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The discipline of orthopaedic surgery is a fast growing surgical specialty directed at the diagnosis and management of disorders of the musculoskeletal system e.g. acute trauma, fractured or dislocated joints, elective reconstructive surgery as well as related research. The standard of care in orthopaedic surgery treatment reflects the status of its evolution and what is currently available in terms of the knowledge, surgical expertise, orthopaedic implant materials, and equipment. It is the duty of the orthopaedic surgeon to live up to the promise as best he or she can to heal when it is possible to heal and to provide the level of care expected that transcends simple surgical expertise and bio-technological intervention. The informed consent process is an often neglected but vital component of the standard of care which has to satisfy prescribed ethical and legal requirements. This research is focused on how to heighten the awareness of, and to encourage engagement within the orthopaedic surgery fraternity with the informed consent process. If the informed consent is given more recognition within this group, it will benefit the potentially vulnerable orthopaedic patient, protect the orthopaedic surgeon against litigation, and importantly, contribute to the ethical imperatives bound in a doctor-patient relationship. For this research, a vast search of the available local and international literature has been perused and my finding is that the application of Ethics and recognition of the informed consent concept within the medical community in general is gathering momentum and it must be both supported and internalized by those in orthopaedic surgical practice.

Globally, trade and industry has shifted its focus from the traditional service delivery approaches to various alternative practices to be more successful, cost efficient, customer orientated, flexible and innovative. This shift in focus has lead to organisations applying a customer centric approach in their business. In order to understand customer centricity, it is necessary to be familiar with the term customer service. Customer service is the offering of services to customers before, during and after a purchase. It is a series of activities designed to enhance the level of customer satisfaction, i.e. the feeling that a product or service has met the customer’s expectations. Although it seems to be difficult to create and maintain a positive service culture, the implementation and upkeep of service excellence hold numerous advantages for organisations in both the short and the long term. Excellent customer service leads to an increase in profits as well as assist organisations in achieving a competitive advantage. Organisations with a customer centric approach can expect to experience a 30% higher return on investment on their marketing efforts compared to their peers not embracing customer centricity. Moreover, exceptional customer service will lead to customer satisfaction, which in turn, may well lead to customer loyalty which is crucial in the current volatile economic market. Recent economic instability triggered financial uncertainty in trade and industry. This causes difficulties for organisations to gain a competitive advantage and predict consumer behaviour. The organisations that will survive and outlive these uncertain circumstances will be those that maintain a customer centric focus. A customer centric focus implies that organisations place their customers first by concentrating on their needs and behaviours. These organisations will also attempt to eliminate internal factors that constrain service offerings to customers. Furthermore, customer centricity includes the alignment of resources of the organisation to successfully respond to the ever-changing needs of the customer, while building mutually profitable relationships. The main difference between customer service and customer centricity appears to relate to meaningful changes that customer centric organisations make in addressing their customers’ expectations and providing reciprocal support. Customer centricity seems to take customer service thus a step further with regards to service delivery. The healthcare environment forms an important part of trade and industry and economic instability also affects this sphere. In this study, the focus filters to the healthcare industry in South Africa and the role and importance of a customer centric approach to doctors. The South African healthcare environment consists of two sectors, namely large public (managed by government) and smaller, higher quality private healthcare. The South African healthcare system is unique to those of other countries as it is dynamic and multifaceted. The legislative framework within the healthcare system gives South African citizens the right to access healthcare services. Due to a skewed financing system in healthcare, this framework has a major impact on both the public and private sectors. The private healthcare industry in South Africa has grown dramatically with the number of beds doubling between 1988 and 1993. This was mainly due to the international trends toward privatisation and advanced by government's policies for privatisation. This resulted in the migration of doctors from public service to private practices. Specialists play an integral part in providing healthcare services. The private hospital industry provides admitting and treating facilities where doctors prescribe the care that hospitals should deliver to patients. This interplay between private hospitals and specialists emphasises that specialists are important customers of private hospitals. The importance of obtaining and retaining doctors is also highlighted in the vision and mission of the top three private hospital groups in South Africa, namely Mediclinic, Netcare and Life Healthcare. Many challenges exist to grow and maintain patient volumes for the private hospital sector. One thereof is to establish doctor (and their practices') support by building an optimum mix of loyal specialist and general practitioner (GP) networks for the hospital. The management and nurturing of relationships with doctors through these networks could lead to a competitive advantage for private hospitals. A study was therefore conducted to gain insight as to how specialists define customer centricity as well as their expectations of private hospitals when applying a customer centric approach towards doctors. The research was of qualitative nature. An experimental research design was applied and included 11 participants. Semi-structured interviews with specialists from one of the top three private hospital groups were conducted in order to gather relevant data. The interviews were transcribed and coded. Results were analysed and interpreted via thorough content analysis. Participants highlighted the following elements as important when defining customer centricity: customer focus, satisfaction, facilities and resources, accessibility, safety and cost effectiveness. In addition, participants confirmed that the following aspects marked their expectancies of a customer centric organisation: quality patient care and services, facilities and resources, effective communication, support and cooperation, provision of sufficient and well trained staff, mutual financial gains, appreciation, resolving of problems, involvement in decision making and respect. Conclusions and recommendations pertaining to future research were also provided. / MBA, North-West University, Potchefstroom Campus, 2014

Globally, trade and industry has shifted its focus from the traditional service delivery approaches to various alternative practices to be more successful, cost efficient, customer orientated, flexible and innovative. This shift in focus has lead to organisations applying a customer centric approach in their business. In order to understand customer centricity, it is necessary to be familiar with the term customer service. Customer service is the offering of services to customers before, during and after a purchase. It is a series of activities designed to enhance the level of customer satisfaction, i.e. the feeling that a product or service has met the customer’s expectations. Although it seems to be difficult to create and maintain a positive service culture, the implementation and upkeep of service excellence hold numerous advantages for organisations in both the short and the long term. Excellent customer service leads to an increase in profits as well as assist organisations in achieving a competitive advantage. Organisations with a customer centric approach can expect to experience a 30% higher return on investment on their marketing efforts compared to their peers not embracing customer centricity. Moreover, exceptional customer service will lead to customer satisfaction, which in turn, may well lead to customer loyalty which is crucial in the current volatile economic market. Recent economic instability triggered financial uncertainty in trade and industry. This causes difficulties for organisations to gain a competitive advantage and predict consumer behaviour. The organisations that will survive and outlive these uncertain circumstances will be those that maintain a customer centric focus. A customer centric focus implies that organisations place their customers first by concentrating on their needs and behaviours. These organisations will also attempt to eliminate internal factors that constrain service offerings to customers. Furthermore, customer centricity includes the alignment of resources of the organisation to successfully respond to the ever-changing needs of the customer, while building mutually profitable relationships. The main difference between customer service and customer centricity appears to relate to meaningful changes that customer centric organisations make in addressing their customers’ expectations and providing reciprocal support. Customer centricity seems to take customer service thus a step further with regards to service delivery. The healthcare environment forms an important part of trade and industry and economic instability also affects this sphere. In this study, the focus filters to the healthcare industry in South Africa and the role and importance of a customer centric approach to doctors. The South African healthcare environment consists of two sectors, namely large public (managed by government) and smaller, higher quality private healthcare. The South African healthcare system is unique to those of other countries as it is dynamic and multifaceted. The legislative framework within the healthcare system gives South African citizens the right to access healthcare services. Due to a skewed financing system in healthcare, this framework has a major impact on both the public and private sectors. The private healthcare industry in South Africa has grown dramatically with the number of beds doubling between 1988 and 1993. This was mainly due to the international trends toward privatisation and advanced by government's policies for privatisation. This resulted in the migration of doctors from public service to private practices. Specialists play an integral part in providing healthcare services. The private hospital industry provides admitting and treating facilities where doctors prescribe the care that hospitals should deliver to patients. This interplay between private hospitals and specialists emphasises that specialists are important customers of private hospitals. The importance of obtaining and retaining doctors is also highlighted in the vision and mission of the top three private hospital groups in South Africa, namely Mediclinic, Netcare and Life Healthcare. Many challenges exist to grow and maintain patient volumes for the private hospital sector. One thereof is to establish doctor (and their practices') support by building an optimum mix of loyal specialist and general practitioner (GP) networks for the hospital. The management and nurturing of relationships with doctors through these networks could lead to a competitive advantage for private hospitals. A study was therefore conducted to gain insight as to how specialists define customer centricity as well as their expectations of private hospitals when applying a customer centric approach towards doctors. The research was of qualitative nature. An experimental research design was applied and included 11 participants. Semi-structured interviews with specialists from one of the top three private hospital groups were conducted in order to gather relevant data. The interviews were transcribed and coded. Results were analysed and interpreted via thorough content analysis. Participants highlighted the following elements as important when defining customer centricity: customer focus, satisfaction, facilities and resources, accessibility, safety and cost effectiveness. In addition, participants confirmed that the following aspects marked their expectancies of a customer centric organisation: quality patient care and services, facilities and resources, effective communication, support and cooperation, provision of sufficient and well trained staff, mutual financial gains, appreciation, resolving of problems, involvement in decision making and respect. Conclusions and recommendations pertaining to future research were also provided. / MBA, North-West University, Potchefstroom Campus, 2014