addresses fiduciary concerns with nominal impact.

Discussion in 'English Only' started by sirmus, Jan 26, 2013.

  1. sirmus

    sirmus Member

    I'm trying to translate a sentence but I can't even begin to understand what it means. I can't even get the syntaxe properly. So I know I'm asking too much but could you please, please simplify this for me?

    I'm giving you the context, but the part that I don't understand is emphasized in bold:

    "However, there will have to be some cuts. And I'm going to suggest one that is going to seem surprising at first, but that addresses fiduciary concerns with nominal impact on the core facility and the human and physical resources. I am proposing that we close your E.R."

    I'd appreciate any help. Thank you.
  2. boozer Senior Member

    I think there are some fiduciaries (what does this company do?), something like trustees, who are concerned over the financial situation of the company. Then those trustees' concerns will be addressed by effecting those cuts. At the same time, the cuts will have next to none (nominal) effect on the 'core facility' (I presume this is the main production plant) of the company; they will have nominal effect also on the human and physical resources.

    All in all, I think the context is somewhat insufficient...
  3. sirmus

    sirmus Member

    We are talking about a hospital and these are the words of a physician advisor. She says, in order to keep the hospital running, they need to close the Emergency Room which doesn't bring in the money.

    So, for example, what could it be the "core facility"? And by "that" does she mean the "cut"?
  4. boozer Senior Member

    Then 'core facility' is probably the rest of the hospital excluding the Emergency Room, i.e. the hospital itself in its part dealing with planned (as opposed to emergency) treatment - all the other wards. See, I do not know much about the typical structure of hospitals. I believe 'that' refers back to 'one' and 'one' refers back to one of those 'cuts'.
  5. gramman

    gramman Senior Member

    Hi sirmus

    This is a fairly complex sentence, and I can understand that it could be difficult to translate. But if I've got my grammar right, there's a simple underlying structure. There's the main clause:

    >>And I'm going to suggest one

    and there are two relative clauses:

    >>that is going to seem surprising at first
    >>that addresses fiduciary concerns …

    A relative pronoun (like that, which, or who) is being used to introduce each of these clauses. The second that is doing just what the first one is: allowing the speaker to offer a description of this particular action (cutting the budget by closing the ER).

    The use of relative pronouns in English may be difficult; I can't say because I don't know how they're used in other languages. It sure looks like they're used a lot. I used them a lot in this post.

    Here's a resource that may be useful to you: relative clauses from the British Council's English Grammar section.

    I agree with boozer that the information provided in you original post was insufficient. We need to now that it's the second that that's confusing you.
  6. gramman

    gramman Senior Member

    Hey again

    The information I provided is stuff I'm sure you already understand. I suppose the language in a physician advisor's formal presentation is at times complex.
  7. Parla Senior Member

    New York City
    English - US
    Most of that was evident from your initial quote (though not the fact that it was a physician speaking; actually, I assumed it was a financial adviser). She's saying that closing the ER will satisfy the concerns of those who are responsible for overseeing the hospital's financial stability, and the action won't seriously affect the hospital as an inpatient facility (taking care of people who have to spend time in the hospital) and its equipment and staff.

    An ER is chiefly an outpatient facility, treating people and sending them on their way. (I don't know the statistics, but I imagine that only a small percentage are held as inpatients.)
  8. gramman

    gramman Senior Member

    On a narrow point, physician advisor seems to be a specific job title, although I don't know if that's how sirmus used it, and certainly someone in that role could also be a doctor. I'm guessing the reference here is to someone in a senior position rather a case reviewer. Both areas are listed in this document describing the work from BHM Healthcare Solutions. a healthcare management consulting firm. So I would further speculate that this person is indeed a financial and management advisor more than someone focused more narrowly on medical care.

    In regard to Parla's second point, as I'm sure you know, emergency rooms are very expensive to operate, and so a large savings can be realized by closing one. On the other hand, the cost to the community in terms of essential healthcare services could also be large. In that light, words and phrases like "surprising," "fiduciary concerns," "nominal impact," and "core facility" may be a budget-cutter's way of describing the potential closing of the ER as one that needs to be considered, while guiding the audience away from adjectives like shocking or unacceptable and terms like "quality and access of healthcare to the community."

    I realize this is all probably off-topic, but this sentence reminds me of a phrase like "acceptable losses" in combat, focused on unit morale and cohesion. I have to wonder if the total social cost incurred through a denial of life-saving medical care is properly represented in these calculations.

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