case study

Once you have read through the case study, imagine that you have been asked by your chief executive officer to review the case with the organization’s senior leadership team.  Your PowerPoint presentation should include slides that address the following: background, major problems(s) and secondary issues, your role in addresses the major problem(s) and secondary issues, strengths and weaknesses that exist in relation to the major problem, alternatives/recommended solutions, and evaluation. THIS IS A POWERPOINT presentation, not a written assignment.  PowerPoint slides SHOULD BE “powerful” points of information that you will expand upon in the verbal delivery.

Your presentation/slide show should contain at least 6-12 slides, not including title and reference slides.

Dr. X and the Disappearing Clinical Trials Money

Sharon B. Buchbinder

Dr. Xavier, or Dr. X, as he liked to be called, was a newly hired oncologist at a large cancer center at Upstate New York Oncology Center (UNYOC). During his negotiations for the job, he displayed a propensity for the finer things in life and demanded those things be moved from his farm in North Carolina to his new one in New York. The list of his favorite things included: a rare book collection, an antique clock collection, three antique cars (a Bentley, a Rolls Royce, and a Mercedes), a dozen black Orpington show chickens, and two dozen Marino sheep. In addition, his 1,500-bottle wine collection had to be transported from North Carolina to New York in a refrigerated truck. All of these demands were met by UNYOC because Dr. X had a reputation for bringing in clinical trial money for new cancer treatments. In exchange for his hefty salary and transportation costs, the revenues from pharmaceutical firms for his research were to be handed over to UNYOC.

Dr. X worked hard, and as expected, the money began to roll in from the research trials. At his first annual review, Dr. X met with the managing partners of UNYOC and informed them that he felt it was time for them to make him a full partner. After all, he’d brought in revenues from the trials, plus he was a productive member of the team. In his opinion, his net worth to UNYOC far exceeded the salary he received. If they didn’t accede to his request, then he was going to leave and take his huge revenues with him.

The partners were taken aback, to say the least. The senior partner was most vocal with his annoyance. “You’ve got a lot of nerve, Dr. X. You conveniently forget that we have a very high overhead in this practice. Look at all the staff we have. They take care of your every whim. We have state-of-the-art equipment, as well as the best supplies for our patients’ needs. This past year, you’ve barely covered your salary and your direct and indirect costs of services. Full partner, indeed. Harrumph.”

Dr. X was chagrined. He’d expected the partners to cave in, just as they had to his demands during the hiring process. Truth be told, he had been bluffing. There was no other job offer on the table. And his expensive chickens and sheep were eating him out of house and home. He had to do something.

Dr. X thought it best to placate the old man and buy some time. “I’m sorry. I’m really not a business person. I hadn’t considered all the overhead costs. Please forgive me.”

The senior partner raised a shaggy eyebrow, then shrugged. “Well, that’s why we’re here, Dr. X, to keep us all on track. Apology accepted.”

The meeting adjourned. Everyone went back to work, but Dr. X’s mental wheels were spinning. He needed more money. But where would he get it? He was working 60 hours a week;it wasn’t as if he could moonlight. He wasn’t about to give up his books, clocks, cars, and wine. That was unthinkable. And the show chickens were like his children. He couldn’t sell them. Pretty soon it would be time to shear the sheep and get a bundle of cash for their fine wool. But he needed money right now. Where was he going to get it?

He sifted through the mail in his inbox and opened three envelopes with the latest four figure checks from several big drug companies. He realized what he needed to do. The checks from the pharmaceutical firms were all made out to him, not UNYOC. He put the checks in his pocket, walked across the street to his bank and deposited the money to his personal checking account. As he walked back to his office, he felt as if a weight had been lifted off his chest. Soon he’d find another job elsewhere, one where he’d be able to live the lifestyle that he’d become accustomed to and deserved. Problem solved.

Discussion Questions

1.    What are the facts in this situation? What is known and not known so far?

2.    What are the indications that embezzlement may have occurred in this case?

3.    According to the Association of Certified Fraud Examiners (2012, p. 4), “Perpetrators with higher levels of authority tend to cause much larger losses … and work in one of six departments: accounting, operations, sales, executive/upper management, customer service and purchasing.”Does Dr. X fit this profile? How long do you think it will take before the practice manager realizes the clinical trial checks aren’t being handed over to her?

4.    What do you think the partners will do when they find out? Do you think they will want this to go public? Why or why not? Provide a rationale for your responses.

5.    Based on your knowledge of this topic and the Additional Resources provided, what do you think the outcome of a case like this will be? If there are penalties, what do you think they will be?


Association of Certified Fraud Examiners. (2012). Report to the nations on occupational fraud and abuse. Retrieved from

Baum, N., &Dowling, R. (2009). Is your practice protected against embezzlement?Urology Times, 37(10), 46.

Borkowski, N. (2011). Organizational behavior in health care (2nd ed.). Sudbury, MA:Jones and Bartlett.

Buchbinder, S. B., &Shanks, N. H. (Eds.). (2012). Introduction to health care management (2nd ed.). Burlington, MA: Jones &Bartlett.

Fallon, L. F., &McConnell, C. R. (2007). Human resource management in health care: Principles and practices. Sudbury, MA: Jones and Bartlett.

Have checks and balances in place, or open the door for embezzlement. (2009). Same-Day Surgery, 33(9), 85–87.

Mathis, D., &Lewis, M. (2009). Employee embezzlement: A growing problem. The Journal of Medical Practice Management: MPM, 25(3), 146–148.

Morrison, E. E. (2011). Ethics in health administration: A practical approach for decision makers (2nd ed.). Sudbury, MA: Jones and Bartlett.

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