There is no doubt that private medical practice is a capital-intensive venture because of the high initial start-up costs associated with acquiring equipment. The Ophthalmic Consultants of Boston was established in 1969 and comprised of a group of certified ophthalmologists who offered their member physicians with both the administrative and clinical structure while at the same time giving each physician the discretion to create his/her own practice depending on the their personal goals and styles. Since its establishment, OCB has built its reputation in its respective industry because of a number of factors including ophthalmology related publications, global reputation associated with its members, and its associations with some of the most prestigious medical schools in the United States. In order to minimize costs, OCB makes use of a centralized structure that aggregates its business functions including financial reporting, patient history archives, billing, common front desk used in patient reception, information systems, call center, human resource management, office space, and procurement. The aggregation of these functions from these functions into a centralized form of administration has allowed OCB to exploit economies of scale while at the same time enabling the ophthalmologists to have adequate time to focus on meeting the needs of their patients as well as the demands of their personal lives. Achieving success in the ophthalmic market in the United States depends significantly on reputation, which plays a crucial role in attracting patients and referrals from other medical practitioners. By guaranteeing high services quality, OCB has managed to maintain a positive reputation in the ophthalmic industry, which has contributed significantly to its growth. Nevertheless, because of its centralized structure, the sustained growth of OCB depends significantly on the growth of the individual member physicians. At present, OCB does not have an overarching growth strategy. In addition, standardization of procedures and practices is lacking because of the fact that member physicians have the discretion of undertaking their practices according to their goals and style. In addition, the decision making process at OCB is relatively long since decisions are made using consensus. Owing to the fact that no formal business plan was used when setting up the business, tactical and strategic decisions are often made individually, posing the need to conduct several meetings as well as long debates in order to determine the best course of action for OCB and its members. The outcome of such an arrangement is an ineffective resource allocation and high operating costs. This paper performs a case analysis of the Ophthalmic Consultants of Boston and Dr. Bradford J. Shingleton. In analyzing the case, emphasis is placed on ways that Dr. Singleton appears different than his colleagues at OCB; things that OCB are doing well or bad as an organization; the business goals of OCB and the sustainability of its current strategy in the long-run; and the action plan to be adopted by Dr. Shingleton.
In an attempt to achieve maximum returns from his practice, Shingleton came up with efficient processes aimed at ensuring the standardization of all facets of his consultancies, which played a crucial role in enhancing the overall productivity and efficiency of Shingletons team. In addition, Shingleton placed emphasis eye surgeries, which was in high demand because of the observation that those aged 65 and above need glaucoma and cataract surgeries. Shingleton is also different his colleagues at OCB relates to his attitudes towards innovation. Innovation has been established to be a critical attribute of entrepreneurship because it enables entrepreneurs to adapt their business in accordance to the market demands, which helps in ensuring the relevance of the business. In addition, Shingleton takes into account the abilities of all members in his team in order to help him create robust ophthalmic practice. Dr. Shingleton performs more operations when compared to other physicians at OCB. Shingleton is also continually improving his practice in order to enhance operational procedures. A case in point is that he is credited with implementing the team suggestion program as well as refining the procedures for post- and pre-operative drops. Shingleton is also different from other physicians at OCB because of his infrequent use of the organizations resources.
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The structure of OCB is characterized by individual practitioners acting like smaller organizations under a larger organization. An evaluation of the OCB using the Greiner model shows that OCB is currently in the third growth phase. In this regard, OCB has managed to solve the problem of autonomy through permitting independent practices by its member physicians. Nonetheless, it is imperative to note that despite the fact that OCB as a whole is in the third growth phase, the individual practices under the organization are at different growth stages. Dr. Shingleton practice can be considered to be in the second phase of growth because he acts as a leader by developing an efficient process and is involved in the making of strategic decisions that have the main objective of advancing practice. This is contrasted with his colleagues at OCB who are yet to address the leadership crisis and are still in the first growth phase based on Greiner model. Despite the fact that the Greiner growth model is somewhat helpful in assessing organizational growth, it fails to take into consideration organizations having units in different phases, and how these units can adapt to ensure consistent growth phase with the larger organization. In fact, the biggest problem facing OCB can be attributed to the fact that individual practices have the discretion to govern themselves resulting in growth inconsistencies.
The business goal of OCB should focus mainly on helping the various practices under the organization improve their efficiency and adopt standardized services. OCB should not focus on increasing its patient volume before first addressing the issues related to standardization of practice and inefficiencies. The problems at OCB can be solved by eliminating the issues in OCBs organizational structure, which has resulted in lengthy decision-making processes and growth inconsistencies owing to the fact that different physicians exercise autonomy, which implies that the goals and visions of individual practices may not be consistent with the goals and visions of the larger organization. In such a case, standardization of practice acts as an effective measure to address this problem in organizational structure. Standardization could be achieved by suing a centralized organization structure having a central mission and vision with a leader who oversees the 18 practices. The individual practices should not be disbanded; however, their practices should be standardized and be subject to the requirements set by OCB rather than based on their discretion. The current strategy is not sustainable owing to the fact that OCB has undergone an evolution phase and is currently undergoing a revolution phase, which implies that the decentralization approach that was effectively previously is no longer effective. There is the need for OCB to adapt its organizational structure with its subsequent growth.
Owing to the fact that Shingletons practice has grown significantly and he is approach his peak, a good idea for Shingleton would be to delegate a number of his duties through recruiting another physician to be in charge of clinical functions while he devotes his attention to administrative and surgical roles.