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The fact that michelle's signature is required on all documents and her word is the last word on all decisions relating to her unit, suggests that

The fact that michelle's signature is required on all documents and her word is the last word on all decisions relating to her unit, suggests that
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The fact that michelle's signature is required on all documents and her word is the last word on all decisions relating to her unit, suggests that

User Lingfeng Xiong
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The hospital has a centralized structure
User MatthieuW
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