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“Measuring Gaps Service Quality on Medinova Medical Services in Dhaka”

Service Marketing
Course Code: EMKT 511
Semester: Fall 2017

Submitted By

Group: Volunteer’s

Name Student ID
Md. Asraful Alam (Leader) 20171119
Md. Rokonuzzaman 20163041
Monjurul Islam 20163042
Saiful islam Rubel 20162042

Submitted to

Nigar Sultana
Associate Professor
Department of Marketing, FBS
Jahangirnagar University

Date of Submission: 25th November 2017

About Medinova and Its Services

We the Medinova Medical Services Ltd. an approved Medical Check-Up Center of the
Executive Board of The Health Minister’s Council for G.C.C (Gulf Co-operation
Council) States, bearing G.C.C Computer Code No. 05/01/ . We are one of the member
medical centre under GAMCA, Dhaka-Bangladesh. We are situated at the prime location
of Dhaka city located at house # 71/A, road # 5/A, Dhanmondi 5/A, Dhaka-1209

The details of our Medical Center are as follows:

01. Name of the owner: Dr. Md. Manowar Hossain
02. Name of the contact person: Dr. Md. Manowar Hossain
03. Full Address: Medinova Medical Services Ltd. House # 71/A, Road # 5/A
Dhanmondi R/A, Dhaka – 1209, Bangladesh.
04. Telephone Number: +8802-58610661-5, +8802-58610682-4
05.Email Address:
(Medinovamedicalbdcom, 2017)


1. To develop and coordinate amongst the member Medical Centre’s Performing medical
check-up of the passengers bound for Gulf States.
2. To bring homogeneity and equality among the member Medical Centre’s.
3. To implement and execute the guidelines provided by the Executive Board of the
Health Minister' Council for the G.C.C States to the Member Medical Centre’s and to
take necessary steps against defiance of the guidelines.
4. To coordinate between the member Medical Centre’s and the Embassies of the G.C.C
5. To ensure the medical check-up of specific number of people against specific number
of visas.
6. To ensure the medical technical staff and other employees of the member medical
centers through workshop, symposium, etc.
7. To encourage the Medical Centre’s to stand beside the nation during natural calamities
like flood, cyclone, drought, earthquake etc.;.
8. To request the member States of G.C.C to recruit more workers from Bangladesh
(Medinovamedicalbdcom, 2017)

The Model of Service Quality Gap

Today’s consumer has become increasingly demanding. They not only want high quality
products but also they expect high quality customer service. Even manufactured products
such as cars, mobile phones and computers cannot gain a strategic competitive advantage
through the physical products alone. From a consumer’s point of view, customer service
is considered very much part of the product. Products that do not offer good quality
customer service that meets the expectations of consumers are difficult to sustain in a
competitive market. Service Quality is an attitude formed by a long term overall
evaluation of a firms performance (Hoffman & Bateman, 2016, P. 324).

FIG 1: Conceptual Model of Service Quality

(Freefr, 2017)

The model, illustrated in Figure 1, is anchored on the customer and integrates customer
focus throughout all gaps within the model. As depicted in the model, a firm’s primary
goal should be to meet or exceed customer expectations, and strategies used to achieve
that objective (whether operations, human resource, or technology-based) are all focused
on the customer. Every gap and every strategy used to close the gaps in the model retain a
focus on the customer at its core.

The central focus of the model is the service gap – the difference between customer
expectation of what will be delivered and perceptions of the service as it is actually
delivered (Hoffman & Bateman, 2016, P. 326). The other four gaps in the model represents
a potential cause behind a firm’s failure to meet customer expectations.

Closing the service gap – delivering quality service – at the top of the model is a complex
undertaking involving many different organizational and employee skills and tasks.
These tasks can be sorted into four other gaps – each of which needs to be closed in order
to close the service gap. The following four gaps, shown under the horizontal line in
Figure 1, are the underlying causes behind the service gap:

 The knowledge gap

 The standards gap
 The delivery gap
 The communication gap

At its most basic level, the logic of the model suggests that the service gap is a function
of any one or all of the four gaps. Ultimately the service gap is a function of the
knowledge gap, the standards gap, the delivery gap and the communications gap. As each
of these gaps increases or decreases the service gap responds in a similar manner.
(Hoffman & Bateman, 2016, P. 325).

Implementation of Service Quality Gap Model in Medinova

Customer service and patient satisfaction matter more than anything. Patients have higher
expectations and less tolerance. To provide the highest level of satisfaction, health care
providers must control patients’ expectations and perception of treatment quality .The
gap model of service serves as a framework for service organizations attempting to
improve quality of service.

 The Service Gap:

The service gap is the difference between customer expectations of a service and
perception of the service actually delivered (Hoffman & Bateman, 2016, P. 332). Customer
expectations are standards or reference points that customers bring into the service
experience whereas customer perception are subjective assessments of the actual service

Customer expectations

Service Gap

Customer’s perception of

In the case of Medinova medical services Patients are considered as customers and
providing satisfactory services are major concerns.

Some factors influencing Customer Expectations:

1) Word of mouth: Word of mouth is the passing of information from person to person
by oral communication. If patients are satisfied they will spread good comments
about Medinova medical services. Patients depend on the judgments of people close
to them such as relatives, colleagues and friends. Patients choose the clinic that
provides the best services with economic cost. In the case of Medinova medical
services most the patients are marginally satisfied.

2) Personal needs: Patients will be happy if they get desired level of service from
Medinova medical services. But as there are few departments available, some
patients are sent to other clinics as a result they feel dissatisfied. Some patients
complained that they were not given proper attention.

3) Past experience: Patient’s past experience is a crucial part of service industry. Most
of the Medinova medical services patients relate present services with the past
experiences, which is moderate level of satisfaction.

Major customer Expectations

1) Doctors pay full attention to their complains: Patients expect doctors will carefully
listen and understand their complains. Patients expect that doctors will show sympathetic
attitude towards their problem. They believe that if the doctors listen to them, they will be
2) Patients expect proper treatment: Patients of Medinova medical services expect
proper treatment for all types of illness. Especially for chronic diseases they want
appropriate treatment. Proper treatment is needed for healthy and good future.
3) Caring attitude: Patients expect caring attitude from all level of workers starting from
doctors to ward boys. Caring attitude gives them comfort, trust and a sense of reliability.
The patient feels happy and satisfied if the attitude towards them is comforting and

4) Economic charges: Patients of Medinova medical services expect economic charges

for visiting doctors and laboratory investigations. They also expect a fair rate for the
indoor stay charges. So they can afford all the expenses for their treatment.

Customer perception:

1) Moderate health services: Medinova medical services provide moderate level of

services to its patients. Treatment to consultation all slightly touches marginal level of
satisfaction. Some patients are not fully satisfied.
2) Costly investigations: Some of the laboratory investigations like x-ray, blood
examinations are higher than other clinics. So many of the patients cannot afford such
higher costs.
3) Limited time from doctors: Doctors of Medinova medical services don’t spend much
time on one patient. As a result some patients feel deprived and less important.

4) Inefficient management: The management of the patient from reception to admission
is not properly coordinated. As a result patient gets confused about where to go for
investigation or admission. There is also lack of communication between reception and
workers of indoor. Sometimes it harasses the patients.

 The Knowledge gap: 

The Knowledge gap is the gap between what customers expect of a service and what
management perceives the customers to expect (Hoffman & Bateman, 2016, P.327).
Primary cause of this problem is service providers do not accurately understand customer
expectations. In the case of Medinova medical services there also exists a gap between
patient’s expectation of services and the services acquired by the clinic.

Customer expectations

Knowledge Gap

Management perceptions of
customer’s expectations

1) Lack of adequate, formal and friendly behavior: Patients are very sensitive towards
their health so they should also treat delicately. Doctors are very busy sometimes they
don’t give proper suggestions and attention towards patients. As result patients also feel
hesitated to openly share what problems he/she is facing. Friendly attitude of doctors
make patients become more comfortable.
2) Lack of female doctors: Women in our country are very shy and conservative.
Majority of the woman patients demand a female doctor for checkup. Medinova medical
services have few numbers of doctors and mostly they are male.
3) No Emergency Room: Medinova medical a service doesn’t have separate emergency
room. So the services for emergency situations like accident, trauma, and burn patients
are treated in a common room. As a result patients are not getting proper attention.

 The standards gap: 

Customer driven standards are different from conventional performance standards that a
firm establishes. These problems are reflected in standards gap, the difference between
what management perceives consumers to expect and the quality specifications set for
service delivery (Hoffman & Bateman, 2016, P. 328).

Management perceptions of
customer’s expectations

Standards Gap

Standards specifying service

to be delivered

1) There is no separate waiting room: Medinova Medical Services is very small in size
and don’t have sufficient space. Patients of Medinova Medical Services are very
dissatisfied that there are no separate waiting rooms. Even sitting arrangements are not
enough. Many patients have to stand for a long time even they are in critical condition
and wait for their serial to come.
2) There is no pharmaceutical shop near reception or clinic: As Medinova Medical
Services is very small in size. There is no pharmaceutical shop near the clinic. Patients
feel difficulty getting suggested medicines prescribed by the doctors.
3) No car parking facility: Medinova Medical Services is situated on the edge of main
road. There are not enough garages for car or motorcycle parking; patients face difficultly
if they travel by their own transport.
4) No EICU services: EICU is for critical patients. At Medinova Medical Services there
is no EICU unit. This is one of the major issues of the majority patients.
5) Few departments present for service: Medinova Medical Services has only few
major departments like Medicine, Pathology and Radiology etc. But absence of other
departments like Surgery, Eye, causes dissatisfaction and also patients mark their services
as under rated.
6) Few beds are available: Medinova Medical Services is a small clinic so there is few
numbers of beds approximately 25 beds are available for hospitalization. Bed numbers
should be increased to meet daily demand. There is huge shortage of beds.

7) Monitoring work: All the clinic and hospital need to have a proper monitoring panel
to execute and manage all the coordinated work of the doctors, nurses and other staff. But
this clinic lacks the proper monitoring. So most of the patients are not satisfied.

 The Delivery gap: 

This is the difference between the quality standards set for service delivery and the actual
quality of service delivery (Hoffman & Bateman, 2016, P. 331). Standards must be backed
by appropriate resources (People, systems and technology) and also must be enforced to
be effective.

Standards specifying service

to be delivered

Delivery Gap

Actual Service Delivered

1) Lack of modern technology: Medinova Medical Services lacks use of modern

technology in all areas from investigation of diseases to provide reports. Important
investigations like CT scan, MRI should be included with update equipment.
2) No ambulance service: Ambulance service is crucial for the patients. Some patients
are in very critical condition and need extra care. Twenty- four-hour ambulance service is
needed for Medinova Medical Services which is present but not effective.
3) No home delivery services: Some pregnant lady may be in very serious condition so
they need home delivery services. Normal delivery under supervision of a doctor or
trained nurse can save the life of both mother and baby. But Medinova Medical Services
doesn’t provide these services.
4) Delay in making Appointment: Patients routinely face long delays when making an
appointment with a doctor in Medinova Medical Services. Half of primary care patients
wait two or fewer days for an appointment as a result some patients are dissatisfied.

5) Maintenance of hygiene: Hygiene is one of the most important factors for hospitals
and clinic. Due to small number of working staff Medinova Medical Services is unable to
maintain proper hygiene.
6) No female washroom: Medinova Medical Services provides a common washroom.
More than fifty percent of the patients are female. They feel embarrassed to use
washroom, which does not provide adequate privacy. So the clinic needs to provide a
female toilet.

 The Communication gap: 

The communication gap illustrates the difference between the actual quality of service
delivered and the quality of service described in the firm’s external communities
(Hoffman & Bateman, 2016, P. 332). The discrepancy between actual and promised
service can widen communication gap. Broken promises can occur for many reasons such
as advertising and personal selling, inadequate coordination between operations and
marketing, differences in policies and procedures across service outlets.

Actual Service Delivered

Communication Gap

Retailer’s communications
about services

1) Free Friday clinic services: Medinova Medical Service provides free Friday clinic
services to its patients. Patients those who are very poor come to the clinic for free
checkup and tests. But some patients do not get proper attention and friendly behavior.

2) Delay in providing reports: Medinova Medical Service has few numbers of doctors
and nurses. As a result delivery of report is delayed maximum time. Patients get very
annoyed and lose their temper.
3) High fees charged for consultation and tests done: Medinova Medical Service
charges high for visiting doctors and pathological tests. Patient’s come to Medinova
Medical Service are mostly middle class people and cannot afford such high price
charged by the clinic.

4) Proper consultancy not given: Huge numbers of patients who are not well educated
come to Medinova Medical Service. These patients need proper advice and health tips.
But as there are few numbers of doctors, patients do not get much time and support from
5) Long Wait in Reception Area: Time is important. When patients have to wait 10
minutes or longer, they become upset and frustrated. If the practice is running behind, it's
best to let patients know. Patients of Medinova Medical Service have to wait for a long
time, as there is no serial system and no supervision.
6) Food service in hospital is not up to mark: All the hospitals provide food for the
indoor patients for three times a day. Medinova Medical Service also provides food but
the taste and presentation of the food lack the appeal of a delicious food. Most of the
patients complained about it. Shortage of staff might be a cause of this problem.

Suggestions and Recommendations

1. Medinova Medical Service should improve the quality of services provided by the

2. Medinova Medical Service must increase number of doctors, nurses and other staff
members in order to provide adequate services to patients.

3. There should be a separate emergency room in the clinic.

4. Departments must be extended, as now days there are many diseases around the

5. Pharmaceutical shops must be located near the clinic.

6. Fees charged should be economical and reasonable.

7. Modern technology must be used to do tests and analyze reports.

8. Separate EICU unit must be included for critical patients.

9. Reports must be provided within the time frame.

10. Separate washroom must be provided for female patients.

11. Ambulance service must be provided for patients whenever needed.

12. Proper patient consultancy must be provided by the clinic.


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4. Hoffman, K. Douglas & Bateman John E.G 2016. Defining and measuring service
quality. In: ed. Essentials of Service Marketing. : South Western, PP. 324-334