A brief history of strategic management
Strategic management has gone through gradual advancement both empirically and theoretical in the last twenty five years. The roots of the field can be traced to the year 320 BC from the works of Tsu Sun. Since then the field has gone dramatic evolution (Teece et al, 1997). Some of the most remarkable historical works of strategic management includes; corporate strategy, industrial organization economic, product diversification, and the behavioural theory of the firm (Andrews, 1971).
Traditional strategic management
Traditional strategic management offers a number of options that can be taken by the organization to manage its affairs. There are basically two principle paradigms that have been reflected by Teece et al, 1997. The first is the competitive forces approach which was developed by Michael porter and the strategic conflict approach. The competitive advantage approach focuses on the actions that can be taken by the organization when faced with an issue (Campbell & Wilson, 1996). It is a paradigm that focuses on the outward forces and the subsequent actions that can be taken. The strategic conflict approach on the other hand focuses on the market at large and tries to identify some of the imperfections that are hindering its performance.
The other principle of traditional strategic management is focusing on a firm’s efficiency through the resources and processes that they posses. It is basically the capability of a company which owns such resources that can determine how it can utilize the resources to have a competitive advantage in the market. A company that has minimal resources may not be able to effectively compete with a similar company that are well equipped. Efficiency is also based on the competency of the workforce of the organization. Employees form a basis on which the company can effectively utilize its resources for subsequent growth (Enders, 2004). The more competent the employees are the more likely it is for the company to experience growth.
The services sector
The service sector is a sole determinant of performance of a product on the international market. International trade has seen companies moving basically from ma regional coverage to an international one. There is hence no guarantee that a company will enjoy a monopoly of production despite the unique products that they may be engaged in producing. This has made most companies to raise their standards min terms of providing services to their customers. Customers have a wide variety of choice to chose from and will hence for high quality and economical products. There are a lot of changes taking place in the market which includes the ever changing demands of the customers. The company is also obliged to meet the expectations of its stake holders to secure a place in the market. These are some of the challenges that have to be considered by a company even as they gear towards high productivity.
Porter’s Five Forces
Before a newly established firm enters into the market, there a number of questions that they need to ask themselves. There is usually that need to be assured that the investment is worth making and that they will be able to counter any kind of competition that comes their way. To assist such companies make it in the market and assess whether they have the ability of making nit in the market, porter, in his book, ‘competitive strategy’ looks at mainly five forces that a firm is likely to encounter min the market and how they can effectively handle the situation. The five forces that have been described by porter enumerate the market environmental structure that the firm is likely to be exposed to. They describe the intensity of competition depending on other similar establishments and predict the likely outcome if the industry was currently in operation (Easton, 1992).
The five forces have been summarized in two kinds of competitions. The first is the horizontal competition that describes three forces. The second kind of competition is the vertical one that has two forces. In horizontal competition, there is the threat of new products entering into the market, the threat of other firms that deal in the production of similar goods and the threat of substitute products that may be preferred by the customers. According to Easton (1992) “In vertical competition, there is usually the bargaining power of the customers that is likely to make the goods to go at a slightly lower price and the bargaining power of suppliers which may have both positive and negative impacts on the products.”
The five forces as described by porter include:
The threat of the entry of new competitors; the entry of a new brand in the market can be a major threat to existing brands. This is basically because customers tend to try out on the new products that have just been launched in the market. Depending on the quality of the product, customers may be attracted to it and hence developing a loyalty towards it. A competitor in the market will also fight for a place in the market. If there has to be balance, it will mean that the market share of other established brands will also go down.
The intensity of competitive rivalry; companies have different strategies through which they gain competitive advantages over the others. This mainly depends on the strategies that they use to carry out their businesses. With many improvements being made in the field of information technology, many firms have chosen to adapt such innovations to attract clients their way. Companies that have not made use of the latest technology may not be able to attract as many clients as those that have decided to utilize such innovations.
The threat of substitute products or services; substitute products will mostly gain an advantage if the price of other products have risen in the market. Substitute products may hinder the performance of the main products in the market as they have to maintain the price. The quality may not matter much to consumers who may be looking out for any means possible to cut on their expenses and make some savings.
The bargaining power of customers; customers have different bargaining skills that may either boost or lower the performance of a firm. There are clients who will take the product or service according to the price that has been quoted to them. There are however others who will try their best to ensure that they take the product vat a slightly cheaper rate. Depending non what will be encountered by the firm, the company is likely to gain or loose depending also on the sales personnel that are in charge.
The bargaining power of suppliers; suppliers are the main people that ensure a company gets a regular flow of the raw materials. Their reliability may be limited with the demand for such products. When suppliers discover how competitive their materials are, they are likely to increase their prices and hence making the company to incur higher expenses. If there is no cooperation between the supplier and the firm, they are likely not to supply them with such products and hence causing a threat to their production activities. The company may also be forced to look for suppliers far away which may make it to incur high transportation costs.
Criticism of Porter’s Five Forces
The five forces as presented by porter have received a lot of criticism from other economic experts who have risen to challenge them. Teece, Pisano and Shuen (1997) have observed that the approach of porters stems from the paradigm of structure –conduct performance. According to them, rather than the paradigm putting emphasis on strategy, it puts meaning in context. This hence makes the forces to be more workable on a public approach rather than the designed approach of approaching companies (Mintzberg, 1990). Porter’s strategy also seems not to put into consideration the changes that are taking place in business. There is more of digitization, globalization and deregulation which have not been taken into consideration.
According to (Grundy, 2006) the theory as observed by, porter can only be practical for a maximum of twenty percent of the managers. This hence reveals the rigidity in the application of the paradigms which reminds them unpractical. He however recognizes the formulistic advantage that it has which can be effectively applied for profitability. When companies are given the ability to identify areas of maximum profitability, they will be well equipped to handle the challenges that come with competition.
Nijel Slack’s Five Forces (Performance Objectives)
Nijel slack is an economist that has also identified some of the strategies that may be used by firms to successfully execute their functions. In his book the operation function, he distinguishes three main purposes of a company. According to him, the company has mainly three basic functions that include; operations, marketing and finance. Operation is however a technical key in all operations of the company as it is the one that determines how the mother functions will run. Operation is at the center of all other activities that involve the stake holders of the company. Nijel has highlighted some issues that may be experienced by the company in the operation process. These issues include;
Cost is an important determinant of every activity that the company engages in. before carrying out any business activity, the company should be able to ascertain the total costs that will be incurred before venturing into it (Cohen, Briand & Newman, 1990). This will go along way in facilitating the planning process. The cost of engaging in an activity will tell the company whether they have adequate finances for it or not. It is therefore a fundamental requirement that can not be ignored.
The rate at which a company grows will ultimately determine its performance. Speed has to do with the grate at which the management makes decision and implement change. This can only be affected if they have the ability to predict the market situation in an environment. They are able to know when there is likely to be a high demand for the products produced and hence employing urgent measures that will ensure that there is enough stock. They are also able to effectively monitor their competitors and hence devising strategies that will ensure they effectively counter attack the situation.
Flexibility is usually the ability of a firm to respond to change. There are times when the objectives that have been set by the organisation may not work and hence not granting it the outcome expected. It is at this point of time that they need to review them in relation to the current market environment (Dyer & Singh, 1998). It may be required for a company to change its product line and adapt a product that will be accepted and appreciated by consumers. Consumers are the main barometer of a company’s success and hence need to be considered in every production process.
Dependability is usually the acknowledgement of the company that it needs other firms to network with. Despite the specific objectives that they may have, they can’t deny the fact that they will need assistance from other firms. There needs to be a proper coordination between a company and other establishment for the purpose of working together. In its initial stages, a company may not have all the facilities to carry out its business. It may hence need to collaborate with a distribution firm or any other firm that deals in the supply of its raw materials. Such kind of networking will enable the company to also be exposed to many more clients and also learn a lot from the other companies it is networking with (Galaskiewicz & Zaheer, 1999).
Production of high quality goods and services is what sustain a company in a competitive market. Clients will always be attracted to firms that will assure them of a continuous quality. Due to the other firms that are coming up, a firm may always think of a new way of improving the quality of its products so that they are continually attracted to them. Good quality may not be necessarily what the company may feel is good for the consumers but rather what they feel about the product. This can be facilitated by market research which will prove to them about customer’s tests and preferences. It will hence be appropriate if the company focuses on the needs of the customers and give them exactly what they need.
Global sourcing, global markets and global financing
Advances in technology
Product variety and mass customization
Importance of strategy
Environment and ethical concerns
Emphasis on quality
Criticism of Slack’s Five Forces
The five forces as presented by slack have also received criticisms for simplifying the entire process. There is a lot of information that seems to be left out in the entire process which makes it quite inapplicable. The forces may however be used alongside other principles. Slack has been criticized for focusing so much on the perspective of cost and not really realizing that there may be other influencing factors that may affect the performance of an organisation. In as much as the five principles have an impact on the performance of an organisation, other aspects like networking can not be ignored. His ideologies were also found to have a number of weaknesses that could not be completely relied on by firms.
Resource-Based View (RBV)
The resource based view (RBV) is a strategy that was considered to be most appropriate after the failure of porters view to accommodate current business needs (Enders, 2004). The RBV is a tool that has been considered to determine the strategic resources that can be applied by business organization for sustainable development (Staw, Sutton & Sutton, 2000). The principle emphasizes on the importance of applying valuable resources which are at the firm’s disposal (Wermerfelt, 1984). RBV has formed the basis of all business studies in the current world due to the practical principles it puts forth. According to the RBV the competitive advantage of the company can only be worn when it is looked at basing on the internal perspective rather than the external that is emphasized by porter (Dyer, 2000). The success or failure of the organization mainly depends on the internal abilities and weaknesses as displayed by the work force. They are the ones that have been ordained with the responsibility of ensuring that company activities run smoothly. The resources of the company on the other hand need to be aligned to the managerial plans of the organization.
The RBV looks at the internal issues of the organization and aims at finding a solution (Staw, Sutton & Sutton, 2000). The external problems may not matter much if the organization has adequately taken care of the internal issues. In fact, the principle suggests that it is easier to handle external challenges of the organization if the internal ones have been well taken care of. According to Edvinsson & Malone (2000) “the three main resources of a firm is human capital resources, physical capital resources and organizational capital resources.”
Criticisms of Resource-Based View
Despite a number of successes that have been observed in the use of RBV, there are some aspects of the principle that have been strongly criticized. Peteraf (2003) considers the principle laying so much emphasis on the internal issues of the organization when the external ones also have a role to play in the competitive advantage of the organization. The success of an organization also depends on the external networking with other organizations with the main aim of combining efforts and hence coming up with appropriate strategies (Dyer, 2000). It has also been argued that the resource based value requires a firm to develop internal solutions for the problems that may be encountered. This is done without proper consideration of the fact that some of the problems that may be encountered by the organization may not find their answers internally. There are hence a lot of assumptions that have been made in the theory which can not be verified practically (Kirsch, 2007).
The RBV has completely neglected the importance of external resources which includes networking in the daily running of its activities (Galaskiewicz & Zaheer, 1999). It hence implies that an organization is a self sufficient unit which may not need the help of other external sources. This is a bit controversial considering that modern companies are in fact resolving to networking rather than depending on their own abilities (Frels, Shervani & Srivastava, 2003). There is so much about companies that there is usually a need for them to share and interact. Networking has become the basis of solving some of the issues affecting companies as many of them resolve to mergers and acquisitions to manage the current competition. It is hence rather impossible for a company to survive on its own by mainly looking bat internal ways of solving their problems (Kirsch, 2007). Networking has become an important force that makes managers to consider what is making the other companies to perform well or vice versa in the market (Arbib, 1995). It is a measure that sensitizes them on what may be applicable for them and what may not. The RBV seems to have neglected this important feature which has formed the basis of conflict with other economists (Kirsch, 2007).
Push and Pull Processing
Push and pull processing is a medical term that is used to describe the need for patients to participate in decisions that pertain to their health. Despite their minimal knowledge in the medical field, they deserve an explanation on what is being done to their bodies to facilitate their healing process. However most health care practitioners will simply do what they feel is right and not go a head to give any tangible explanation to their patients. All they do is to scribble something on the paper that contains some medical terminologies that can not be understood by the patients. Some patients may end up not knowing what they were treated for as there was nobody to give them a good explanation. It is usually the right of a patient to be informed about their health condition and also be consulted before any treatment is given to them (Stegwee, Ton and Spil, 2001). The necessity of such consultation came due to the need of finding out if a certain therapy would be appropriate for the patient.
Medical history of the patient is a necessary requirement by the doctors or any other health care staff (Stegwee, Ton and Spil, 2001). They are required to find out if the patient has ever suffered any other illness that is related to what he or she is currently suffering from. This will facilitate any other decisions that may be done towards identifying the right kind of medication that will serve the patient well. The medical field ahs provided various options of dealing with any of disease. There may be certain kind of treatments that may not be suitable for a patient due to their medical history. Apart from the signatures that have to be obtained from the patients and their next of kin before any operation is done, the patient also needs to know other available alternatives to treat this disease. Min fact they are supposed to be given all the available options where they will get a clear explanation of what their possible side effects are. This will enable the patients to make informed decisions about their health and avoid any form of regret (Stegwee, Ton and Spil, 2001). In case a patient is not in a position to determine the right kind of treatment, the doctors may use any that they feel will work out best for the patient. This should however be done after explaining to the patient more about it.
Patients have a right to deny any kind of treatment or therapy that has been suggested to them by their doctors. They are also not obliged to give any kind of reason for their refusal. The doctors on the other hand do not have a right to administer any kind of treatment that the patient has not consented to. There are however certain limitations to this where the case may be of emergency. If it is not possible for the doctor to obtain consent from the patient, he may do so as per their medical knowledge. However in most cases, for instance if the patient is in a subconscious state, the doctors may only administer first aid until when they are in a position to talk (Cruez, 2008). There are also cases where by the patient may actually not be in the right mental status to consent to treatment. People with mental problems or those that are under the influence of any intoxicating drug may not be in a position to make concrete decisions. Such considerations are also put in mind by the doctors even as they administer to the patients.
Value network is an avenue that is provided by a firm to other firms to facilitate communication and distribution process (Eccles, Herz, Keegan & Phillips, 2001). It is a procedure that is considered important especially in the global economy where there is a need for distributing goods and services world wide. There is no limitations through which the firm may network and mainly depends on the activities and coverage it can manage (Galaskiewicz & Zaheer, 1999).
Background of network study
Network study has been used by individuals from various fields which include psychology, biology, neuroscientists, sociologists, engineers and computer scientists. Network study is mainly a strategy that is used to enhance awareness among business practitioners and to make them apply the best tactics min their management (Christensen, 1997). It aims at connecting different business units with the aim of maximizing on what they have. Despite the rising competitions within and among business units, there has been a need to form alliances that will basically deliver them from falling out of the market.
About value network
Value network is basically a networking zone for business organizations. Business units come together through such a network to discuss what may be affecting them and to find a way forward that will ensure continuity and growth (Cartwright & Oliver, 2000). The network makes good use of supply chain management to manage the resources of a company as well as enhancing marketability (Bovet & Martha, 2001). Value network brings together all the stakeholders of the company and considers them to be important sources of company growth (Fjeldstad & Ketels, 2006).
Value chain is a strategy that has been considered and applied by companies to increase the value of their products and hence attracting customers their way. Customers are usually the most valued stakeholders of a company and are hence to be given goods and services as per their demands (Farjoun, 2002). Value chain hence plays an important role in ensuring that customers get the best in terms of providing them with services and products (Eccles, Herz, Keegan & Phillips, 2001). Porter mostly used the term to asses how competitive a business unit was. The concept has been in use for the past two years especially among strategy practitioners. Value chains were mostly used in the twentieth century when most industries were dealing in the manufacture of goods. It was basically to assist them venture into high quality production to attract and retain customers (Caswell, Nikolaou, Sairamesh, Bitsaki, Koutras, & Lacovidis, 2008).
Value Network vs. Value-Chain
Value network has a wider coverage than value chain. Value chain was mainly coined by porter in consideration of the twentieth century organizations that mainly dealt in the manufacturing process (Fjeldstad & Ketels, 2006). Value network is however a system that can accommodate most of the modern establishments as it looks at a wide variety of resources necessary for growth (Bovet & Martha, 2000). Value chain is a linear model that has no room for organizations to enter into alliances. In this model, the company mainly concentrates on the internal solutions for any issue that may arise in the organization (Anderson, Haakansson & Johansson, 1994). Porter believed that everything that may affect the organizations performance has an internal solution that has to be sought after by concentrating on the inside. The model was designed for a specific time and when the business environment changed its course, it could not be applicable to all business units. However, the value added network pus into consideration business happenings between customer clients and mother business organizations (Galaskiewicz & Zaheer, 1999). Value chain insists on the importance of involving in high quality production to attract more customers. On the other hand, value network emphasizes on the need of entering into alliances with other organization with the aim of sharing ideas on what can be done to enhance high productivity (Galaskiewicz & Zaheer, 1999). Value chain does not believe in external interventions while value network looks at the importance of networking which is likely to have a positive impact on the organization.
Value Network Analysis
Some years back, it was easier to draw a line between goods and services. This was mainly because there was a specific criterion that was used to gauge them. The main four characteristics that were used to differentiate one from another included inseparability, heterogeneity, durability and intangibility (Zeithaml et al, 1985). Such a criteria can however no longer be used to categorize goods and services. This is basically because of a wide variety that firms can produce. The term that have been, commonly adopted for the same is now products and services. There is however no clear definition that can be given to the products as all produces of a firm are referred to as the same. However, the definition of services has not really changed much due to the nature min which they are provided. By considering the value network analysis, we come to realize the wide area in which it covers. It almost gives solutions to the needs and requirements of an organization by enabling it apply the necessary measures. There are practical solutions that are put fourth by the analysis that critically looks at the issues that are surrounded the company at a particular time (Galaskiewicz & Zaheer, 1999).
In value network analysis, the general situation of the market is looked unto as well as well as the procedures that may be used to ensure that the situation is under check. There are some factors that will impact on the growth of the business. Such factors may slightly differ depending on the period in which an establishment has been in the market. Newer establishment may be encountered with slightly complex challenges eve n as they try to adjust to the situation. Their main aim is probably to ensure that the products that they are dealing in get enough coverage that will attract customers their way. There is also the issue of whether the products or services that are being provided by the company will satisfy the needs of the customers. This will hence require extensive sales promotion techniques to potential customers (Jeldstad & Ketels, 2006). For an establishment that has been in the market for long, the challenge is usually to maintain high quality production and to fight competition with the upcoming organizations. This requires the use of modern technology as well as changing on its sales promotion techniques (Christensen, Rosenbloom, & Richard, 1995). Jeldstad & Ketels (2006) noted that, “In facilitating the process, it requires the use of both financial and non financial procedures.”
Value Network Analysis Methodology
There are two mappings that are used to evaluate the value network analysis methodology. The first is the roof top and the second is the helicopter view. There are various steps that need to be used in the whole procedure;
Define the network: this is the first step that has to be considered before a correct methodology is defined. It is s stage that involves the definition of boundaries, by this, the topic of study needs to be considered and studied in details. The solution to the issue may need to be dealt with in stages and in groups. Once this has been known and established, it will be easier to carry put the subsequent procedures.
Identify and define network entities: this is the second step that involves the identification of major players. The standpoint is usually considered as the focal point the participants will network from. Different roles of the participants have to be identified and allocated appropriately to avoid any kind of inconveniences. Positions need to be filled with individuals that will have a clear understanding of what they care meant to do. It is a responsibility that will involve drafting and sending messages that will facilitate the decision making process.
Define the value of each entity perceives from being a network member: it is very necessary for planning a value delivery strategy by identifying value participants (woodruff, 1997). This facilitates the identification of the different members and also their role in the network. In analyzing whether the network is yielding results or not, the participants will always be asked to identify how it is affecting them. This is a process that has to be done on a regular basis to know whether some changes need to be facilitated or not. This kind of system is differentiated from the traditional one by having the ability to predict the outcome of the network (Conner, 2007). Since there are usually positive and negative outcomes of the network, they are both weighed to consider if the deal will be worth making or not. There are also various alternatives that will be provided to the participants who are also given a chance to make a decision on what will be most appropriate for them. Since the system takes into consideration the different types of entities, it is usually important that they chose from m a variety of methodologies. There is advice that may be provided for them to make wise decisions, but the sole choice is left up to them to decide. This is usually considered necessary to avoid cases of failure that will be blamed on imposition (Peppard & Rylander, 2006). Perceived value is a key that drives all the activities on network development. It is the sole determinant of how far the business is able to go and also achieve.
Identify and map the network: in the fourth step, different linkages between members are identified among network members. The linkages used in this case are usually referred to us network influences or transactions (Allee, 2000b).transaction roles are displayed by an arrow that moves from one specific direction to the other. They take the trend of start, middle to the completion stage. They are presented in deliverables which may take a verbal or physical form. Deliverables have further been divided into two forms that include tangibles and non tangibles.
Tangible deliverables are the deliverables that that have a direct impact on he production and delivery of goods and services. Tangibles are transactions that are involved in business undertakings (J. B. Barney, 1991). Those that are tangible imply that they are deliverables that can be contracted or mandated on.
Intangible deliverables are the extras in form of knowledge and favours that may be extended to a business establishment. This may be due to the good relationship that the enterprise may have had with other service providers and businesses. They are usually extended free of charge to the business and will usually facilitate the smooth running of the firm.
Analyze and shape: this is the fifth step that draws some conclusion on the strategy that has been used to distribute resources. The roles that have been assigned to different participants are once again analyzed to find out if they are appropriate in fulfilling the required objective. The driving force behind such an analysis is finding out the value dimensions of all participants, how they work and influence the rest of the participants in the network. The network is however finally created by the customers.
After a thorough analysis of the review of some of the methodologies that may be used to gauge the state of health care system in Malaysia, it can now be possible for us to identify the SWOT analysis of the system. Strengths, weaknesses, opportunities and tests will give us a clear view of our study topic. Below is the analysis.
The health care system in Malaysia has been credited by various international health care organizations as having the ability to provide quality health care facilities. This acts as an added advantage to medical tourism in the country (Cruez, 2008). The government in collaboration with other private health care institutions is working hand min hand to ensure that medical facilities are up to date. There is a lot of networking when it comes to medical health centres. There is a sense of willingness and desire within health care practitioners to employ measures that will ensure that the situation is adequately handled. There are also strong health care policies that are meant to minimize on the issue of competition which can be adequately taken advantage of.
There are however a number of weaknesses that may hinder the performance of the system. This is mainly due to the expansion of medicinal facilities on Malaysia (Elsham, 2008). There are more and more companies that are investing into the medical industry which is becoming a weakness to other medical institutions (Easton, 1992). There is also a lot of specialization in Malaysia when it comes to health care. This hence makes every upcoming health care organization to specify its area of specialization. It is also required that they have a clear understanding and knowledge of what they intent to engage in and also prove that they have the necessary machinery (Anderson, Haakansson & Johanson, 1994). For a new establishment, it may not be an easy thing to establish a unit considering the facilities that may be required. During the initial stages of its establishment, it may not be easy for them to carry out their operations. It will hence take time before the firm is equipped and also gains the confidence of its clients.
It times of opportunities, Malaysia provides a wide variety of choices that can be chosen from by a firm. The medical industry is growing at a higher rate and so are the medical institutions. Many students are also venturing into medical studies that are making them to be more knowledgeable in the field. It is hence not difficult to obtain players that will be part of any system and strategy that may be employed. Medical students are also obtaining education which can be said to be of high quality. There are also avenues provided for students to acquire high level of education from neighbouring countries which has become an added advantage to the systems. This enhances the kind of services produced and also serves the institutions with a variety of resources.
Some of the threats that may be experienced by health tourism in Malaysia could be the rising need o health care facilities (Deloitte, 2008). Health care is becoming a necessity in the country which is posing a challenge to the government. There are also a continuous report of new viruses and diseases whose cure has to be identified. This makes health care organizations to invest more money in research which may quite interfere with other projects. For instance, the recent outbreak of swine flue posed a lot of challenge to health care organization as they put in efforts to find curative and preventive measures towards the same (Basole & Rouse, 2008). As a number of people lost their lives, there was an urgent need to sensitize the society on correct hygienic measures as they fight the disease. Health care has become one of the sectors where most of the funds are pumped into. This has been related to the changes in people’s lifestyles and the need for high living standards. Government hospitals have become the source of consolation for most people due to high medical costs in private hospitals. The government hence needs to equip its health care centres to meet the needs of the people.
Medical tourism has become an area that is currently being considered as a business institution. This has been due to the rising need to employ managerial strategies for its proper running. Due to the arising of many other private health care centres, it has become necessary for the industry to look for strategies that will ensure more clients are attracted to these centres. Competition is not only experienced in mother business units but also in health care firms. Even though the industry is experiencing growth due to the arising needs in health care, there seems to be a great demand for quality services. Apart from ensuring that the units are adequately equipped, there is also a need to employ certain managerial strategies that will ensure a good return. The paper has looked at the various paradigms as brought forth by various economists as the main factors that will promote growth. They are all about making a business establishment to be an exemplary one by having the ability to outsmart the others. Of all the paradigms identified, and the various strategies suggested by various economists, we realize that there is no perfect one. There is a certain strategy that will have to be followed depending on what the unit desires to achieve. It is therefore up to the health care system to observe some of the suggested means to find out if they can be practicable in their case. It would be necessary for them to pick one from each and see how well it works for them.
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