Describe the vertical and horizontal dimensions of this organization. Describe the authority/responsibility relationships that will present in this organization.  

In this case, the horizontal dimension aspect would be only three health care providers that start the organization. The three physicians and only a handful staffs are involved in running the organization. On the horizontal relationship, the three physicians will be involved in communication and making crucial decisions regarding the organization (Fagerstrom, 2009). The vertical design of the organization would be with three physicians and all the members of the entire organization. The order of hierarchy would start from top to the bottom or vice versa. Making of crucial decisions and communication will start from the seniors to the juniors in the entire organization (Khatri et al., 2006). Nurses and other staffs in the lower ranks will be answerable to their seniors. The three physicians would be in the front line to lead others in providing health care to the patients. Responsibilities would be assigned according to the ranks that every staff in the organization holds.

Should this practice become centralized, decentralized, mechanistic, or organic in its design? Defend your answer.

The practice is organic in its design. The system is characterized by processes that are free-flowing (Kongstvedt, 2013). The organization is started by only three doctors and a handful staffs to assist the three physicians. The system has few rules and procedures as the ones of organic design. The levels and organizational ranks are also minimal and thus provide room for informational relations among the staffs (Fagerstrom, 2009). The ladder of authority is unclear since only a handful people have started out the organization hence lacks clarity in order of power that would govern the organization. The system also lacks centralized decision making hence to run the organization smoothly.

Explain the importance of differentiation, integration, and managing complexity, interdependence, and boundary spanning activities for this organization.

The differentiation is one of the important aspects of an organization. The organization distinguishes its services from other organizations that provide related services. In this case, three physicians including a gynecologist, urology and obstetrician would combine their different practices to provide health care services. Most of the services seekers would find these interrelated practices attractive.  Thus, most of the patients would seek medical services from the organization. Employees would continue learning and experimenting since the structure is flexible due to the strength of horizontal communication (Khatri et al., 2006). Integration which is collaboration quality among practices and departments also serves a great role in the organization. With three doctors each specializing in a different field from each other, it would help to cater for different needs of the patients. Since the environment of the organization is not certain, regular changes would need more processing of the information to attain horizontal coordination (Kongstvedt, 2013). Thus, integration becomes would serve a crucial purpose in organizational structure.

Managing complexity is also an important aspect of the organization. When people focus on his or her area, it would promote accountability among the staffs and hence providing quality services to the patients. Medical personnel would continue to learn to offer good leadership for the benefit of the organization (Fagerstrom, 2009). Interdependence assists in sharing of resources within the organization. In the case study, interdependence would help the physicians to combine their practices to cater to the needs of the patients. The doctors would depend on each other through the provision of services in the area of one’s specialty. Boundary-spanning activities are roles that provide connection and manage an organization with important elements in an environment outside the organization. Thus, boundary spanning activities would provide coordination of the organization in the provision of health care and link the organization to the outside environment (Khatri et al., 2006).


Fagerstrom, L.  (2009). Evidence-based human resource management: A study of nurse leaders’ resource allocation. Journal of Nursing Management, 17(4), 415-425.  Retrieved from EBSCOhost

Khatri, N., Wells, J., McKune, J., & Brewer, M.  (2006). Strategic human resource management issues in hospitals: A study of a university and a community hospital. Hospital Topics, 84 (4), 9-20. Retrieved from.EBSCOhost.

Kongstvedt, P. R. (2013). Essentials of Managed Health Care. Burlington, MA: Jones and Bartlett Learning.


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