The establishment has a civilian physician and three physician assistants (PAs). However, since the implementation of this strategy, Kenner has lost service providers and has not been able to replace them. Due to staff shortages, many employees are coping by breaking protocol and refusing to do their jobs. Furthermore, since the clinic cannot function without a doctor and the doctor is aware of this, she manipulates the system to achieve her ends or threatens to leave. As can be seen, adopting such a strategy does not add any value to the process, but it harms the process of care and patient satisfaction. Unfortunately, the clinic is in disarray and the quality of care is