This case uses two important examples based at the Stanford Hospital. In the first, Joe Kelly is diagnosed with fast-growing lung cancer and must quickly go through a series of chemotherapy. Joe's path includes discussions with his wife, son, and doctor about his prognosis and treatment. While Joe believes he is cured after the first round of chemotherapy, the doctor must communicate that the chance of relapse is high. In the second example, Tina and Beth, graduate students at Stanford Medical School, compete for their Chief Resident's attention. Beth believes Dr. Rivas favors Tina and a great deal of conflict is created in the fight to win over Dr. Riva. After some time, it is noticed that this conflict greatly affects the two's care of their patients and Dr. Rivas must sit down and discuss solutions.
Bernie and Ruby Merwald live in Menlo Park, California during their retired ages when Bernie falls ill to dementia and Alzheimer's. This causes him to have significantly complex medical problems that result in familial conflicts, violence and avoidance of the doctor's orders. When Bernie has a heart attack on top of his failing health, siblings want to pull the plug, but their protective and isolating mother disagrees. Because of a California law, the mother is responsible for all medical decisions and continues to subject her husband to over-medication and worsening of his condition against the doctor's orders.
This case explores three tragic situations that lent themselves to organ donation. In each situation, doctors across the Midwest must work to save borderline deaths while communicating the tragic results to family. The first case deals with an accidental drowning of a toddler in the home pool. The second is a drunk-driving case of an eighteen-year-old resulting in a car crash and lost lives of a couple. Third, a young boy commits suicide by hanging. In each case, extensive details of their death and the timeline of the situation are given. The cases detail why each situation allows for organ donation.
Dystonia is a disease that most of the Marvis family suffered from. Not only this, but mother Stephanie Marvis also was a single mother working hard to finance her four person family. Stephanie and her son David especially had symptoms of dystonia, which forced Stephanie to frequently take her son to the hospital. After much research, Stephanie found the Stanford Hospital's Dr. Fields, who helped implant a device that would halt some of the dystonia symptoms. When the device breaks, David suffers for many months because Stephanie doesn't feel it is necessary to go to the Stanford Hospital. However, when they finally reach the hospital, Stephanie becomes very combative of her situation, defending her choice to not uproot David earlier. The doctors and hospital staff must determine how to communicate with her, while arguing amongst themselves about the appropriate way to address the situation.
Dr. Curley is an obstetrician that deals with a very difficult birth of the new Santorini child. The Santorinis have been through a stillbirth, and upon getting pregnant again, extreme cautions are taken to ensure the safety and health of their new child. This case takes the reader through the difficult decisions that must be made by the doctor and family as "a perfect storm" of birthing complications ensues. The Santorini's son is born with down syndrome and heart problems that require difficult surgeries. To add on to the strain, the family is tied down by significant financial problems. The doctor must decide how to tell the family their options before they expose their newborn to highly risky surgeries, with the added financial difficulties.
A Brief Note on Difficult Discussions Between Doctors and Patients provides students with a framework to help them think about how to have such discussions. The framework has three parts: 1. The contextual realities of a given case. Two categories of contextual realities exist. First, there are the factual components that surround a case. Without a full understanding of all the facts, a doctor will be handicapped in a difficult discussion. Second, there are complicating factors - the "invisible" obstacles that can create unnecessary tension or otherwise compromise a difficult conversation. 2. The goal(s). What is success in a difficult doctor-patient discussion? 3. Guidelines for difficult discussions. The specific steps to take during the discussion to create the best odds for success.
This case uses two vignettes to illustrate ethical questions that may occur at hospitals. In the first, 89-year old widow Theresa Addison is faced with the challenge of finding a facility that will care for her 47 year old son on a long term basis. Her son had been born with cerebral palsy, and facilities had deemed his situation futile. In the second vignette, hospital staff missed a key indicator during a newborn's first baby wellness check, resulting in considerable brain necrosis.
This case is about the diagnosis of Alzheimer's at a relatively young age, at a time when the patients are forced to juggle jobs, family, and dementia. The case is based on the article When Alzheimer's Hits at 40 from the Wall Street Journal (November 14, 2008). While most people who get Alzheimer's are over 65, Andy Smith, the protagonist in the case, is one of about 500,000 Americans living with Alzheimer's or other dementias at an atypically young age. Alzheimer's takes a long time to develop - usually, it isn't diagnosed until 10 years after the first symptoms appear - but more Americans are identifying it early, thanks in part to aggressive screening programs pushed in recent years by groups including the Alzheimer's Foundation of America, a national alliance of caregivers. This case has three vignettes that focus on different difficult conversations between Dr. Henderson and Andy and Cindy Smith. Dr. Henderson is there at the beginning of this ordeal as he attempts to inconclusively identify the cause of Andy's initial symptoms. Finally, after several years and many different treatments, Dr. Henderson diagnosed Andy's condition as Alzheimer's.
Starts by describing a typical day in the life of Randy Hetrick, the founder and sole full-time employee of Fitness Anywhere. Hetrick starts his work day on Friday, September 10, 2004, at 6:00 a.m. By 8:30 p.m., he has accomplished a lot. However, he has only been able to get to a few items on his morning's to-do list . . . and his list is growing by the day. Chronicles the creation of Fitness Anywhere--how Hetrick developed the product as a Navy SEAL; how he put together a business plan for commercializing the product during his two years at Stanford's Graduate School of Business; and his first full year of operations, 2003/2004. In describing the first full year of operations, focuses on Hetrick's fundraising efforts, the product's development, and the three market segments that he has targeted--military, commercial health fitness, and retail. By September 2004, Hetrick surveys the major topics on his to-do list; the activities that need to be completed to generate military, commercial, and retail sales; the activities related to protecting the product's intellectual property; completing a business plan, deciding his fundraising strategy and raising capital before the company runs out of it; and hiring his core team.
Introduces the venture leasing or lending industry by looking at pioneering in the industry: Western Technology investment. Asks students to walk in the shoes of a venture lender by outlining a term sheet of a "live" investment decision that Western Technology needs to make about Quinstreet, an emerging Internet start-up.
For three years after its spin off from Lucent in late 2000, Avaya struggled with how best to structure its go-to-market organization. Chronicles Avaya's repeated attempts to create an effective go-to-market structure. Ends in late 2003, when Don Peterson, the CEO, must choose between four final options.
Silver Lake Partners led a syndicate that took Seagate private in 2000. Crystal Decisions was an underperforming software subsidiary of Seagate and had been an immaterial part of Seagate. Silver Lake assigned $95 million (of the $1.1 billion in equity paid for Seagate) to Crystal Decisions. Chronicles the turnaround of Crystal Decisions and the eventual harvest of the company in 2003. The Silver Lake syndicate must consider whether to sell the company to Business Objects or pursue an IPO.
Blackwell Consulting Services is the largest minority-owned IT consulting firm in the Midwest. Describes the growth of the firm and focuses on the issues of how the protagonist should handle the issue of succession and a difficult partnership separation with his minority owners.
This teaching note instructs on three major methods to value entrepreneurial companies and uses an example to illustrate each method. The three methods are Balance Sheet Valuations, Income Statement Valuations, and Discounted Cash Flow. For each of the three, the note explains the mechanics and highlights common problems with its use. Then, the note discusses when it is best to use each of the methods. Finally, the note discusses some other considerations, including the difference between financial and strategic buyers, the use of industry-specific operating metrics, and some other ways people value start-ups, including using comparables and required rates of return.
This case tells the story of McAfee Associates, which was the leader in anti-virus software. The case gives extensive background on John McAfee, the founder, as well as the anti-virus software industry as it emerged in the late 1980's and early 1990's. John McAfee realized the potential opportunity in protecting computers from viruses and created a small software package that would help solve the problem. He distributed the product primarily by shareware, giving the product out for free to individuals. However, corporate customers were required to pay for the software. With this, McAfee Associates grew to be a $5 million revenue business with 90% operating margin, and had strong prospects for continued rapid growth. John was approached by the CEO of Symantec, which wanted to purchase McAfee, with an attractive acquisition offer. At about the same time, he was approached by two VC firms, which wanted to invest $10 million for 50% of the business. Now, he had to decide which of the financial offers, if any, to take.