While reading this case study, one problem can obviously been observed- paradox of change. Shouldice is operating at its "best operating level"(as we can see from the case), a specialized work force but it is failing to meet all the demand for its chosen market niche. Adding additional capacity to meet market need may upset the existing work force and lower quality of operations.
Failing to meet market requirements may cause competition that would lead hospital to loss market share.
I make a SWOT analysis for better understanding of the case:
-Strengths:
1)Unique surgical techniques.
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