The Concept Of Service

Published Date: 02 Nov 2017

Services represent a form of a product consisting of activities, benefit (advantage) or pleasure up for sale, and which, in its essence, are impalpable and eventually cannot be owned (1).

Service and product differ in five important characteristics:

Intangibility

Inseparability

Variability

Perishability

Ownership

In order to reach an appropriate level of service it is necessary to add three more (Ps) to the four Ps marketing mix (Product, Price, Place, Promotion):

People who perform the services

Processes necessary to perform the service adequately

Physical evidence of the place where the service is offered, of people who perform the service and of equipment used for the service.

Modern companies have been introducing 4Cs instead 4Ps, as well as its more advanced variant – SIVA (Solution, Information, Value, Access). Instead of the product, problem solution is offered, promotion is replaced by information, value is more important than the price and access complements distribution or the place where the product or the service is available.

Having in mind the great importance of interaction of service users and service performers, a great number of companies include in their portfolio a chain of services that allows connecting service performers, service users and company profit. This chain is consisted of 5 links:

Internal quality of service

A content and productive employee

Creating a true value of service given to the user

Content and loyal service user

Profit increase and a healthy growth of the service offering company.

Having in mind all the aforementioned, companies that offer services must create a strategy that differs from a strategy used by companies-producers. These strategies do not only include external marketing – using 4Ps, but must also include internal marketing that stresses employees’ education, the importance of the fact that the client always comes first as well as interactive marketing because the service is an interactive process in which both the service and the employee who offers it are important, that is, the employee's ability of establishing and keeping contact with the service user (2).

Specific properties of services in dental service

Services in dental service are specific in relation to services in other branches of medicine. This can be seen in the fact that dental services consist of a palpable part (product) and an impalpable part characterized by patient – service user’s experience that require trust in the doctor that performs the service. Services in other branches of medicine must often be based only on trust made between the doctor and the patient, since the patient cannot physically "feel" the final result of the treatment. Exceptions to this rule are certain branches of medicine (ORL, plastic surgery, orthopedics, etc)

The "impalpable" part of the service that usually strikes as unimportant is found in the additional 3Ps (3). Those are processes of ordering, of movements of patients in the office, of people that offer the service, as well as the physical appearance of the premises and additional details (uniform, office design, bills, test results, etc) that fulfill the service.

Service portfolio

Every company (institution) has a collection of products or services that make its basic activity. That collection represents the company portfolio. Creating and planning of the product or service portfolio is one of the most important segments of strategy in every type of business. Service portfolio planning is done in two steps:

Analyzing the current portfolio and making decisions about the faith of the business or services performed;

Planning portfolio that will be interesting in the future.

The purpose of strategic planning is that the company uses its resources and opportunities to the best of their potential. The first step in this process is recognizing the most important activities, service or products that, in this case, are marked as a strategic unit (4). Every strategic unit is analyzed through a matrix - using a method we choose. There is a great number of matrix creating methods - GE McKinsey, ADL (Arthur D. Little), but the most common one is by using the BCG (Boston Consulting Group) matrix (image 1)

The aforementioned matrix is represented via the horizontal axis that represents the market share (MS), which is the measure of the company’s current strength, as well as the market growth degree - the vertical axis, which represents the attractiveness of the market. According to the BCG matrix we can distinguish four types of strategic units:

Stars – products or services with great growth and great share at the market that require additional investments.

Cash Cow – services with small growth, but a great share at the market, which bring most profit and keeps the company alive.

Question marks – businesses with great growth, but a small share at the market. Question marks require a decision – whether they are profitable, and whether there is a need for their liquidation or whether it is necessary to invest additionally.

Dogs – small growth, small share at the market – they can sustain themselves, but not the entire company.

The BCG method has its insufficiencies since the great market share is not always the indicator of success, neither is the market growth the only indicator of the attractiveness of the market. This method, globally-wise, requires a lot of time and costs to make the analysis, where the stress is on analyzing, and only a small part about future planning. That is why major companies stimulate making strategies on lower levels that are very close to the market itself, and therefore well acquainted to the market conditions.

Having determined to which group the forms of current business (service) belong one can plan their future, all in order business growth. Therefore one can choose to:

Penetrate the market – without changing the service the focus in on more intensive sale.

Develop the market – expanding the market for current unchangeable services

Develop the product (service) – modifying the existing services or introducing innovative components

Diversification (combining with the competition) – buying, selling certain capacities that offer required services (5).

1.2. Service Innovation

Service innovation represents a particularly important link in creating additional values for service users. Even when the product and service are combined, the true value is brought service, not the product.

If the goal is to introduce innovation in the service sector, we need to be aware of the basic service characteristics (6):

Service impalpability

The fact that the "production" – making of and service delivery take place simultaneously

The fact that it is difficult to protect the service

The fact that it is very easy to introduce innovations in the service sector

During the innovation process it is important to include the service user as well as everybody else that provide the service. In that context, we are introducing the concept of internal marketing, which answers to the question "how" to offer the service, instead of "what" to offer. One needs to distinguish creativity and innovation. Innovation includes a new idea, method of work or new tool, device, material, which needs to be commercially used (7). There is a great number or methods and models used successfully at innovation management support.

These methods are:

Creative idea generating methods

Life cycle model

Portfolio analysis method

Technological foreseeing method

Strategic evaluation and alternative selection method

Information support to innovation management

Creative idea generating methods are used for solving problems by using workers’ creative potential. The most famous and used are brainstorming, mind maps, lateral thinking, theory of inventive problem solving (TIPS) and SCAMPER (substitute, combine, adapt, magnify, put to other uses, eliminate, rearrange) (8).

Creative process is rarely linear and simple. Most commonly, there are four states that intertwine – absent-minded search, intuition, penetration and finally – logical formulation.

Researches that focused on innovative decision making method started with the assumption that decisions are generally made at meetings, that meeting participants presents make points closely related to their knowledge and cognitions and that meetings are an important part of the management process. (9)

1.2.1. Brainstorming

Brainstorming is most famous and used technique to start the creative process, and represents a basic frame for other techniques. It was first defined by Alex F.Osborn in 1953 in his book "Applied imagination", and set basic rules required by this technique (7):

There is no criticizing or previous judgment of any idea,

All ideas are taken into consideration,

Quantity has a value on its own, it is better to have more ideas,

Mutual exchange and combination of ideas will result in a eventual set of quality ideas (10).

Brainstorming process steps are precisely defined (11):

- the choice of the facilitator (a sort of a moderator) that will provoke ideas, but will not directly take part in their choosing, nor will he be emotionally attached to the problem itself and the manner of solution.

- accepting parallel processing technique, in which the participants write their ideas themselves which facilities the very process, unlike the serial treatment in which all the ideas are written down by the facilitator, as well as the speed of work which also depends on the speed of the facilitator.

- Defining the right problem, the key moment, if we bear in mind that people always solve the problem they define. If one defines the wrong problem, that problem will be solved, but we will wonder why that solution cannot be applied. Defining the right problem is not possible before the session itself and usually is not productive.

- Proposals for soultion – generating ideas - „green light thinking"

- Checking ideas and solutions about which idea needs to be implemented

- Idea presentation

1.2.2. Brainmapping

Brainmapping is a powerful graphical tool which represents an expression of brilliant thinking and thus represents a natural function of the human mind (12). Graphic representation provides a universal key for liberating the potential of the brain.

Using maps in management gives multiple benefit, in segments:

Structure management (organization, roots, cooperation, media use, market planning, SWOT analysis)

Marketing (product portfolio, primarz messages in marketing, use of mediatenje medija, market planning, SWOT analysis)

Leading

Time management - planning

Accountancy

Cadre education

Improvements in the company itself are visible because we have a better management and organization, which leads towards a happier and more motivated workforce, which results in lesser loses of workforce due to illnesses, and the company image is better. It is also reflected upon mutual communication among the staff, cadre education is more efficient , and marketing and promotion can function better, which improves the sales.

Brainmapping represents a combination of brainstorming and brain mapping in which we create a brain map used as an incentive for a brainstorming session. It is convenient in conditions in which the tradition does not allow a free expression of creativity and ideas. This way, the process participants are released from "bars" behind which they are captured and they start thinking out of the box.

PROBLEM DEFINITION

"The conflict" between marketing and medicine has been going on for decades, ever since marketing, as a separate branch of science, has become an integral segment of business (13). The basic problem lies in the perception of doctors that marketing is not an ethical activity, and that it negatively influences the basic postulates of the medical profession.

Besides this, doctors believe that marketing is irrelevant in health care, that it is an expensive activity and that it represents an artificial creating of demand. A doctor wishes to provide a service that is truly needed without any interference of the commercial aspect.

However, the biggest misconception lies in the fact that doctors coincide marketing with advertising and sales. Creating marketing messages in health care depends on legal regulations, but also on creativity and responsibility of doctors who create the messages. Researches show that the influence of the message on the patient depends also on the fact of how news is the service, but also how new is the risk for the patient (14). Based on that the patient decides on a certain operation or procedure.

Having in mind the history of marketing, that is, the main concepts that have intertwined through the theory of marketing, some of these delusions could be right. This particularly relates to periods when the priority was on production, product or sale. However, recently, with "marketing" , and particularly, "holistic" approach we can note that the stress is on the buyer (patient) and on the values that we bring into it through the work done (15). Holistic marketing consists of internal marketing, integral marketing, socially responsible marketing and marketing of relations. The holistic approach, thus, introduces an important segment of internal marketing that relates to preparation of workers for a more quality relation towards the service user. That is how we come to an equality sign between a dental service and marketing of that service. The value that the service brings becomes the priority. Ethical action in marketing becomes on the of the most important turning points which in long term leads to:

Growth in sales and market share

Strengthening of the position of company brand

Strengthening company reputation with consumers and in public

Increase of attractiveness for the employees

Decrease of operational costs

Increase of market value of the company and easier access to sources of capital (16)

Innovations in marketing give more importance to all employees which encourages them to make an extra effort in their work. With these innovations the patient gets the complete service, because he/she partly influences the selection and type of service (7).

Our experience shows that a very small number of doctors use creative potentials of their employees be they junior colleagues, nurses, technicians or administration employees.

In order to make quality service we must know how to reach the service that is adequate to the level of a doctor or doctor’s office, that is feasible, necessary, and finally profitable. That is why we plan the office/clinic business strategy by creating the portfolio of the service that will meet the demands of patients in short, middle and long term. Apart from planning service type and adequate equipment, strategy planning must include human resources planning that will meet set tasks (18). Innovations represent an ideal way of entering the market or for the change of image of existing dental practice. One needs to think over and develop a new product or service and act operatively on applying what was imagined. It represents a particular challenge for doctors, but they should not be afraid because the steps they need to take are identical to those already used in other areas (19). In cases where the dentist starts his/her business, one needs to think on "disturbing" innovations (20) which are a good way to make the office recognizable. For this type of innovations its is necessary to offer an acceptable service (complete), not only affordable.

The traditional health care role has been based on people (doctors–professionals) and their medical expertise. It is necessary to complete the service with additional items since the 21.century patients are becoming ever more demanding. In the quest for, the selection of and use of health care services that will meet the health (existential) needs, the user behaves differently than in case of any other existential need. In most cases, the user can not foresee when or how he/she will get ill, and the recovery process is often related to unpleasant experiences. Satisfaction of the user with the health care service partly lies in the pleasure of the service provider as an individual, and partly it depends on the broader establishment of the health care system (5).

Introducing information technologies allows advancement of two important elements of the marketing mix, namely: Process and Physical evidence. Physical evidence also favors the promotion of the brand of health care institution, where patients are pleased with the appearance of the IT equipment, and by using every possibility modern technology offers. Its particular quality lies in the fact that in public health care institutions we can rarely find fully computerized procedures. IT is mostly used as a substitute for a typewriter. Fully equipped office gives the patient additional security and strengthens trust in service quality. For contemporary health care systems we can say that "they have the data, but do not have the information". Aiming at providing the highest possible standards of health care services, Republic of Croatia has initiated the process of introducing large information systems with the need of support to business processes in health care. Two major demands were given: provide efficient data management in health care as a support to decision making process and provide a constant support for health care costs optimization (6). Acceleration of all administrative processes and transfer of relevant information is of crucial importance for a modern age health care institution. Use of IT allows precipitation of administrative processes, ordering process and patient mobility process, facilitates data accessibility, reduces unnecessary waste of time so doctors and auxiliary staff can dedicate to the patient. Test results conducted in one place can be transported to another place swiftly, which facilitates work, especially in case of urgent procedures.

It becomes clearer that marketing is not only advertising but the complete experience of the office that the patient wishes to feel, starting from the smell of the office, manner how it is used or how the receptionist answers the phone, how we keep our medical cases, technology which is used, ending in the manner of bill charging (21) (22).

Simplification and acceleration of procedures makes the patient / user of the service satisfied. A satisfied patient will recommend the polyclinic to other potential users – thus creating the word of a mouth effect as a form of promotion.

The process as part of the marketing mix is an important element in the service activities and can provide a significant comparative advantage, although, as such it can be neglected due to a false perception of marketing activities and marketing within the framework of certain activities. It is, therefore, necessary to introduce the doctors with marketing basics, especially with the fact that marketing is not just promotion and advertising, that it does not work against principles of doctors’ ethics, but that it includes many more segments in the very providing of efficient health care service which will guarantee clients’ satisfaction.

Research shows (23) that the most important questions to pay attention about, marketing innovation-wise, are:

Adequateness of marketing in certain situations, particularly about hospital condition

Marketing effectiveness

Expenditure and manner of perception of values brought by marketing

3. Hypotheses

Innovative methods and creative potential of employees in private dental practice are not in use

Use of creative potential of employees is possible in strategic planning

of services portfolio in dentistry

4.RESEARCH GOALS

1. Determine knowledge, standpoint and practice of the dental therapist – in private practices on the use of innovative processes in solving problems of adequate service offering.

2. Check possibilities of the use of innovative methods in strategic planning of service portfolios in private dental practices in short, middle and long term period (24) (25)

3. Check the relation of dental therapist in various types of private dental practices towards marketing activities and the past use of marketing in practice.

4. Creating a strategy of portfolio stervices by the BCG principle, used already by innovative companies, especially pharmaceutical companies (26)

5.TASKS

1. Make brainstorming/mapping sessions with doctors in private dental offices, gather their experience, suggestion and ideas that can be used in service portfolio planning.

2. Analyze the secondary data from existing research made in Bosnia on marketing in dental practice

3. Interview doctors-dental therapists (of various specialties) about past and future activities on strategic portfolio planning and statistically treat the received information.

6. Material and methods

 The study will include doctors from the dental private practice.

Brainstorming/mapping sessions with all employees will be held in order to take their ideas, suggestions, experience etc. which could be used in services portfolio planning . We will use group mind maps additionally filled up by the employees

Secondary dana will be analyzed on following issues:

- the use of creative potential of the employees,

- the use of marketing in private dental practice in general and

- experience in strategic planning

7.INFORMED CONSENT ACQUISITION PROCEDURE

The respondents will be further informed about the research goal, their role in it, as well as presented with a written form of informed consent with the procedure description.

The respondents will be informed about the fact that the research bears no risks for their status, reputation, etc, that it will be confidential and that the date made in the research will be only available to the researchers. Publishing the results of the research will be for scientific purposes only.

During the research the respondents will be registered in a form of a number.

8.RESULTS

9.SCIENTIFIC CONTRIBUTION

The scientific contribution of this papers reflects in:

Importance of heightening of the holistic approach in health care marketing that primarily relates to introducing internal marketing in terms of using creative potentials of employees. These activities help designing a successful team consisted of content employees (27).

Importance of long-term planning of service portfolio and appropriate cadre educating (28), as well as planning of adequate medical equipment acquisition.

Importance of educating medical workers in market management for the purpose of better use of present resources.

Importance of breaking prejudices on impossibility of connecting best practice in dental care and marketing, especially having in mind the fact the ideal system of oral health protection must, among other things, be efficient, financially stable, socially responsible and integrated with other segments of health care (29). These are the characteristics of a strategically planned and marketing-well defined system.

CONCLUSION

From the answers it is evident that there is an emphasis on promotion, where one third of respondents consider Internet Marketing to be the set of tactics used to advance promotional activities. Yet, it is also noteworthy that no specific emphasis on the other P, place, was given. Also, there wasn’t given a clear emphasis on pricing as a marketing tactic. What is more worrying is that there is no practice of cooperation between marketing professionals and dental practitioners. Dentist professionals are uncertain of legal environment and the possibilities they may have in marketing communications. From the results it can be deduced that the simplification and acceleration of procedures makes the patient and user of the service satisfied. A satisfied patient will recommend the polyclinic to other potential users – thus creating the word of mouth effect as a form of promotion. The process as the part of the marketing mix appears as an important element in the service activities and can

provide a significant comparative advantage, although, as such it can be neglected due to a false perception of marketing activities and marketing within the framework of certain activities. It is, therefore, necessary to introduce the doctors with marketing basics, especially with the fact that marketing is not just promotion and advertising that it does not work

against principles of doctors’ ethics, but that it includes many more segments in the very providing of efficient health care service which will guarantee clients’ satisfaction.

This appears as a result of the misconception that marketing is the same as advertising (this relationship is comparable to relationship dentistry = filling). There is no awareness of the importance of using marketing to improve the quality of service. It is necessary to educate dentists in the field of marketing, having in mind the transition period in economy. A potential way forward for the marketing management of dental services could be in planning the optimal combination of marketing process and then creating internal marketing process considering the practice and the employees, because only capable and satisfied employees

can ultimately lead to the full and true patient satisfaction.

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