The document discusses issues facing Health Care Office Solutions, Inc. (HCOS) including a slowdown in growth, complaints about service quality, and a damaged reputation. It analyzes HCOS's strengths, weaknesses, opportunities, and threats. Four alternative courses of action are presented: 1) focus on customer advocacy to build trust and commitment, 2) use pre-emptive sponsorship of events to shape buyer attitudes, 3) employ viral marketing and blogging, or 4) rely on traditional advertising. The recommendation is that customer advocacy as the top priority to improve customer relationships and marketing context.