An attractive brochure that had been printed recently, although neither dated nor distributed to prospective patients, described Dr. Earle Shouldice, the founder of the hospital:

Dr. Shouldice’s interest in early ambulation stemmed, in part, from an operation he performed in 1932 to remove the appendix from a seven-year-old girl and the girl’s subsequent refusal to stay quietly in bed.

In spite of her activity, no harm was done, and the experience recalled to the doctor the postoperative actions of animals upon which he had performed surgery. They had all moved about freely with no ill effects.

By 1940, Shouldice had given extensive thought to several factors that contributed to early ambulation following surgery. Among them were the use of a local anesthetic, the nature of the surgical procedure itself, the design of a facility to encourage movement without unnecessarily causing discomfort, and the post-operative regimen. With these things in mind, he began to develop a surgical technique for repairing hernias1 that was superior to others; word of his early success generated demand.

Dr. Shouldice’s medical license permitted him to operate anywhere, even on a kitchen table. However, as more and more patients requested operations, Dr. Shouldice created new facilities by buying a rambling 130-acre estate with a 17,000-square-foot main house in the Toronto suburb of Thornhill. After some years of planning, a large wing was added to provide a total capacity of 89 beds.

Dr. Shouldice died in 1965. At that time, Shouldice Hospital Limited was formed to operate both the hospital and clinical facilities under the surgical direction of Dr. Nicholas Obney.

In 1999, Dr. Casim Degani, an internationally recognized authority, became surgeon-in-chief. By 2004, 7,600 operations were being performed per year.......................................

Questions 

1. What is the market for the service off ered by Shouldice Hospital? How successful is the hospital?

2. Defi ne the service model for Shouldice. How does each of its elements contribute to the hospital’s success?

3. As Dr. Shouldice, what actions, if any, would you like to take to expand the hospital’s capacity? How would you implement such changes?