* Reduce your menu to simple, accessible dishes with a restaurant "specialty".
* Reduce price.
* Source fresh ingredients.
* Redecorate.
What annoys me most about the show (even the BBC version) is that personnel changes never seem to be on the docket --- you have people that clearly shouldn't running a kitchen, and at the end of the episode there they are, plating Ramsay's sauteed skate wing.
I think you fail to consider that the places he goes into are usually owned by a family or a clueless person. He can't go in and say "well, honestly since you asked to be on my show, it's clear that YOU are the problem. You'd be better off if you just closed."
More importantly, the fact that Ramsay is willing to yell and bare his chest for the camera does not change the fact that he does not seem willing to stick to his guns and demand that they fire the old guy in the kitchen and hire a talented Ecuadorian to take his place.