1. Presented By:Sonia
Kuldeep
Pardeep
PGDM 2nd (Satyug
Darshan Tech.
Campus)

2. Contents
Shouldice insight
Introduction
2

3. Administrative Information
• Corporate Name: Shouldice Hospital Limited
• Established: 1945
• Location: 7750 Bayview Avenue, Thornhill Ontario,
Canada, L3T 4A3
• Telephone: (905)889-1125
• Fax: (905)889-4216
• Toll Free: 1-800-291-7750
• Specialty: Abdominal Wall Hernia Repairs

4. Insight Shouldice

5. History
Dr. Edward Earle Shouldice graduated from the
University of Toronto in 1916.
During World War II, he was called to serve on the
Medical Examining Board.
Dr. Shouldice, a major in the army, found that
many young men willing to serve their country had
to be denied enlistment. These men needed surgical
treatment to repair their hernias before they could
be pronounced physically fit for military training.
5

6. Unique Appointment Procedure
Patients living within 100 km (60 miles) from the hospital
should come to the office for a personal examination.
Examination Hours are:
Monday to Friday :
WALK IN CLINIC, NO APPOINTMENT NECESSARY
from 9:30 am to 3:30 pm
Saturday :
BY APPOINTMENT ONLY from 10:00 am to 2:00 pm

7. Unique Appointment Procedure
For patients living at a greater distance who wish to arrange an
examination, admission and operation all in one visit, please complete
Questionnaires 1 and 2 by taking the following steps:
Step 1.
Click on Medical Information , and print the questionnaire on your
printer.
Step 2.
Return to the Booking for Surgery page, click on Insurance
Information, and print it on your printer.
Step 3.
Complete all documents as required and forward by fax (905-8894216) or regular mail to our office
Upon receipt of your completed documents, a surgeon will review
the information, and office will make the necessary arrangements
to schedule you for surgery.

8. Unique Operating Method
There is no use of foreign bodies such as synthetic screens or
meshes, except in extremely rare cases where there has been
destruction of the tissue usually due to previous surgery.
The vast majority of our (their) hernia repairs are done with a
sedative (sleeping pill), analgesic (pain relief pill) and local
anesthesia. If necessary, additional medication is administered.
The youngest patient to date was a child of 4 months, while the
oldest was a man of 100 years.

9. Shouldice Business Process
If not OK…
Day 1
30/36
Arrivals
1–3 pm
Check by
MD
(15 mins)
If OK:
Check-in &
admin
Surgery
(40 mins)
Rest in room
(2-3hrs)
Blood
test
Explain
process
steps
Dinner
at 6 pm
Tea &
cookies
at 9 pm
Day 2
Local
anaesthesia
(-20mins)
Start
eating &
moving
Dinner
at 6 pm
Tea &
cookies
at 9 pm
Dinner
at 6 pm
Tea &
cookies
at 9 pm
Day 3
Loosen
stitches
Walk, play, & eat with
your buddies
Day 4: Remove stitches, walk, play, eat, check out 

10. Service Concept
What does Shouldice hospital offer to its customers?
The hernia surgery (the Shouldice method)
Peace of mind/low risk/Low Recurrence
Independence/Dignity/Control
Social experience, fraternity
Excused absence from work without guilt

11. Facility at Hospital
Two facilities at one building
oHospital
oClinic
Facility divided
Level-1
Kitchen and
Dining room
Level-2
Lounge
area,Addmission
office, Patient room
Level-3
Additional patient
room and
Recreational room

12. 7P’s of Service Marketing
PRODUCT
PRODUCT
PRICE
PRICE
PLACE
PLACE
PROMOTION
PROMOTION
PHYSICAL EVIDENCE
PHYSICAL EVIDENCE
PEOPLE
PEOPLE
PROCESS
PROCESS

13. Continued…..
Physical evidence -A relaxing, resort-like setting
Process- A unique program of care and recovery
Promotion
– A lifetime of care and support by mutual
relationship and follow up.
A total environment- a total environment of comprehensive,
compassionate and supportive patient care – is the reason that
we continue to be the world’s leading centre of excellence in
hernia repair.(World of mouth)

14. Continued….
People – Very satisfied employees long waiting lines for joining hospital as
well as satisfied employees by giving bonus other than their fixed salaries
Price – Less price than their competitor with best service support which offering
same at high cost (954$ vs. 2000-4000$)
Product – Providing service related to Hernia
Place –Green and calm place outside from main city

15. Price Comparison
Costs of typical operations
Transportation
$954
$200-600
$2000-4000
$0
Time Lost from work in Hospital
4
days
5
days
Time lost from work while
recovering
5
days
10
days
Value of time lost
(ranging from $50 to 500 per day)
Total before Allowance
for recurrence
Probability of Recurrence
Expected Cost of Recurrence
Total cost to patient, employee
and insurer
$450-4500
$750-7500
$1604-6054
0.80%
$13-48
$2750-11500
10.00%
$275-1150
$1,617-6,102
$3,025-12,650

16. Profit
Hospital:
Revenues
(4 days X $111/day x 6,850 patients/year)
( in $ )
3,041,400
Cost
2,800,000
Profit:
Clinic:
Revenues (($450+ 60 + 75 X 0.20) X6,850) 3,596,250
Cost
241,400
2,000,000
Profit
1,596,250
Total Profit
1,837,650

17. How did they do that
Patients are carefully screened
Patients are active participants in the service delivery process
The avoidance of general anesthestics allows a wide range of involvement of patients
Staff is freed from much disagreeable work
Reducing the cost of nursing, housekeeping and laundry
Structure hospital jobs that involves more counseling and positive interaction with the
patients.
Highly focused factory
Highly productive surgeon:
300 hernia/yr Vs. 30 by less focused surgeon
High compensation ($50,000 + $40,000)
Opportunities for surgeons to observe and advise one another
Peer group pressure that leads to higher level of self-control of quality
A conscious effort is made to make Shouldice a “family "experience.

18. USP of Shouldice
“There is No Substitute for Experience”
Shouldice Hospital has been dedicated to the repair of hernias for
over 55 years. The trained team of Shouldice Hospital surgeons have
repaired more than 300,000 hernias with a greater than 99% success rate.
Surgeons at Shouldice Hospital have a virtual 100% success rate performing
primary inguinal indirect hernia repairs. Shouldice Hospital has offered its
Medical Guarantee for more than 55 years. Shouldice’s strategic service
concept

19. Marketing Strategy of Shouldice
The three important aspects of services marketing triangle are
the employees, customers and the company itself.
Shouldice keeps its staff happy through profit sharing policy,
wherein the employees are paid a part of the profit in addition
to their fixed salaries.
Company
This sharing is done based on their contribution towards the
success of the firm. This encourages them to work hard and
put in more efforts. From the management point of view, they
have given their staff a lesser working load and weekends off.
External
marketing
This enables people to spend time with their family and this in
term keeps them contented and in the long run reduces the
attrition rate
Internal
This is internal marketing for the company.
marketing
Employee
Interactive
marketing
Customer

20. Problem
Increase Capacity
Shouldice is operating at its “best operating level” for a service company
with limited flexibility in its plant, a specialized work force but are failing to
meet all the demand for its chosen market niche. Adding additional
capacity to meet the unmet market need may upset the existing work
force and lower service quality. Failing to meet the market demand may
invite competition that could eventually cause Shouldice to loss market
share and end up with excess capacity.

21. Problem Justification
There is limited operating facts presented in the case so assumptions
have made based on the information that was presented.
It is assumed that they are operating at the “best operating level”
because the way the case describes how efficiently the hospital is ran and
how the patients appear to be pleased with there treatment
There is limited operating facts presented in the case so assumptions
have made based on the information that was presented.
It is assumed that they are operating at the “best operating level”
because the way the case describes how efficiently the hospital is ran
and how the patients appear to be pleased with there treatment

22. Alternatives
Add Saturday operations
Add a new floor
Establish a new facility for hernia
Expand to other types of operations

23. Alternatives Evaluation
Schedule Saturday as an Operating Day
Advantages
No investment is needed
Can still maintain quality
Disadvantages
Require to schedule 23-25 operations on Saturday
Six surgeons and a supervising surgeon have to work on
Saturdays
Additional other personnel
Violates the implied contract that Shouldice has with its
surgeons, strong opposition by the senior doctors

24. Alternatives Evaluation
Add a new floor
Total Number of Rooms: 89 +45= 134
Advantages
Easy to control and maintain quality
Retain the culture and environment
Disadvantages
Require to schedule doctors to the full capacity of five days per
week
Increase work load on admissions, kitchen, laundry,
housekeeping and accounting
Further staggering of meal hours for patients (100 seat dinning
room)
Disruption during construction

25. Alternatives Evaluation
Establish a new facility for hernia
Advantages
New location close to the customers, say USA
Improve its competitive position and increase its profits
Operate in a less restrictive environment
New Opportunities for existing personnel
Transfer of knowledge and expertise to the new facilities
Disadvantages
Requires a significant investment.
Control of quality
It is difficult to create the same culture and atmosphere
Potential competition with the existing facility

26. Alternatives Suggested
Add Saturday operations
No fresh investment required.
Can maintain quality.
New surgeons not required