Southern Medical School

This case examines the misalignment among the structure, culture, strategy, and environment in a nonprofit university. Specifically, the Division of Plastic Surgery within Southern Medical School operates with a different structure and culture than the rest of the university and medical school. Furthermore, the nature of academic medicine requires that strict policies and procedures are followed. In this case, problems ensue when Dr. Larry Smith decides to follow his own procedures for what he believes is the best interest of the patient. By not complying with billing policies, his actions create an ethical dilemma for the division and the medical school.

Main Topics

Bureaucracy and structure, Ethics

Secondary Topics

Organizational culture, Communication

Teaching Purpose

To demonstrate how misalignment of structure, culture, and environment within an organization can lead to problems in communication and decision making, and ultimately contribute to unethical behavior.

The Organization

The case examines the Division of Plastic Surgery within Southern Medical School, a nonprofit division within a university hospital.

Main Characters

Dr. Larry Smith, Medical Doctor and Faculty Member

Jan Ellendale, Reimbursement Manager

Michael James, Business Director