Dr. Alexander Thomas, CEO, Bangalore Baptist Hospital invited one of the case writers to his hospital to develop a case study. " By God's grace our hospital has grown from an 80 bed secondary care centre to a multi super specialty hospital over the years. We have been awarded the "Excellence in Teaching" by the National Board. Our mission is to care for the marginalized and to this end we reach out to those in need through outreach programs such as palliative care, community health, as well as address vulnerable groups like HIV/AIDS, mental health, and geriatric care. In response to the critical need for palliative care services in the city of Bangalore, the Palliative Care Division was started in January 1995 in partnership with the Wake Forest University Baptist Medical Center, North Carolina, USA." Dr. Ravi Livingston who heads the Palliative care unit and his team are a devoted, passionate, committed and self-reflective group. Dr. Ravi is planning to re-locate, to be with his family. After considerable discussions, the BBH management has moved its palliative care unit to the community health division, headed by Dr. Gift Norman. The Community Health department is doing excellent work and impacting the communities. Though much thought went into this decision, Dr. Alex wanted to analyze the implications of this organizational change.