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Reflection Paper:
RAT Applied to the Oral Health Care Industry: Marketing Services and Resource Advantage Theory
Odontologίa
Graduate Histology Lab Report: Identification of Unknown Tissue Samples
By Stephanie Lomeli Graduate Student in Interdisciplinary Studies
Texas Tech University Lubbock, Texas
Cell: (832) 443-3573 Email: [email protected]
May 2012
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Acknowledgement: I would like to acknowledge Dr. Brian Reilly and Dr. Jorge Zamora who supported and inspired me over the past few years. These two professors stood by me, even during times when I was over whelmed with school and distracted with my Pre-Dental Society officer obligations, stressing about dental school or when I would come down with a severe case of Bronchitis. I would also like to thank Dr. Arnett, Dennis who took the time to step in to review my Masters Portfolio.
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Table of Contents
Title page…………………………………………………………………………………………1
Acknowledgements………………………………………………………………………….….2
Table of Contents……………………………………………………………………………….3
Reflection Paper…………………………………………………………………………………4
Odontologίa…………………………………………………………………………………….19
Resource Advantage Theory Applied to the Oral Health Care Industry: Marketing Services and RAT……………………………………………………………………………..31
Graduate Histology Lab Report: Identification of Unknown Tissue Samples…………...66
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It was a beautiful July summer day in Farmington Connecticut, but despite the
warm sun and the cool breeze outside, I found myself stressed, exhausted, and sleep
deprived inside a conference room face to face with 12 other prospective dental
students in a similar state of mind, who lined both sides of a long rectangular table. At
the head of the table sat Dr. Edward A. Thibodeau Associate Dean of Admissions for
the University of Connecticut School of Dental Medicine. As he sat there arms folded to
his chest speaking in a stern matter of fact way he proceeded to enlighten the students
of the sobering reality of our chances of getting into dental school. As he splits the table
in half, he states half of us present would gain entry to dental school, while the other
half won’t. As he said this you could see reality hit in each and every person. The fact is
that on average 11,000 students will apply to a limited number of spots with only 5,000
lucky students able to pursue their dream career in any given applications cycle. For
many students in the room they were hearing this for the first time. As the mood
changed from one of nervous excitement to fearful depression I, on the other hand, felt
a sigh of relief that I was not hearing this information for the first time. Although I felt a
rush of relief, due to the experience gained during my masters’ studies, I knew I had
come a long way. In fact, two years before this somber day I had visited Baylor College
of Dentistry where I had learned about these critically important dental application
statistics. It was at this visit that I came to the realization that I was so close but yet still
so far from accomplishing my career goals. It was this realization that inspired me to
pursue my masters.
Every year students spend hundreds to even thousands of dollars applying to
dental school only to receive disappointing news. I always knew I never wanted to be in
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that devastating predicament. When it was time to apply I wanted to be 100% ready and
confident that I would gain admission to the dental school of my choice. As I write this
reflection paper, at the end of my masters’ studies, I am proud to say that I
accomplished my goal by gaining entry into several dental schools. I am confident that
my Masters in Interdisciplinary Studies allowed me to develop into a better dental
school candidate, enabling me to score in the 97% tile on the DAT when previously I
had failed to even receive a passing score.
In 2008, I found myself studying for the DAT for the first time. At the time I was in
my third year of my biochemistry undergraduate degree where I was taking particularly
challenging classes. It was at this time that I took a moment to really analyze my long
term and short-term goals for the future. I evaluated my strengths and weaknesses, and
identified areas for development. After careful reflection, I postponed taking the DAT,
and applications for the 2008 dental school cycle. I also made the decision to return to
the Texas Tech Center located in Seville, Spain where I had spent the previous spring
semester in Seville and had fallen in love with the language and the culture. Studying
Spanish in Seville, Spain ended up being an opportunity of a lifetime that inspired me to
pursue a dual degree in Spanish.
As the academic year wound down in the spring of 2009 and graduation grew
ever nearer, I found myself exploring my options once again. I had decided that I was
still not ready to apply to dental school. I wanted to transform my weaknesses into
strengths. It was during this time that I had been invited to tour Baylor College of
Dentistry, where I was armed with the knowledge necessary to accurately evaluate my
candidacy as a dental school applicant. Upon evaluating my academic history against
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the information I obtained at the dental school tour it became clear that there were some
gaps I need to fill based on my grades, estimated practice DAT score, and classes in
order to better position myself to accomplish my career and personal life goals.
An Ideal dental school candidate will have a thorough knowledge of the biological
sciences. During my undergraduate career I found chemistry to be almost effortless,
while struggling to understand and link many of the concepts in the biological sciences. I
knew that if I wanted to be successful in dental school and have a chance at ranking in
the top 10% of dental students then I would need to drastically develop my
understanding of the biological sciences. The desire to gain a better understanding of
the biological sciences lead me to take classes such as Microbiology, Immunology,
Pathogenic Microbiology, Virology and Histology. Histology proved to be a particularly
important area of knowledge to obtain, a fact I realized during multiple meet and greets
with dental students. Through these interactions I learned that one of the most
challenging biological sciences that dental students take in their first two years is
Histology. A class that leaves many 3rd and 4th year dental students stating that they
regretted not taking this class as an undergraduate, especially due to the sheer mass of
specific information the students are exposed to in such a short duration.
After the dental school tour, I became the secretary of the Pre-Dental Society.
During my recruitment and retention efforts I meet with several dentists, and sought
their advice. After speaking with many dentists it was clear that there was a common
trend in the advice they gave finding the main take home message being that if you
want to have a successful dental practice then it is imperative that you gain a basic
understanding of business and learn Spanish. Probably one of the most common advice
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dentists would stress was the importance of taking business classes. I had heard
multiple dentists state that you can be the best dentist but your practice will fail if you
are not business smart. This because, once you complete your Doctorate of Dental
Surgery and enter the real world your focus shifts from the sciences to running a
business. These interactions lead to my decision become educated with a basic
business foundation in order to secure my future personal career goals after dental
school. It was this strong desire to have my own successful practice that inspired me to
take Marketing Tools and Concepts, an introductory Marketing class followed by
Marketing Services, as dentistry is a service based business. I choose to take Personal
Financial Planning to gain a basic understanding in finance that would assist me in
reaching my goals. The Negotiations and Conflict Management class helped develop
my interpersonal and negotiation skills. These skills will give me the competitive
advantage necessary to accomplish the superior financial performance I desire in the
future.
Any health care provider will stress the importance of being proficient in multiple
languages. For those who aspire to practice in Texas, especially the southwest, it is
highly beneficial to speak Spanish. My desire to maintain and further develop the
language That I began learning during my last two years of my undergraduate studies
inspired me to take Business Spanish, Spanish Colonial Literature, and Medical
Spanish. Throughout my maters studies I found my Spanish classes were heavily
interrelated with the other two areas of discipline I was studying.
Project Assessment
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Having heard many excellent peer reviews about Business Spanish, I was eager
to take this class. I was deeply intrigued with the class and its interactive nature. When I
sought out Dr. Zamora concerning the class, he was very enthusiastic and immediately
had an idea for a graduate project. His eagerness was contagious, and I was
immediately captivated by the class and the graduate project he assigned to me. During
our initial conversation Dr. Zamora inquired as to what my career goals were. I
explained to him my passion for dentistry, the purpose behind my masters, and what I
hoped to achieve in the future. He understood that I had a fascination with orthodontics
and most importantly that I one day aspired to have my own practice. I had explained to
him how ambitious I was and he felt strongly that in order to execute a successful
practice in the southwest that Spanish would play a key role in gaining the competitive
advantage over fellow practitioners. Because my aspirations are to be the best he also
stressed the importance of needing to understand what goes on behind the scenes, so
he encouraged me to see how a top orthodontics office runs. He recommended top
Lubbock orthodontics practice, Smile by St. Clair. Prior to this assignment I had done
extensive shadowing and volunteering at multiple dental practices with a focus on
learning about dental techniques, but I have never shadowed and orthodontics practice.
I had also never stopped to explore and analyze how a dental practice runs or how the
office is organized. During my shadowing sessions it seemed as though the dentist’s
only focus was the patient. Dr. Zamora had pointed out that if I wanted to be successful,
I would have to understand how the practice runs in the absence of the dentist’s
attention. For his project I would need to be able to translate this understanding to the
Spanish language.
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I began my project by first conducting basic research on dentistry, orthodontics,
and the Texas Dental Association. As I conducted my research, I took note of any key
vocabulary terms that were new and then translated any relevant information I found. I
then proceeded to research the orthodontics’ office in question. I began by first googling
Smile by St. Clair where I found the practice’s web page and proceeded to study every
aspect of their website in order to learn as much as I could about the practice. My next
step in the research process was to make arrangements to observe the orthodontics
office, this was a portion of the project that proved to be a more challenging. I began by
explaining the nature of my call, providing a brief description of what the project entailed
and what I would need to observe. The receptionist who took my call informed me that
she would have to speak with the orthodontist first. With his permission she would then
call me back with a time and date that I could conduct my observation. I received a call
the next day confirming the date and time of my observation, along with directions to
report to head public relations representative Lindsey Trook. I reported to the office
eager and armed with a pen and small pocket pad to take notes of any relevant
information. Upon arriving I was initially directed to Lindsey who began by introducing
me to Dr. St. Clair, along with his staff of dental assistants. I was informed that if I
wanted to I could start and end the day on the dental floor observing the orthodontist
and his assistants Smile by St. Clair’s runs very different from other offices owing to the
fact that the dental floor was organized quite differently. Rather than having individual
cubicles the floor was organized with a circular arrangement that was open and free
flowing.
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Before and after lunch they did new patient screenings which were confidential.
This time provided an excellent opportunity for me to meet back up with PR Rep
Lindsey for an in depth explanation on how the practice is run as well as a chance for
me to ask any question. I immediately realized that Dr. St. Clair was not exaggerating
about the different manner in which his office ran. It was amazing how efficient and
effective the floor ran. Not a moment was wasted, with every action executed with
purpose. I highly value efficiency and effectiveness and in viewing how smoothly every
aspect of the office ran, I found myself in awe, knowing that I would one day aspire to
have an office that ran in a similar manner.
When my time on the orthodontics floor ended, I met back up with Lindsey, and
she began explaining certain key background elements that facilitated in the smooth
operation of the orthodontics office. She explained Dr. St. Clair’s daily schedule, as well
as his weekly schedule, with special attention to his weekly lunch meetings with local
dentists and the bi-weekly closing of the office on Tuesday afternoons in order for a
special consultant to come in for staff development. As she spoke, I began to
understand why Dr. St. Clair was so successful, with his attention to relationships and
his drive to constantly improve. She also explained that Dr. St. Clair went out of his way
to make the patients feel that they were active participants in the service experience.
Some of the ways he executed this was by allowing patients to check themselves in via
thumb print identification, rewarding them for clean teeth and being early, as well as
describing many other forms of participation. Before leaving for the day, Lindsey
showed me around the front desk area where she explained to me what each
administrative representative’s specific job entailed. Because administrators each had a
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specific job assignment, they were experts, thus allowing the business side to run more
efficiently and effectively.
After my observation, I created a detailed outline for my paper and presentation
incorporating as much as possible of what I had seen. From here I began to focus on
translating the new terms and then creating a Spanish PPT presentation and paper to
accompany it. This part of the project proved to be the most challenging, having to go
through several drafts, which required a significant amount of editing. I personally found
the editing part to also be extremely educational since I strongly believe you learn a
great deal from your mistakes.
The last part of the project focused on the presentation. I spent a significant
amount of time focusing on how to properly pronounce the new terminology I had
learned during this project. As I reflect back on the experience I gained from this project
it is clear that this exposure gave me an excellent foundation for my Marketing class.
During the fall semester of 2010 I took Marketing Tools and Concepts, a class
that came highly recommended by many students. After missing a test in order to
present at a national science conference in Anaheim, California through the Society for
the Advancement of Chicanos and Native Americas in Science (SACNAS), I was given
the task of writing an extensive paper over the Resource Advantage Theory (RAT)
applied to any industry of my choice. Rather than viewing this paper as a chore, I saw it
as a great opportunity to gain a deeper understanding of the various business aspects
of dentistry. Although I observed how a practice ran the previous semester I knew that
certain aspects were important but didn’t understand the significance of each of the
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elements that I’d identified and how they contributed to the practice’s success until I
analyzed them in the context of the RAT. The concepts I learned in class literally gave
me the tools and knowledge to understand what needed to be done and why in order to
be a successful business, while writing this paper allowed me to link these concepts to
real world examples. The basic foundation I received in marketing and previous multiple
exposures to different dentist offices allowed me to identify how small differences in the
way a practice is run can have a major impact on the overall success of the practice.
Using Dr. St. Clair’s business as a foundation I also observed several other offices to
make a comparison against. The knowledge gained in this class combined with the
concept of the RAT, proved to be very important in understanding how specific
elements of a business can have a significant impact on the overall performance of the
office.
I had always approached the class with the intent on learning how to create a
better dental practice once I had gained the necessary experience. After I was given
this assignment I realized my outlook of the entire class changed. Because of its
significance due to its interdisciplinary nature, I knew instantly that I wanted to apply the
RAT to the oral health care industry. I received the assignment for the paper in October,
but at this point in the class I still didn’t have enough background knowledge to start
relating the RAT to dentistry. My initial research began with me going back over the
RAT content already covered in class as well as reviewing a journal article over the RAT
by Dr. Shelby Hunt. At this point I gathered a collection of notes related to the topic that
would be useful.
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Once I felt more comfortable with my understanding of the RAT, I began relating
every aspect of the knowledge gained to how it would affect a dental practice, reflecting
on my past exposure to multiple practices. I began to notice small details which before
seemed insignificant. It was these small details that determined the success of the
practice, the targeted market segment, and the market offerings presented to them.
As the semester progressed my main focus was the accumulation of information.
I kept a notebook were I would transfer any content I found either through my research,
lecture, or in the textbook. Initially the notebook started as the location of paraphrased
research and quotes that I found interesting and possibly relevant. In the beginning of
my research I choose not to limit myself by any specific topic or purpose other than the
broad ones assigned to me (the RAT and oral health care). I chose to execute my
research in this manner because it allowed me to look at the big picture of obtaining
information relevant to my future career, rather than having blinders on so to speak.
Since Professor Hunt was the initial visionary of the RAT I knew that his book, A
General Theory of Competition: Resources, Competences, Productivity, Economic
Growth, and journal articles he wrote and co-authored would be my most valuable
resources. I found his book to be a particularly critical element, as it explained the nine
premises behind the RAT in exhaustive detail. I read though the book twice, once upon
the start of my research and then again prior to beginning my first draft when I’d
completed my research. The first time I read through the book, it was with the purpose
to develop a better understanding of the RAT, giving me a foundation to build upon.
After I had a basic understanding of the RAT I was then able to cast a wider net with the
material I included in my research, finding journal articles that summed up the RAT or
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that focused on a specific concept involved in the theory. This allowed me to fill in the
gap in my understanding of the RAT and marketing in general. Having developed my
understanding I reread Hunt’s book prior to writing my paper. Rereading it helped me
notice the small details I missed the first time. Those small details ended up being
essential element that allowed me to understand Dr. Hunt’s deeper purpose.
After I had conducted a sufficient amount of research and felt more confident with
the direction I wanted to go in, I created an outline of how I wanted to write and organize
the paper. From here I was able to easily organize all the notes I had accumulated. I
also did a round of shadowing rotations to several different dentist offices in order to
obtain more examples of how the RAT applied. Now that I had a better understanding of
the theory I was able to better identify the small differences between dental offices that
set each apart from the other. From here it was simply linking ideas into a cohesive and
informative paper. The research conducted during the project took months to learn and
understand, as well as weeks to link into a cohesive manner. The knowledge I gained
here is invaluable as it was content I wouldn’t have been exposed to in such depth had I
not pursued my masters. I am confident that, armed with this knowledge I will be able to
better lay out what direction my future career will take.
My masters studies also allowed me to gain deeper knowledge of other areas of
study. One of the biological sciences that often plague dental students is histology. Over
the past few years I have visited multiple dental schools for tours as well as interviews.
At each of these tours we had the opportunity to meet with dental students and question
them during the panel discussion. One of my favorite questions to ask was a variation of
the following: “What is the hardest biological science in dental school?” or “what
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classes do you wish you would have taken that would have better prepared you for
dental school?” Without fail at every discussion with dental students, at least one
student would mention Histology. It is for this reason that I chose to take Histology. As I
write this paper reflecting back on my experience, I am so very thankful I listened to
their answers. This class ended up changing my whole perspective of the biological
science. This was definitely a class I found to be extremely rich in content. Although we
were going through subject matter I had been exposed to before, I had never seen it in
such depth and specificity. Since I would need to be able to identify the tissue samples
taken from various murine organs, based on their Histological characteristics in order to
complete my graduate histology final project I would need to develop a high
competency at preparing, mounting and staining unknown samples.
We were informed about the details of the project from the start of class, but did
not begin until late October. At the start of the project we were able to see how large
precut samples taken from various murine organs were first dehydrated and then
embedded with paraffin over the course of several hours using the fully automated
Tissue TRK II histological tissue processor. From here our lab TA stored the samples in
fabric softener and then refrigerated them. The fabric softener, I learned, was a
histology trick used to allow for better sectioning by softening up the hardened paraffin.
The sectioning and identification of the tissue samples proved to be the most
challenging. I began sectioning my tissue samples right away learning immediately that
this part of this project had its limitations. Since the paraffin would become rock hard,
we had to soak it in fabric softener, but it quickly became clear that only the portion of
the paraffin that was in direct contact would become soft. Therefore on any given day I
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was only able to a small sample from each tissue, then have to replace the sample in
fabric softener for at least a day. Another challenge I encountered in the beginning was
getting the hang of the microtome, which produces sections in the form of a ribbon, that
are then mounted on glass slides. Unfortunately the sectioning process did not run this
ideally at first, rather than nice flat ribbons, I was producing shredded crinkled strips, but
with much practice I finally got the hang of sectioning. As the class and lab progressed
throughout the semester I worked diligently to understand what each tissue presented
looked like, focusing on form meets function It was this new focus that allowed me to
understand the reason why each tissue looked the way it did and how its appearance
contributed to its specific action. In focusing on form meets function, I was able to learn
how to understand why each tissue preformed its action, and how this impacted the
organ as a whole, which then impacted the digestive system or reproductive system for
example. This approach to learning the biological sciences was different from simply
memorizing facts. When it came time to identify my samples, I had to search for several
of my best slides from each sample and then take photos using a microphotograph. I
initially examined each specimen in detail making note of any identifying characteristics
that were present. I started by making an educated guess of what I thought each
specimen was and then proceeded to confirm my suspicions using my lab manual,
textbook, and known tissue slides that were used in lab. I found that reexamining the
known tissue slides from lab proved to be the most useful source in making a
comparison against my unknown tissue samples. In order to make the proper
identification, it took a certain eye for detail an important trait for dental school. I chose
to spend a great deal of time confirming my predictions so that I was positive of the
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outcome. In most cases I ended up finding a known specimen slide that looked exactly
as the unknown I sought to identify.
Histology proved to be a very valuable class allowing me to gain an
understanding of the concept “where form meets function”, a statement later repeated
by Dr. Ravindra Nanda, B.D.S, M.D.S., Ph.D., Professor and Head, Department of
Craniofacial Sciences Chair, Division of Orthodontics at University of Connecticut
School of Dental Medicine, who explained to me how Fundamental this idea is in
dentistry. Dr. Nanda pointed out that dentistry is at the intersection where art meets
science, stressing the importance of not only developing an eye for detail, but knowing
what to do with these details. Histology exposed me to the specific images I would need
to recognize, as well as the understanding of why each specific characteristic
contributed to tissue function. While the class gave me the knowledge, it was my
graduate project that allowed me to gain valuable experience in tissue identification.
This experience enabled me to dominate the biological sciences section of the Dental
Admissions Test. When my fellow Kaplan Test Prep peers would ask me how I
memorized the details behind all the systems of the body so fast, I would tell them that I
didn’t need to memorize since I’d learned to understand the specifics in Histology, which
made remembering the basic biology facts easy. This experience will allow me to excel
in dental school when other students will struggle.
I started my masters in interdisciplinary studies for very specific reasons. I
studied the biological sciences with the goal of become a better dental school
candidate, as well as increasing the probability of my success in dental school. In order
to increase my chances of becoming a successful private practice owner I chose to
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study business with a focus on marketing. The ability to speak Spanish and obtain a
wider segment of the market inspired me to continue my education in Spanish. With that
said I feel very strongly that I have been able to accomplish my goals. I write this
conclusion a future dentist in dental school, who has developed her vocabulary and also
had a very detailed plan for the future. Plans that would not have been realized had I
not taken the risk of delaying applying to dental school and pursuing my masters.
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Odontologia By Stephanie Lomeli
Jorge Zamora
Advance Business Spanish
SPAN 5304
Spring 2010
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La odontología es un tipo de medicina que lidia con el estudio y práctico de
diagnósticos, prevención y tratamiento de enfermedades bucales. El cuidado dental
regular es necesario para una gozar de una salud completa. Las investigaciones
demuestran que la primera cosa que otros toman en cuenta es nuestras sonrisa sana y
hermosa. En realidad una sonrisa es un rasgo prominente que sirve de “tarjeta de
presentación”. Los dientes torcidos son el resultado de una incorrecta alineación de los
mismos, causada a menudo por presión de la lengua o la configuración muscular de la
región. Por su parte, la ortodoncia tiene como tarea la supervisión del correcto
crecimiento y desarrollo de los dientes para lograr una sonrisa sana y hermosa. Los
materiales y las técnicas que eran sólo sueños hace años. Los avances permiten una
revolución en la experiencia dental. La tecnología ha cambiado la manera en la que
llevamos los aparatos de corrección dental y la imagen que tenemos de nosotros
mismos. Los pacientes necesitan menos visitas, se ha reducido el tiempo y las
molestias. Hay muchas ventajas en la especialización en este sector gracias al
constante progreso de tecnología. El salario medio que un dentista general gana al año
es casi doscientos miles dólares con un aumento de valor significativo para un
especialista como un ortodontista que puede llegar a ganar más que trescientos miles
dólares. Hay varios factores que juegan un papel en estas cifras. Las organizaciones
dentales son muy importantes y tienen un papel significativo en el desarrollo personal y
profesional. Las sociedades de futuros dentistas son fundamentales para el éxito de un
estudiante universitario y para facilitar la transición del ámbito universitario al
profesional. La Asociación de Dentistas en Texas integra a los doctores en una
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comunidad profesional y les da recursos fundamentales para realizar trabajo con total
profesionalismo.
En Lubbock hay una clínica de odontología que demostró una ética de negocios
ejemplar, se llama “Smile by St. Clair”. Esta clínica de ortodoncia se dedica a proveer
un servicio con calidad excelente y habilidades técnicas. Algo de lo que el Dr. John St.
Clair y el Dr. James St. Clair se enorgullecen es el hecho de que tiene la tecnología
más avanzada del mercado. Los Doctores tienen dos clínicas con su oficina principal
en Lubbock. Esta clínica celebra treinta años de excelente servicio en ortodoncia.
Cuando la clínica de Lubbock empezó había sólo cuatro empleados, durante los años
esta empresa ha crecido a treinta empleados con una facturación de ciento cincuenta
pacientes al día. Tienen una capacidad tan grande gracias a que cuentan con lo último
en tecnología de radiografía, fotografía y diagnósticos. Dicha tecnología les da la
habilidad de efectuar un reconocimiento riguroso de los dientes, los relaciones de
estructura facial y las de la mandíbula. La información que ellos reciben les ayuda al
desarrollo un plan de tratamiento personal. Después la evaluación y creación del plan
de tratamiento, uno de los doctores determina qué tipo de aplicación de los aparatos es
necesario. Los aparatos usados en esta clínica se llaman “Damon System” y es el
equipo más moderno en el área. El sistema Damon mueve los dientes utilizando
presión muy suave que trabaja con la presión natural del cuerpo. Estas fuerzas se
realizan mediante por la aplicación de un alambre creado de materiales de la NASA. La
única cualidad del alambre que contribuye al función especial continuamente
trabajando a vuélvase a forma original. Después de la aplicación de los aparatos el plan
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de tratamiento sigue con chequeo de rutina y termina con la eliminación de los aparatos
y aplicación de un retenedor detrás de los dientes.
Tecnologías de punta y habilidades de negocios son factores claves que
contribuyeron a la práctica exitosa que distingue a la clínica de St. Clair de otras
empresas de ortodoncia. Además de estos factores clave, una ética superior ayuda a la
clínica de St. Clair en manteniendo sus principios básicos y relaciones estrechas y
personales con sus clientes. Dr. John St. Clair, fundador de “Smile by St. Clair”
entendió los conceptos de negocios y la importancia de enfocarse en ciertos elementos
para producir una empresa más eficiente y personal. Cada aspecto de la empresa
“Smile by St. Clair” funciona con juntos y puede describir como una “máquina bien
afinada”. La realidad de la medicina privada en el mundo de la odontología es que el
aspecto económico es una parte primordial del mundo del dentista recién graduado. Es
muy común a escucha que unos odontólogos digan, “Un doctor puede ser el mejor y
tener más éxito odontólogo, pero su práctica fracasará si él es un mal empresario malo.
Una vez que pases por las puertas de la escuela de odontología, es importante que te
conviertas en un empresario”.
Los negocios juegan un papel importante en el mundo dentista. Un aspecto
fundamental del dentista es el “networking”, ósea las conexiones y relaciones públicas
que puede realizar. Este aspecto es una idea central para los odontólogos de St. Clair y
trabajan para levantar la empresa hacia el logro de relaciones estrechas con clientes.
Trabajan en relaciones entre doctores a través la “Texas Dental Association” y
almuerzos regulares con otros odontólogo. Esto ayuda a formar relaciones personales
entre los doctores y a facilitar referencias. Tan importante como las relaciones entre
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doctores son las relaciones con los pacientes. La Clínica St. Clair hizo diferentes
actividades que captan la atención de los clientes y pacientes: fiestas de apreciación,
preminos y pequeños incentivos para cuidarse los dientes, y concursos son varias
actividades para los pacientes. En la oficina de St.Clair hay muchos trabajadores que
tienen un trabajo muy específico y cada personal ejecuta un trabajo. Algunos ejemplos
de los trabajos son Relaciones de Pacientes, Coordinador de Tratamiento, Coordinador
de Finanzas, Coordinador de Seguro, Coordinador de cita, Coordinador de
Documentos, Relaciones Públicas. Cada puesto tiene un trabajo específico y esencial
para que el siguiente puesto o trabajo funcioner. Generalmente el paciente va a
comunicarse con el coordinador de cita y pedirá hora al dentista para una evaluación
de tratamiento. El coordinador de Tratamiento acompañará al dentista en la evaluación.
Después de evaluar, los dos hablan con la paciente sobre su plan de tratamiento
personal y discuten varias opciones de pago. Este coordinador le da una llamada de
seguimiento a cada paciente, le informa sobre cambios o mejoras y le mandará una
segunda carta de seguimiento. El coordinador de finanzas establece una cuenta
automática de retiro después cada cita. En general es muy importante ser competitivo
en la industria. La tecnología de última moda lo ayuda a ser competitivo, organizado y
un innovador. La Clínica de St. Clair ha utilizado tecnología para crear una página de
Internet que da información sobre cada aspecto de su empresa. La clínica de St. Clair
usa el mencionado sistema de Damon que es más rápido, seguro y fácil de usar. Las
instalaciones de la clínica tienen equipo de tecnología avanzado y ayudan a trabajar
mejor con cosas como registro de huella digital y todos los documentos se pueden
obtener por el ordenador. Los aparatos típicamente cuestan alrededor de 5000 dólares
24
por esta razón esta clínica tiene varias maneras para pagar sus honorarios. Se provee
con tratamiento asequible de alta calidad que te lo puede permitir.
Un odontólogo con una práctica exitosa es aquel quien entiende que cada uno
de estos aspectos es esencial para tener una clínica exitosa y lucrativa. Cada elemento
investigado es uno de los pilares de los negocios. Si se tienen buenas relaciones con
otros doctores se obtendrán referencias que son buenas para los negocios. Un equipo
administrativo ayuda a que la oficinal funcione de una manera eficaz sin supervisión del
dentista y que lo permite ver a más pacientes y pasar más tiempo con cada paciente
también. Las instalaciones con tecnología de punta producen resultados más rápidos y
más precisos en un corto tiempo que también ayuda con rotaciones de pacientes. La
Clínica de St. Clair le ofrece varias opciones a sus clientes para el pago de servicios
médicos que le da un plan personal para ajustarse a cada presupuesto. Cada punto
ayuda a hacer un negocio más fuerte y más exitoso, lo que permite obtener más
clientes y ganar más dinero
25
Spanish Presentation Outline • ¿Que es la odontología?
o un tipo de medicina que trata con el estudio y práctico de enfermedades bucales.
§ necesario para una gozar de una salud completa o la primera cosa que otros hacen caso es nuestros sonrisa sana y hermosa
• ¿Ortodoncia? o Los dientes torcidos son el resultado de una incorrecta alineación de los
mismos, causada a menudo por la presión de la lengua o la configuración muscular de la región. La ortodoncia tiene como tarea la supervisión del correcto crecimiento y desarrollo de los dientes para potenciar una sonrisa sana y hermosa
§ Los materiales y las técnicas que eran sólo sueños hace años § Los progresos permiten una revolución en la experiencia dental
• Necesitan menos visitas, se ha reducido el tiempo uso diario y las molestias
• Ventajas en la Especialización o El salario medio que un dentista general gana
§ Al año 198,354 dólares o Un aumento de valor significativo para un especialista como un ortodoncista
§ Puede llegar a ganar 304,024 dólares • Organizaciones Dentales
o Muy importantes y tienen un papel significativo en el desarrollo personal y profesional
§ Las sociedades de futuros dentistas • Facilitar la transición del ámbito universitario al profesional
§ La Asociación de Dentistas en Texas • Una comunidad profesional y les da recursos fundamentales
• Smile by St. Clair o Demostró una ética de negocios ejemplar o Se dedica a proveer un servicio con calidad excelente y habilidades técnicas o Tienen la más nueva tecnología disponible
§ Dr. John St. Clair § Dr. James St. Clair
• La Clínica de St. Clair de Lubbock o Celebra 30 años de excelente servicio en ortodoncia o Cuando empezó había sólo 4 empleados
§ ha crecido a 30 empleados con una facturación de 150 pacientes a día.
o Las rotaciones de pacientes § Evaluación de los nuevos pacientes
• Instalaciones son los últimos modelos para radiografía, fotografía y diagnósticos
26
• La habilidad de desempeñar un reconocimiento riguroso de sus dientes, relaciones de estructura facial y de la mandíbula
• Desarrollo un plan de tratamiento personal § La aplicación de los aparatos
• El sistema Damon o El equipo disponible más moderno o Mueve los dientes utilizando presión muy suave que
trabaja con la presión natural del cuerpo o Presión a través de la aplicación de un alambre creado
de materiales de NASA § Sigue con chequeo de rutina § Eliminación de los aparatos § Aplicación de un retenedor
• ¿ Qué contribuye a la práctica de éxito que distingue a la clínica de St. Clair? o Tecnologías de punta y habilidades de negocios con éticas superiores
§ “máquina bien afinada” o “Un doctor puede ser el mejor y tener más éxito odontólogo, pero su práctica
fracasará si es un mal empresario”. • Los negocios en el mundo dental
o “Networking” y Relaciones § Relaciones entre doctores
• La Asociación de Dentistas en Texas • Almuerzos regulares con un odontólogo
o Formar relaciones personales entre los doctores o Facilitan referencias
§ Relaciones con los pacientes • Fiestas de apreciación • Carrera de relevo para cepillar los dientes • Concursos que captan la atención de los clientes y pacientes
o Equipo Administrativo § Relaciones de Pacientes § Coordinador de Tratamiento § Coordinador de Finanzas § Coordinador de Seguro § Coordinador de cita § Coordinador de Documentos § Relaciones Públicas
o El último modelo de las instalaciones y las tecnologías § ser competitivo, organizado y un innovador
• una página de Internet que da información • registro de huella digital • los documentos pueden obtener se por el ordenador • una cuenta automática de retiro
§ El sistema de Damon • Más rápido, seguro y menos fuerzas
o Aparatos cuestan alrededor de 5000 dólares
27
§ Se provee con tratamiento asequible del alta calidad que te lo puede permitir.
§ Varias maneras para pagar sus honorarios • Opciones para pago • Tarjetas de Créditos aceptadas
o Depósito directo § Póliza de seguros incluido beneficios de ortodoncia
o Educación Dental § Edad de 7 años es el momento crítico para prevenir daños § Escuela primaria pública
• febrero – el mes de salud dental • octubre – el mes de ortodoncia
• ¿Qué significa todo esto? o $$$$$
§ tener una clínica con éxito que sea lucrativa o Recapitula de negocio en el mundo dental
§ Conexiones de Redes y Relaciones • Obtener referencias de otros dentistas/pacientes
o Equipo de Administrativo § La oficina funciona en una manera eficaz sin supervisión de dentista
• permite ver más pacientes • tiene más tiempo con cada paciente
o Instalaciones con tecnologías de punta § producen resultados más rápidos § más precisos en un corto tiempo § ayudan con rotaciones de pacientes
o Opciones para paga § Crea un plan personal para ajustarse a cada presupuesto § Ganar clientes si no puede hacerlo
28
English Presentation Outline
• What is Dentistry? o Beautiful healthy smile is the first thing others notice about us
• Orthodontics? o Crooked teeth are cause by the tong and muscles in the face that are out
of balance § Technology has provided us with materials and techniques that
were only dreams a few short years ago. § Shorter time with less discomfort and fewer visits
• Benefits of Specialization o $198,354 general o $304,024 for a specialist
• Dental Organizations o Pre-Dental Society o Texas Dental Association
• Smiles by St. Clair o Dedicated to providing excellence in the field of orthodontics through
quality service and technical expertise o Always on the cutting edge of new technology
§ Dr. John St. Clair § Dr. James St. Clair
• Lubbock Location o Celebrating over 30 years of orthodontic excellence o Pictures o History
§ Progress (4 employees – 30) o Turn over rate 150 patients a day
§ New patient screening • State of the art facilities to X-ray, photograph and diagnose • Thorough examination of your teeth, facial structure and jaw
relations • Series of radiographs, models of your teeth and photographs
to assist the doctors in diagnosing and developing a personalized treatment plan
§ Application of Braces • Damon system
o most modern equipment available o vary gentle pressure working with the natural
pressures of the body o Space aged wires are unique in that they continually
work to return to their original form. § Check ups § Removal of Braces § Retention check-ups
29
• What makes St. Clair’s office such a successful practice? o State of the art Technology and business skills
§ Well oiled machine o A doctor can be the best most successful Dentist, but his practice will fail
because he is a poor business man • Business in the Dental World
o Networking/Relationships § Doctor/Doctor Relationships
• Texas Dental Association • Doctor lunches
o Work on Doctor person relations ship • Facilitation of Referral
§ Doctor/Patient Relationships • Patient appreciation parties • Bush your teeth relay • Contest to keep patients engaged
o Administrative Team § Patient Relations § Treatment Coordinator § Financial Coordinator § Insurance Coordinator § Scheduling Coordinator § Records Coordinator § Public Relations
• Marketing • Facilitator
o State of the Art Technology/Facilities § Accessible information
• Internet Web Page § Damen3 Braces system
• Faster, safer, less force o Orthodontics cost ($5000)
§ Provide you with affordable, high quality treatment that fits your budget
§ Variety of payment options to meet your needs • Financing options
§ Many insurance policies have a lifetime orthodontic benefit § Credit Cards Accepted
• Direct Deposit o Dental Education
§ Age 7 is critical time to prevent damages § Public Elementary Schools
• February – Dental Health Month • October – orthodontist month
• What does this all mean?
30
o $$$$$ • Business in the Dental World Recapped
o Networking/Relationships § Obtain referrals from other dentists/patients
o Administrative Team § Office runs smoothly without Dentist supervision § Enables Dr. to see more patients and have more face time.
o State of the Art Technology/Facilities § Faster more accurate results in a shorter about of time § High turnover rate
o Financing options § Creates a plan to fit every budget, gain clientele
31
Resource Advantage Theory Applied to the Oral health care Industry: Marketing Services and Resource Advantage Theory
By Stephanie Lomeli
Graduate Student in Interdisciplinary Studies Texas Tech University
Department of Marketing Lubbock, Texas 79409-2101
Cell: (832) 443-3573 E-mail: [email protected]
December 2010
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Resource Advantage Theory Applied to the Oral health care Industry: Marketing Services and Resource Advantage Theory
ABSTRACT
Resource Advantage Theory takes into consideration all of the “tangible and
intangible entities” utilized by an oral health care provider viewing them as resources when
they enable an organization to produce efficiently and/or effectively a market offering that
has value for its customers. Knowing what resources are available and understanding how
an oral health care provider can utilize them is instrumental in creating an efficient and
effective market offering that exhibits the most value.
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1. Introduction
When all of the available resources are taken into consideration and analyzed properly according
to the Resource Advantage Theory (R-A theory) oral health care providers have the
understanding to take into consideration all resources involved in creating a specific market offer
that is valuable for a market segment.
In a business service industry there are a variety of factors, consisting of both internal and
external to the organization, which come together to create a business strategy. Understanding
industry-based, resources-based, competence-based, and knowledge-based strategies enable an
oral health care practice to maintain a position of sustained superior financial performance in a
dynamic business industry. The theories behind market-orientated, market segmentation,
relationship marketing and brand equity strategies are important marketing strategies, which in
many ways heavily over-lap business strategies. There are nine premises that underline the R-A
theory (Hunt and Morgan, 1997). Each premise will be supported by an explanation in further
detail.
2. An Overview of R-A Theory
The R-A theory fills in the gaps that other theories left out defining resources’ heterogeneous
nature, and explains how firms can apply this general theory of competition to any industrial
aspect of business, including marketing relationships (Hunt 1997), ethics (Hunt and Sparks 1998,
Hunt and Hanse 2007) and management (Hunt and Lambe 2000), to create an effective and
efficient competitive market offering that particular market segment(s) perceive as valuable. The
incorporation of a variety of disciplines enables R-A theory to explain the evolutionary dynamic
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nature of competition, there-by, providing a better understanding of how to gain a competitive
advantage needed for superior financial performance. Figure 1, A Schematic of the Resource-
Advantage Theory of Competition and Figure 2, Competitive Position Matrix, provide key
constructs of R-A theory in an easy to follow schematic depiction.
2.1. An Interdisciplinary Research Program
The integrated business and marketing strategy of the R-A theory of competition is a truly
interdisciplinary theory that merges Evolutionary economics, Austrian economics, Institutional
economics, Socio-economics, Economic Sociology, Strategic Management, and Marketing to
create a revolutionary theory1. When all of the available resources are taken into consideration
and analyzed in accordance with the tenants of R-A theory, it is easy to see that other theories
either did not apply or did not fully take into consideration all aspects of a specific market offer.
The R-A theory fills in the gaps that other theories neglect while specifically defining resources,
along with their heterogeneous nature. This explains how firms can apply this Theory to any
business to create an effective and efficient competitive market offering that particular market
segment(s) perceive as valuable. The key to the R-A theories’ success is that it provides and
accurate description of competition due to its interdisciplinary nature, and provides a foundation
for other less broad theories in business including the Heterogeneous Demand Theory, Resource
Based Theory of Firm, and Alderson’s Differential Advantage Theory. R-A theory is a genuinely
modern one that transfers ideas and concepts from other disciplines horizontally, creating a
Horizontal Layers Model where information can easily go across specific disciplines as opposed
to the Silo Model where information goes vertically rather freely but does not go across easily.
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2.2. Contributions of R-A Theory
R-A theory can contribute to the understanding behind many important business aspects. R-A
theory can explain the diversity of firms ranging large corporations to small entrepreneur firms
that may make large profits to those that bring in smaller profits. R-A theory explains how
variables between market-based and command economies can result in differences in quality,
productivity, and innovation when cooperation due to government influence is removed and
competitive marketing can flourish into a better market due to better products and market
offering. Perfect competition is viewed and incorporated into the R-A theory, which consist of
general theory of competition requisites as a limiting, special case. The Neoclassical theory’s
predictive successes are incorporated into the R-A theory, along with preserving economic
science’s cumulativeness.
3. Business/Marketing Strategy
3.1. Business Strategy
Andrews, along with his colleagues at Harvard, produced works on Administrative policy that
heavily influences the modern business strategy. In a business there are a variety of factors,
consisting of both internal and external factors, which come together to create a business
strategy. In today’s growing and diversifying world, there are a number of resources and skills
that form combinations of internal factors as well as influence the external environment to
present opportunities and risks. Together these external and internal factors create the framework
for (SWOT) strengths, weaknesses, opportunities, and threats.
3.1.1. Industry-Based Strategy
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Porter addresses an “external factors” approach, Industry-based strategy that focuses on entering
an industry of choice and/or manipulating the industries structure. Making small adjustments
upon entering an industry can result in improvement by elevating the entrance bar and bargaining
power. A recent example in the dental industry would be the introduction of a revolutionary line
of orthodontic products, by ClassOne Orthodontics, which are coated with unique selenium
based chemical compound that has proven to present antimicrobial qualities. Through Selenium
Ltd., creator Julian Spallholz, Ph.D., professor of nutrition and biochemistry, along with Ted
Reid, Ph.D., TTUHSC professor of ophthalmology, collaborated with Kenny Gallagher,
President and CEO of the Lubbock-based company ClassOne Orthodontics, to modify the way
the oral health care industry viewed traditional braces. Upon entering an industry, it is important
to choose a generic strategy of either cost leadership, marketing a lower cost position;
differentiation, with a unique market offering; or focus, on a specific market segment for which a
tailored market offering is created. Once fixated on a generic strategy the attention focuses on the
internal factors.
3.1.2 Resource-Based Strategy
Resource-based strategy is an “internal factors” approach which considers how all resources are
heterogeneous and imperfectly mobile leading firms to acquire valuable, unique, and rare
resources that are inimitable and nonsubstitutable. Penrose’s states a firm is a “ collection of
productive resources” elaborating that, it is never the resources themselves that act as the
production ‘inputs’ process, but on the services that the resources can render (Penrose, 1959, p
24-5; italics in original) Penrose relays the idea that when resources are brought together the
unique combination forms possible services bundles.
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3.1.3 Competence-Based Strategy
A second theory of “internal factors” is the competence-based strategy that states that in order
for a firm to achieve competitive advantage, and thus achieve a superior financial performance
firms should identify, seek, develop, reinforce, maintain, and leverage distinctive competences.
Resource leveraging leads to competitive advantage and productivity gains due to:
“… more effectively concentrating resources on key strategic goals… more efficiently accumulating resources… complementing resources of one type with those of another to create high-order value rapidly recovering resources by minimizing the time between expenditure and payback (Hamel and Prahalad, 1994, p.160).”
3.1.4 Knowledge-Based Strategy
If a firm wishes to achieve superior financial performance through competitive advantage it is
imperative that the firm realizes that the process of competition is knowledge-discovery.
Therefore firms should methodically gather a knowledge stockpile, which can be then utilized to
fuel innovation for Knowledge-based strategy.
3.2. Marketing Strategy
The theories of marketing strategy heavily overlap business strategy in terms of product,
promotion, distribution, pricing, and sales force.
3.2.1 Market Orientation Strategy- Systematically
Market orientation strategy systematically accumulates information to be utilized in an
integrated manner that leads to the development of strategy recognition, understanding, creation,
selection, implementation, and modification. According to Capon, “ The marketer must decide
the nature of the total “offer” – that constellation of attributes embracing the product or service,
38
its distribution, promotion, and price which is presented to potential consumers.” Capon goes on
to state “Independent private dentist and sellers of the more recently introduced dental delivery
systems make offers to consumers in the market just as do such corporations as Proctor and
Gamble, Lever Brothers, or General Motors.”(p.679) Attributes that prove to be significant when
considering a dental offering consist of the likelihood of successfully treating the presently faced
dental problem, a proactive approach to preventing complications and disease, competency of
controlling and alleviating pain, and most important the personable nature and chair side manner
of the dentist (Lipscomb and Douglass, 1980)
3.2.2. Market Segmentation Strategy
Market segmentation strategy should be used by firms to acquire superior financial performance
by gaining a competitive advantage based on the identification of target demand. Upon
identification of demand, firms can further determine which populations are attractive target
markets that allows the firm to obtain a superior financial performance due to the firms belief
that they can provide this specific market segment more value to than competitors. According to
McGuigan and Eisner, the main reasons for which a patient will visit the dentist falls into four
categories: hygiene, pain-relief, esthetics, or replacement/maintained (p.1429). A specific
segment of patients may put a significant weight of concern about pain and will seek out the best
dentist who full fills this dimension of oral health care (Capon, 680). Therefore in order to create
a market offer for a particular market segment that is perceived as valuable, then it is imperative
that firms understand how patients perceive value and recognize which attributes can be used to
create the desired value (McGuigan and Eisner, 1429).
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3.2.3 Relationship Marketing Strategy
Relationship marketing strategy, initially defined as “attracting, maintaining, and in multi-
service organizations-enhancing customer relationships” by Berry (1983, p. 25), and as since
evolved into a number of definitions. According to Morgan and Hunt (1994) “RM refers to all
marketing activities directed towards establishing, developing, and maintaining successful
relational exchanges.” Amongst the differing RM perspective a commonality found is that the
development of long-term relationships attributes to the competitive advantage by achieving
efficiency and effectiveness through production’s enhancement. As not all relationships will
prove beneficial to the firm’s productivity enhancement Gummesson, suggests the skillful
handling of a relationship portfolio identified as essential for your specific business (1994, p.
17). For an oral health care provider to achieve a competitive advantage that results in superior
financial performance, then a firm should identify a relationship portfolio that will prove most
beneficial by developing a long-term relationship that when nurtured contributes to efficiency
and effectiveness enhancement. According to McGuigan and Eisner a doctors list of patients is
one of the most value resources which they posses that if developed and nurtured properly will
only increase in value, offering increasing returns on investment. The manner in which a dentist
handles its patient list determines the dental practice’s value. Previously it was viewed that a
major success prerequisite was a dentist’s reputation. In a market where competition is
disequilibrating and dynamic, it is critical that the practitioner view “their practice as a business”
and understands how valuable of an asset a relationship can be (McGuigan and Eisner, p.1427).
Dentists, along with their dental team, can create a welcoming atmosphere for patients that can
relay appreciation for the patients business. Patients acknowledge the welcoming atmosphere and
appreciation through referrals to the practice (McGuigan and Eisner, p.1429). When services are
40
concerned service and the people delivering them are inseparable it is essential that dentist have
interpersonal skills, because it is impossible to separate the person from the services they are
rendering. Dentists need to be aware that not only are their clinical skills being judged by
patients but also interpersonal skills. When dentists are skilled at combining professional clinical
skills with interpersonal skills they are able to build not only confidence in the dentist’s skills but
also build a valuable relationship at the same time. The loyalty base that you build will work in
your favor to refer friends, family, and other relations to your practice (McGuigan and Eisner,
p.1430). When the primary asset involved is a valuable commodity such as a dentist’s list of
patients, a practitioner cannot afford to “leave relationships to chance” (McGuigan and Eisner,
p.1431). When “left to chance”, relationships between the practitioner and the patient become a
“transaction-based practice”, rather than a “relationship-base practice” which could lead to
comparative disadvantages of the firm, causing an inferior financial performance. If a dentist
wants to achieve a competitive advantage, then the dentist needs to create a meaningful and
satisfying relationship between a practice and patient through personalization (McGuigan and
Eisner, p.1432).
3.2.4. Brand Equity Strategy
Firms can add significant value to a market offering by utilizing brand equity strategy. When a
brand adds customer perceived value to a market offering it is considered a resource. Some
brands are considered high-equity due to the great value they add. When targeted patients see
that the brand is a part of the market offering, highly favorable association are triggered for the
targeted patient. The triggering of these “highly favorable associations” in targeted consumers
increases firms effectiveness, thus the market offering moves its competitive matrix position to
41
the right. The law protects a brand by preventing competitors from using its name; the protection
the law creates a valuable legal resource. The brands image is a strong motivator for patients.
Dentists need to display in a visible place within the practice their credentials and explain the
significances of these credentials. It is important that doctors inform patients of the details about
the products used in the market offering and fully explain the reasoning why they have chosen
the particular items that create the bundle that makes up the market offering (p.1430). The
Internet is a valuable technological resource that dentist should utilize to create a website for the
oral health care provider that would aid the firm as an informational resource that can aid the
patient in making an educated choice. Dentists can help provide information to influence the
product choices of a patient by developing an advantage proposition, which is a written
statement that should be posted on the firms web page stating the practice and dentist
professional stance (p.1431).
4. Foundational Premises of R-A Theory
There are nine premises that underline the R-A theory (Hunt and Morgan, 1997). Each premise
will be supported by an explanation in further detail.
4.1. Premises 1 :: Demand is Heterogeneous Across Industries, Heterogeneous Within Industries and Dynamic. Heterogeneous demand theory of marketing influences the demand view of the R-A theory,
acknowledging the predominating heterogeneity of intra-industry demand, contributing to the
necessity by different market segments of product differentiation in a market offerings within the
same industry (Hunt book, 2000, p. 10). Differentiations of commodities occur partly in response
to buyers variation in desired taste, preferences, location, etc. (Hunt book, 2000, p. 45). The
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heterogeneous nature of demand across and within industries is the result of differences in the
perceived value of importance’s of various attributions which when combined or bundled create
a market offer. The demand for oral health care can be broadly broken down into four categories
hygiene, pain relief, esthetics, and/or replacement. R-A theory helps explains that within those
categories the demand becomes more specific and tailored to meet the individuals preferences.
Using the demand for esthetics as an example, there are some patients that have the desire of
wearing braces for a shorter length of time with less Doctor visit and minimal discomfort;
Patients who fall into this demand segment would view the Damon System’s passive self-
ligating braces, which utilizes state of the art memory wires to move teeth with less pressure and
force faster than traditional braces and with fewer adjustments, as highly valuable. Some may
require a demand for braces containing an antibiotic coating, SELect Defense, on the
orthodontics to prevent deterioration of the teeth, which results from the buildup of bacteria due
to very poor bushing and/ or poor hygiene. Still there are others who demand quick/instant
cosmetic dentistry preformed as oppose to braces where dentist would utilize venires or demand
a discrete correctional device such as Invisialine. In order for a firm to fulfill a targeted demand,
the buyer may have a preference for one product variety over another. Therefore, different firms
or oral health care providers within the same industry will solve this problem differently due to
their preferences for braces being substantially heterogeneous resulting in differentiate demand
for resources.
4.2. Premises 2 :: Consumer Information is Imperfect and Costly
Patients have imperfect information concerning dental products that might suit their tastes and
preferences, but obtaining such information is often costly in terms of both time and money. For
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this reason, it would be wise for oral health care providers to utilize social institutions, such as
trademarks, licenses, and patents, to reduce patient search cost by signaling a market offers’
attributes (Hunt 2000, book, p.110). A dentist can better assist a patient in making an educated
decision through development of a written advantage proposition that explicitly states the stances
of the practice and dentist. To achieve maximum exposure of the advantage proposition
utilization of the practice’s Web site and other available communication vehicles must occur
(McGuigan and Eisner, p.1431). In an ever modernizing world, it is becoming an oral health care
norm for a practice to have a fully functional website which allows patients to get a look into the
business and inform themselves about the available options, thus enabling patients to make an
educated choice.
4.3. Premises 3 :: Human Motivation Constrained Self-Interest Seeking
R-A Theory explains the best way to view human motivation is “as constrained, self-interest
seeking” (Hunt 2000, book, 118). Human motivation is constrained by personal moral codes,
which influence societal, professional, industry, and organizational moral codes shape.
Deontologists believe that it is the actions people take that should be examined when
determining whether something is ethical or not. To better understand the factors that contribute
to moral views and the choices those views lead to can be obtained from Hunt Vitell Theory of
Ethics (Hunt 2000, book, 120).
Concern over investment return is a strong motivating factor for patients, especially when
a considerable amount of money is in question. When the returns on investment are highly
valued by the patient then the decision to purchase can be justified in terms of logical
cost/benefit analysis. It is important for the patient to know up front what the benefit, such as
44
esthetics and/or improved function will be for a specified procedure. When a patient chooses to
invest a significant amount of money in oral health care such as braces, it is important that the
patient feel a justification on spending the money and going through the painful and
uncomfortable experience, such as an opportunity to get a better job or become more attractive.
In the work place it is very important to create an emotionally welcoming environment and
companies stress the idea of service with a smile. According to a study conducted by Krumhuber
and associates, the effects of the dynamic attributes that contribute to characteristic qualities
significantly shaped the judgment of those who perceived the smile in an interviewing
atmosphere. This shift in judgment effected the interviewer employment decisions (p.2). Social
Intelligences’ Theory gives the reasoning behind this shift in perception due to mirror neurons,
which are responsible for making emotion contagious in turn effecting mood and passing the
smile on due to our natural response to reflect emotion (Stanley).
Time is another strong motivation factor for patients when considering an oral health care
provider. Due to increasing time constraints on patients, more weight is being added to the value
of dentists offices that are efficient at saving time. Clinicians that respect the appointment
schedule or justify rare deviations from specified time gain a comparative advantage with
treating this type of patient (McGuigan and Eisner, p.1426). An example of how Smile by St.
Clair’s resources such as, a fully automated system which begins with a quick finger print scan
that instantly checks the patient in with a time stamp, pulls the patients digital charts utilizing the
Dolphin Management 4.5 software, along with their digital x-rays and photos of the patients
treatment plan progress through the software Dolphin Image. This fully automated system tracks
the patient’s location and duration of wait time, also referred to as “Patient GPS”. These
informational technology resources facilitate in Smile by St. Clair’s competence at achieving
45
their goal of avoiding wait times that exceed 15min between each transition from check-
in/waiting area; assistant preparation/Dentist work; end of procedure/check-out. Smile by St.
Clair also reduces check-out time by utilizing automatic billing withdraws. The patients have the
option of having their checking or credit information on file, allowing the financial coordinator
to send the patient a bill for services rendered, while simultaneously withdrawing the agreed
upon payment. These competences assist the dentist in nurturing the patient’s time motivations,
which in turn results in a higher level of satisfaction with the perceived value of the service thus
resulting in more referrals.
As there is an ethical diversity which exist between people, in this case between the
patient and dentist and in most cases between the dentist and his own dental staff, it is important
to understand the nature behind this diversity (Hunt and Hasen)
4.4. Premises 4 :: The Firm’s Objective is Superior Financial Performance
Superior financial performance is pursued by firms as the primary objective. When a firm has the
security of finances then it can pursue other interest, such as maintaining a substantial
competitive advantage and has the resources to take action towards utilizing these advantages to
create a more efficient operation and the most effective service. . The flow of the resulting
positive superior rewards accumulated through superior financial performance is to the firm’s
owners, managers, and employees (Hunt 2000, book, p.123). By improving patient relationships
doctors can improve the experience patients receive, which cause marketing cost to reduce for
doctors resulting from an increase in patient retention. A reduction in marketing cost results in
the firm achieving a competitive advantage leading to superior financial performance.
(McGuigan and Eisner, p.1426).
46
4.5. Premises 5 :: The Firm’s Information is Imperfect and Costly
Marketing cost begin to rapidly incur when creating a “focused word of mouth campaign” due to
the investment of time, money, and effort required to build as well as sustain (McGuigan and
Eisner, p.1426). R-A theory explains that a competitive advantage is key to achieving superior
financial performance but due to the disequilibrating dynamic nature of competition a firm
should seek a “sustainable competitive advantage in the marketplace”(Hunt, 1999).
Programs implemented towards understanding a practice’s strengths and weaknesses can
be a great benefit by assessing how the patients experience is affected. If a Dental practice
launches a marketing campaign to gain a comparative advantage it must be fact based,
dismissing assumptions (McGuigan and Eisner, p.1426). When dentist understand their “Value
Creation Circle” it allows the firm to better target a segments desired service, thereby enabling
them to create value, but they must also be able to communicate this created value to their
patients in a language they can easily understand (McGuigan and Eisner, p.1429). Consultants
can help firms accomplish their goal of achieving superior financial performance by analyzing
the company for areas of weakness or inefficiencies where changes can be made. Consultants
can perform practice management audits to obtain the information needed to identify the areas of
operation that are hindered by inefficiencies previously overlooked. Valuable information can
also be obtained when the firm’s business practices are compared against a standard. When
measuring a firm against a standard, it allows practices to not only identify inefficiencies but also
deficiencies, or gaps in services, and communication failures. (McGuigan and Eisner, p.1428). If
a company performs regular audits by consultants, then it is given the resources to identify
changes that can be made, enabling it to achieve a sustainable competitive advantage through
47
innovation and change. Utilizing consultants monthly as resources for information allows smile
by St. Clair to be dynamic, staying ahead of the competition.
4.6. Premises 6 :: The Firm’s Resources are Financial, Physical, Legal, Human, Organizational, Informational and Relational
R-A theory defines resources as the tangible and intangible entities available tot the firm that enable it to produce efficiently and/or effectively a market offering that has value for some market segment(s). Resources can be categorized as financial; physical (plant, raw materials, and equipment); legal (e.g. trademarks and licenses); human (the skills and knowledge of individual employees, including, importantly, their entrepreneurial skills) organizational (e.g. controls, routines, cultures and competences); informational (e.g. knowledge about market segments, competitors, and technology); and relational (e.g. relationships with competitors, suppliers, and customers)(p.34, Hunt 2000).
R-A theory takes into consideration all of the resources utilized by a firm, or in this case an oral
health care provider or practice, defining them as the “tangible and intangible entities” accessible
to individual firms, or Practice, that permit the firm to create a market offering, such as a dental
care package, which is efficient and/or effective, for a particular market segment(s) that perceive
the said offer as valuable. When taking a dental practice into consideration it is important to
understand that the main service, which the Dentist is officering, is their dental services, whether
it is for the purpose of hygiene, pain relief, esthetics, and/or replacement. These services that the
Dentist provides are an example of an intangible good or resource, with the instruments and tools
used to perform the job are tangible resources that enable the practitioner to perform their duty.
When analyzing and breaking down available resources there are a number of categories
which tangible and intangible resources can fall under, many of which are often over looked or
taken for granted. Knowing what resources are available is instrumental in creating an efficient
and effective market offering which exhibits the most value.
4.6.1. Physical Resources
48
Physical resources consist of the plant, or in this case the oral health care practice, that when
positioned in a strategic location and/or additional convenient locations are built can lead to
increased efficiencies by allowing the practice to target market segments locally as well satisfy
the needs of a larger market segment; equipment such as the Damon System of self-ligating
brackets used by Smile by St. Clair, along with all of the instruments the practitioners use to
apply the Damon System; and raw materials such as the unique chemical compound of
Selenium, that attributes to SELect Defenses antibacterial characteristic. Abbeville dentistry
utilizes its physical resources through its two convenient Lubbock locations differently than
Smile by St. Clair’s uses of a local Lubbock office, along with a Clovis, NM location to gain
access to a larger segment of the market.
4.6.2. Human Resources
The human element plays a key role when services are involved; in terms of the unique skills and
professional knowledge each individual employee contributes. According to McGuigan, in order
to be a successful dentist in today’s professional health career it not just enough to be a skilled
clinician one must also exhibit strong entrepreneurial talent in order to run a profitable practice
(p.1426). When a service is provided such as with oral health care a key element of the practice’s
success is the dentist’s reputation (p.1427).
4.6.3. Legal Resources
Legal resources for dentist would not include other company's patents. It could include a contract
to be the only dentist in an area to be able to offer a service (e.g., if a company had a new
technique for removing plaque and gave an exclusive contract for using it to a particular dentist).
49
The incorporation of the Damon System name when marketing the Smile by St. Clair business as
seen in the internet banner of there website. Utilizing licensed tools such as the Dolphin
Management 4.5 operating system registered to St. Clair Orthodontics to create a fully integrated
software to track and chart patients progress, as oppose to using inefficient paper charts.
Dolphin Management works in conjunction with Dolphin Imagine, a software for
accessing/viewing patient X-rays, initial patient photos pre-braces, as well as photos tracking the
orthodontic progress of the patient by date. Grimes Dentistry, a family cosmetics dental practice,
utilizes a similar Software Dentrix Patient Chart, which also works in conjunction with an X-ray
software, Dex-ray which captures and view images. Other legal forms of licensing consist of
dental licenses, and certification showing that you are legally and professionally qualified to
perform the offered task. Grimes Dentist office has several of the founding dentist certificate of
completion and acknowledgements on the clinic walls including the International Congress of
Oral Implantologist certificate. These forms of licenses are essential to have visible because it is
not only the law but it also turns an intangible item (education/skill) into a tangible items
(license/credentials) that can be utilized to display the doctor’s significance and credentials.
4.6.4. Organizational Resources
Organizational resources are things like work culture, processes, and procedures that allow the
dentist to provide more value for his/her patients. In dentistry when patients are key it is critical
to keep meticulous records in order to better understand your patient bases. By enhancing
operating strategy a dental clinic can gain a significant competitive advantage (Lee and Shih,
200). Control and specific delegation of duties within a practice will attribute significantly to the
efficiency and effectiveness of each administrator. There are specific competences which some
50
patients’ value more in a dentist office such as duration of waiting time. Smile by St. Clair is
highly competent is this area by making it a point that patients wait no longer than 15min
between each transition (check-in/waiting area; Assistant prep/Dentist work; End of
procedure/check-out). St. Clair orthodontic’s competence is due to the utilization of organization
technological, administrative and informational resources
4.6.5. Informational Resources
Informational resources would be things like knowing more about what patients want then other
dentists by doing marketing research and knowing a lot about your competitors by conducting
competitive intelligence. The ability to access knowledge at the click of a button can save ample
amounts of time, in an industry where time is money and predominating factor, fully automated
computerized charts can be highly valuable to doctors; similarly a well organized informational
website can be a major selling feature for a dentist office when the patient would otherwise be
forced to make a treatment decision in the face of an inadequate understanding of the various
alternative due to limited information provided (McGuigan and Eisner, p.1431).
4.6.6. Relational Resources
In the oral health care field relational resources are perhaps one of the most valuable assets that a
dentist has available. Patient relationships are key business resources with services, such as
dentistry, and cannot afford to be left to chance by practitioners. It is important that dentist
realized that their patient list acts as a primary asset, which retains its value through the strength
of its relationship between the patient and practitioner. Relationships are nonperishable resources
in a perishable service industry that present themselves as rare assets that do not depreciate with
51
use. According to McGuigan and Eisner, “dentist needs to personalize the relationship between
the patient and the practice for it to be meaningful and satisfying” (p.1432). Smile by St. Clair
Orthodontist recognize this essential element as a valuable resource and works diligently to
nurture this resource. Dr. James St. Clair has weekly lunches with local oral health professionals
in the area, which enables him to not only build and nurture relationships with fellow colleges
but also allows him to have a network of available doctors if a referral is needed. As the private
practice oral health industry is largely based off of referrals, it in crucial to maintain a nurturing
relationship with patient.
4.7. Premises 7 :: Resource Characteristics are Heterogeneous And Imperfectly Mobile The characteristics of resources are heterogeneous and imperfectly mobile due to the
heterogeneous nature of demand. When a firm’s market offering is enhanced by available
entities, tangible and/or intangible, that provide firms the means to produce a valuable offer
efficiently and/or effectively for (a) particular market segment(s), then that entity becomes a
resource to the firm.
R-A theory defines resources as the tangible and intangible entities available to the firm that enable it to produce efficiently and/or effectively a market offering that has value for some market segment(s). Resources can be categorized as financial; physical (plant, raw materials, and equipment); legal (e.g. trademarks and licenses); human (the skills and knowledge of individual employees, including, importantly, their entrepreneurial skills) organizational (e.g. controls, routines, cultures and competences); informational (e.g. knowledge about market segments, competitors, and technology); and relational (e.g. relationships with competitors, suppliers, and customers)(p.34, Hunt 2000).
When firms are enabled to utilize available entities that contribute to an increase in perceived
value of a market offering made available to a market segment that is produced both efficiently
and/or effectively, allowing the firm to gain a comparable competitive advantage, thereby,
superior financial performance, then each is considered a resource. Each market offering consists
52
of a market mix of attributes that are tangible (eg. Damon System, Ortho Essentials, Mr. Fresh
disposable toothbrushes) and intangible (eg. clinical skills, credentials, relationship) entities that
when combined in a unique mixture to fill a significantly heterogeneous intra-industry demand.
Within a service industry such as dentistry, different practices will have access to different
products, as well as choose products targeted to answer patients particular taste and preferences
for braces which differ greatly, and are not easily obtained by a competitor. Despite firms
attempts to acquire competitors resources, heterogeneity can persist because of “ those resources
built into the organization such as systems, procedures, contracts, and brands which are not
dependent on single individuals” according to Gummesson (1995, p.17). Gummesson goes on to
point out that firms are beginning to recognize “ the fact that the customer base and customer
relationships are… assets, even the most important assets” (p.18). Therefore, in order to achieve
superior financial performance it is essential to view “Firm’s relational resources… as the
principal determinant of its wealth-creating capacity. Furthermore, it strongly supports R-A
theory’s contention that important firm resources are intangible, significantly heterogeneous, and
immobile” According to hunt (2000, p.129)
4.8. Premises 8 :: The role of management is to recognize, understand, create, select, implement, and modify strategies. The view of management’s role in R-A theory is a business strategy manager. “Specifically, the
role of management (both owner and nonowner managers) is to recognize and understand current
strategies, create new strategies, select preferred strategies, implement the strategies selected,
and modify strategies through time” (Hunt 2000, p. 131). Performance is influenced by the
manager’s strategic choices. “All strategies (at the business-unit level) involve, at the minimum,
the identification of (1) market segments, (2) appropriate market offerings, and (3) the resources
53
required to produce the offerings” (Hunt 2000, p. 131). The continued competitive advantage
resulting from a comparative advantage is due to firm’s strategic dynamic contributions to the
“sustained superior financial performance” (Hunt 2000, p. 131) despite the competitor’s actions.
4.9. Premises 9 :: Competitive dynamics are disequilibrium-provoking, with innovation endogenous. The evolutionary process of competition is explained in the R-A theory as the result of the
disequilibrium provoking actions of firms. Some firms will have more competences in specific
areas that are perceived to be of high value to some markets segment(s), thus influencing the
firm’s performance due to the heterogeneity and immobility of the relative resources that are
strategically chosen. The allocation of resources contributes to R-A theory’s process of
competition, when it enables a firm to produce a more efficient more effective market offering
(Hunt 2000, p. 132).
5. R-A Theory and Marketing Services 5.1. Oral health care services According to Kotler and Keller, “A service is any act or performance one party can offer to
another that is essentially intangible and does not result in the ownership of anything. Its
production may or may not be tied to a physical product” (2010). The oral health care industry
provides a major service, an example of this is the Orthodontic treatment provided by Smile by
St.Clair’s Orthodontist Dr. John St. Claire, D.D.S. and Dr. James St. Clair, D.D.S., M.S. along
with the newest member of their dental team Dr. C.C. Masey, as the skilled service providers, to
improve the smile of patients. The ability of the Orthodontist to provide this service is dependent
54
on minor goods, such as the Damon System’s braces applied by the Orthodontist and then
maintained by the Patient daily with the help of the Ortho :) Essentials a Proctor and Gamble
Crest/OralB dental care package; as well as minor services such as the prompt and friendly
service provided by the dental team. In services such as dentistry, patients do not only purchase
the orthodontics services, which includes the braces, but are responsible in the Coproduction of
results, superior results occur from “high-performance customers” (Kotler and Keller) who play
a very active role in the daily maintenance of their oral health by brushing properly with the
provided “Ortho :) Essentials” dental care package. It is important for Business Services like
Smile by St. Clair’s office to understand how R-A Theory explains how each element in this
marketing mix forms a service bundle which if provided highly efficiently and effectively can
enable the practice to create a marketing offer highly valuable to a market segment.
5.2. Inseparability of services
There is an inseparability of services in dentistry between the clinical skills and functional skills
during the simultaneous production and consumption of a service, therefore in a services market
the interaction between the provider and client is a special feature. The orthodontist at Smile by
St. Clair understand how valuable of an asset the patient is to the firm and manages the
relationship of each patient by adding a personal and friendly touch to make the patient feel
welcomed and valued by the practice. Everyone on the dental team realizes that each person has
a very limited amount of time to make a big impression. To assist the doctors be as efficient as
possibly during the short time together during an appointment they will prep the patient,
including making notes of any significant information in the patients digital charts that may help
the orthodontist make an effective connection with the patient For example, an orthodontic
55
assistant learns from the patient that he is very excite that his cousin went to nationals in golf, the
assistant then makes a note in the patient’s charts. Before the Orthodontist begins to work on the
patient they read the patients charts to see what work has been done and what they discussed
they would be doing, during this time they can also read the personal notes the assistant wrote
and then engage the patient in a conversation tailored to the patients interest. The patient is not
only judging the clinical skills of the doctors, but also the doctors interpersonal skills in making
the customer feel important and of value. By showing interest in the things that stimulate a
patient, St. Clair’s orthodontists form a deeper connection with the patient.
5.3.Variablility of Quality Dependent On Variability of Resources
Services vary greatly among oral health care practices depending on the provider, receiver,
location and circumstances, leading to variability of service quality delivered. When patients
view the services provided to them the quality of service depends on what the patient values and
what they are willing to pay for that value. Many intangible resources contribute to the quality of
service delivered, one element that is a major effector of quality is the firm’s employees and the
training procedures that prepare them for their job. The more skilled and knowledgeable those
providing service are they can be more competent at their job. The service provider, whether it’s
the Orthodontist or an assistant, their professional licenses act as credentials vouching for
credibility of their knowledge and skills. Smile by St. Clair uses their credentials to make their
intangible knowledge and skill resources into tangible resources by publicly displaying them in
the office and posting all resources that contribute to credibility on their website. St. Clair’s
Orthodontist not only gains the patient’s trust by proving their credibility through their
credentials but also by providing consistent and accurate service. Consistent delivery of quick
56
responsive service is possible due to the available resources such as the Dolphin Management
4.5 software and Patient GPS, in conjunction with a highly proficient team. When the highly
proficient team is given not only the proper resources to conduct the job, but is also trained
properly, then they are a valuable source of information and communicate this knowledge to the
patient. When information in communicated properly to patients in a manner that increases their
understanding the firm can gain a comparative competitive advantage.
5.4. Tangibilizing intangible service resources.
Customers judge the “perceived services” based on the experience received against the
“expected services” (Kotler and Keller). According to R-A theory intangible resources are a
major contributor to the heterogeneous nature of a market offering, therefore, to maximize a
patients perception of services their receive it is imperative for firms to tangibilize these
intangible resources that differentiate the quality of one practice from another. When quality of
service is based on patient perception, there are certain determinates of quality that can impact
the patients perception greatly. It is important that patients feel they are receiving the promised
service.
5.4.1. Reliability
St. Clair’s orthodontists are able to demonstrate the reliability of their discussed treatment plan
with regularly take photos that track the patient’s progress. Damon System’s revolutionary
technology allows for fewer adjustments and fewer patient visits needed, while still making
drastic changes in a shorter amount of time. Dolphin Image allows the patients to visually see the
progression of treatment.
57
5.4.2. Responsiveness
Innovativeness can assist firms in maintaining a sustainable comparative advantage according to
R-A theory. Innovative suppliers of information systems can create a sustainable comparative
advantage for firms, such as the fully digital interfaces systems Dolphin Management that is
licensed to St. Clair orthodontics, allowing doctors to access charts, treatment plan, and photos
showing X-Ray and progression. Smile by St.Clair’s patient GPS system is an element of the
information system that allows the team to provide prompt service. Smile by St. Clair’s
utilization of Self-Service Technologies (SSTs) allow the patient to become an interactive part of
this prompt service by scanning their fingerprint to check-in for their appointment. Automatic
thumbprint identification check-in is considered a technological resource by R-A theory. At
check-in a timestamp tells the staff the exact time the patient checked in. Patients are rewarded
by the Orthodontist for early check in and can receive wooden nickels that they can exchange for
prizes.
5.4.3 Assurance
Part of a St. Clair’s orthodontic assistants’ responsiveness is to assure patients they are getting
the expected service by explaining the procedure that will be done by the orthodontist, then the
orthodontist will tell the patient what procedure he is about to perform, followed by the
orthodontic assistance’s explanation of what was done by the Orthodontist. This repetitive
communication of the procedure performed is an Information resource for the firm and attributes
to the firm’s competence in achieving a comparative competitive advantage in obtaining superior
financial performance.
58
5.4.4 Relational Empathy
In a service business, such as the orthodontic treatment provided by St. Clair orthodontists,
relationships are an extremely valuable asset to the firm. R-A theory views relationships as
valuable resources when development of long-term relationships occur, which attributes to the
competitive advantage. For doctors to develop this relationship they must give the patient
personal attention. Each administrator has a competence for a specific job focus (insurance,
charts, schedule) to perform in the office that will increase the practice’s performance efficiency,
thereby, allowing the orthodontist to concentrate specifically on performing their professional
skills enabling them to not only see more patients but spend more time with patients giving them
individual attention. The ability to spend more time giving individual attention to patients can
improve their relationship.
5.4.5. Tangibles
It is the tangible resources that create and reinforce the perception of quality to a patient and the
inability of competitor to easily obtain or duplicate these services attributes to the firm’s
differentiation. The fully digital interfaces systems Dolphin Management 4.5 is licensed to St.
Clair orthodontics allowing them to access patient information at the click of a mouse. Another
major differentiator in the service delivered by Smile by St. Clair is the stylish, uniformed
appearance of the entire orthodontic staff. St. Clair orthodontics gives their staff an allowance
each quarter to help offset the cost of regular changes in the staff’s attire. One member of the
staff is in charge of choosing outfits to create the staff’s neat, uniformed appearance. Damon
System’s revolutionary technology allows for fewer adjustments and fewer patient visits needed,
59
while still making drastic changes is a shorter amount of time. One aspect that differentiates this
resource from others firms that may offer the Damon System is that not only dose the St. Clair
practice use this system of orthodontic, but Dr. James St. Clair teaches this revolutionary way of
performing orthodontic at the University of Texas Houston branch dental School. These are
examples of tangible resources that allow Smile by St. Clair to sustain a comparative competitive
advantage that allows them to achieve superior financial performance.
6. Conclusion
The Resource Advantage theory can explain to an oral health care provider how to better merge
business and marketing strategies to better utilized available heterogeneous, immobile resources
allowing the firm to create a market offering with the appropriate quality and value for a target
market to achieve superior financial performance that can be sustained through innovation and
adoption to competitive dynamics.
60
FIGURE 1
A Schematic of the Resource-‐Advantage Theory of Competition
Read: Competition is the disequilibrating, ongoing process that consists of the constant struggle among firms for a comparative advantage in resources that will yield a marketplace position of competitive advantage and, thereby, superior financial performance. Firms learn through competition as a result of feedback from relative financial performance “signaling” relative market position, which, in turn signals relative resources.
Source: Hunt and Morgan (1997)
Societal Resources Societal Institutions
Competitors-‐Suppliers Consumers Public Policy
Resources Market Position Financial Performance
• Comparative Advantage
• Parity
• Comparative Disadvantage
• Competitive Advantage
• Parity
• Competitive Disadvantage
• Superior
• Parity
• Inferior
61
Figure 2 Competitive Position Matrixa
Relative Resource-Produced Value
Lower
Parity
Superior
Relative
Resource
Costs
Lower
1 Community Health
Center Indeterminate
Position
2
Competitive Advantage
3
Competitive Advantage
Relative Resource Costs
Parity
4
Competitive Disadvantage
5 Abbevill Dentistry
Parity Position
6
Grimes Dentistry Competitive Advantage
Higher
7
Competitive Disadvantage
8
Wentz Orthodontics
Competitive Disadvantage
9
Smile by St. Clair Indeterminate
Position
----------------------------------------------------------------------------------------------------
aRead: The marketplace position of competitive advantage identified as Cell 3 results from the firm, relative to its competitors, having a resource assortment that enables it to produce an offering for some market segment(s) that (a) is perceived to be of superior value and (b) is produced at lower costs. Source: Hunt and Morgan (1997).
62
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