end, should the doctor intervene the natural process and make the person suffer several more years, or should the doctor allow him or her to pass away naturally? These and other ethical and moral questions doctors encounter every day, and surely it is very hard for the doctors to make decisions like these, harder than for a patients family or the administrator, or anyone else.  And so one of the options is to explain all these ideas to the public; sort of fairly justify the doctors. 
On the other side of the spectrum, however, are the doctors who are driven by their own morality and ethics. The task would be then to address them, saying that although they are the ones actually rendering the service and facing all that happens with (or within) a patient, they still have to abide to certain rules and policies. These policies refer to specific regulations, which forbid doctors to act in contrast with what the family of the patient wants. In other words, the doctor must understand that the decisions of the patients and their families are of primary priority, and that if necessary, the doctor must act correspondingly regardless of his or her ethical principles and beliefs.  
In addition to these two issues, the finance people of the hospital reported increases of expenses. It has become more costly to service patients. Because of the reasons discussed above, the quantity of patients decreases, and that is why the expenses per patient per day are growing. The key point in here is that about 30% of costs are fixed, and thus cost per patient per day would decrease if the population of patients increases. If things continue to be that bad, the only reasonable solution would be to cut costs, which may include removing various extras like free luncheons for personnel. Cutting expenses by reducing the overall quality of our core services is out of the question in such a situation. It is crucial to inform the entire personnel of the hospital about this situation, so they might get prepared to the possible changes. But it must be mentioned once more, no way cost reduction should result in decrease of quality of rendered services, otherwise the hospital will face imminent crash. 
The public should understand that Faith Community Hospital is only doing better to its patients and only promotes well being and health of people. In other words, if the Hospital renders any services, or does anything about the patients, this something is only for the better. There is not a single activity done within the Hospital that can harm the patients in long term (but for a few exceptions). Thus, the offensive claims and complains are only grounded on the expectation of better performance (“you are good, why can’t you be perfect?”). In other words, the publicity of the Hospital is getting worse because the public wants the Hospital to function even better than it is functioning at the moment. Because many people do not understand this concepts being driven with emotions, which actually justifies their actions, it is crucial to point that out and clarify the commitments of the Hospital. The attitude would affect the Hospital in a positive way, which would in turn result in better employee performance, and the cycle would go over and over improving publicity, working conditions, and finances. 
The doctors and other personnel, on the other hand, should understand that their continued employment that include benefits and promotion opportunities is directly dependent on their decision making. Thus, there is no other way but to put aside personal moral and ethical principles (only regarding patient resuscitation and the like). If they understand that, public sector would change attitudes, and bring ore patients to the hospital. In turn, if people trust Faith Community Hospital more, the increased population of patients would diminish cost per patient. According to accounting basics, fixed cost per unit decreases if number of units increases. This way, the obedience of the personnel and public trust are the two main priorities, that could be attained with the solutions above.