In 2019, the clinical director of the South East Grey Community Health Centre was conflicted about whether to proceed with presenting the chief executive officer with a proposal to expand the health centre's primary services to a satellite location in the neighbouring community of Port Elgin. The clinical director recalled the challenges she and her colleagues had faced in 2018, during the satellite expansion to Dundalk. As a nurse practitioner, she understood the pressing need for services and the moral imperative to put the patient's needs first. However, as a key member of the Centre's management team, she also knew what this proposal would entail operationally, and what internal pressures and risks were involved. The clinical director wondered how, in an environment of static or declining budgets, the Centre could build on its successes and challenges to date to address the emerging demand for further growth. Should she present the proposal to expand to another neighbouring community during a time of fiscal constraints?
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