Medical

Mystery Shopping Report: PABLO TAGLE JR. D.D.S & Associates Cosmetic & Family
Dentistry

Oscar Ramos

SID: 20227796



MARK 4370-01R Healthcare Hospitality

Dr. Sharon Schembri




Executive summary

This report presents an assessment of services provided by PABLO TAGLE JR. D.D.S & Associates

Cosmetic & Family Dentistry located on Fern Avenue, McAllen Texas. This assessment has been

achieved with a covert investigation conducted September 2nd, 2016 via medical mystery

shopping. The report includes an analysis of marketing orientation and customer orientation as

per Berry, Conant, and Parasuraman (1991), service quality as per SERVQUAL dimensions

(Parasuraman, Zeithaml, Berry 1988), servicescapes dimensions as per Rossenbaum and

Massiah (2011), and service blueprinting as per Bitner, Ostrom, and Morgan (2008). Assessment

of marketing orientation shows current marketing communications performed by this dentistry

with the standard understanding of what the customer orientations are at the local Hispanic

market in the Rio Grande Valley. The dental service quality is presented in five dimensions:

reliability, assurance, tangibles, empathy, and responsiveness. Professional, friendly, and

organized activities were identified at this dentistry with relevant empathy and assurance

components throughout the entire service. Tangibles are also characterized as appropriate for

the dental office since they create a sense of trustworthiness and confidence for new patients.

Further, analysis of the dentistry servicescapes dimensions shows that medical artifacts, living

greenery, appropriate dental décor, and the social environment at the business work well

together conveying an uplifting message to people coming into the waiting room. The service

blueprint analysis remarks the organization of frontstage employees and the important role of

the backstage team. They both collaborate to the goal of providing a complete and professional

dental service. Recommendations highlight improvement on online content as well as the

creation of a brand community among others.

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Introduction

PABLO TAGLE JR. D.D.S & Associates Cosmetic & Family Dentistry is primarily recognized due to

Dr. Tagle, a graduate of The University of Southern California Dental School and now practicing

dentistry in McAllen, Texas. He has specialized in multiple areas within dental care and has

created a small business with approximately fourteen employees. The location is very

accessible for people in the Pharr, McAllen, and Mission area. This dentistry offers various

dental care services with dental technology and provides clients with up-front information on

their website and social media. Based on their website, Dr. Tagle commits to provide a winning

smile by having the best dental health care service in the Rio Grande Valley. This report involves

a covert investigator taking the role of a medical mystery shopper at this dentistry by getting a

standard dental cleaning on September 2nd 2016. The dimensions of service quality will be

investigated by the five SERVQUAL dimensions according to Parasuraman, Zeithaml, and Berry

(1988): reliability, assurance, tangibles, empathy, and responsiveness. The service process will

be investigated via a marketing service audit and blueprinting approach as per Berry, Conant,

and Parasuraman (1991) and Bitner, Ostrom, and Morgan (2008) respectively. Ultimately, the

multiple dimensions of the servicescapes will be evaluated based on the Bitner (1992)

framework, that includes ambient conditions, spatial and functional components, as well as

signs, symbols, and artifacts.

Pablo Tagle, Jr. Cosmetic & Family Dentistry: Marketing orientation

According to Berry et al. (1991), a services marketing audit begins with an evaluation of

organizational marketing orientation, which includes an analysis of the product offer and

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product market positioning, identification of a primary target market and marketing

communications designed for this specific market, as well as product pricing, distribution, and

packaging. Dentists at this dentistry are trained in various areas such as cosmetic and family

dentistry, crown and bridge treatment, orthodontics (braces) and invisalign, pedodontics

(children), periodontics (gum disease) and so forth. Besides basic dental cleaning, this place is a

specialist for multiple dental problems. Due to its location in McAllen, Texas, the primary

market encompasses children, adolescents, college students, and adults. The Hispanic ethnicity

dominates cities such as Hidalgo, McAllen, Mission, Pharr, and Brownsville in the Rio Grande

Valley. Therefore, local Hispanic families are very likely to be a primary if not the primary target

market for this dentistry. This business positions as a cosmetic and family dentistry which opens

opportunities to serve more people. Customers needing special or complicated dental

procedures can get help because Dr. Pablo operates with dental technology which certainly

puts the dentistry in a more attractive market positioning. The marketing and communications

of this business are predominately found digitally. Digital marketing is mostly by having an

online presence on Facebook, Twitter, as well as its website. Strategy wise, email marketing is

also implemented in Dr. Tagle’s digital strategy based on Figure 3 and so on. Development of an

online presence requires a dedicated user-friendly strategy, such efforts build brand

recognition and sustainable reputation. Pricing options are disclosed during the visit or via

phone call, but depends if insurance is available. With only one dentistry, Dr. Tagle has received

multiple reviews on Google and Facebook. People seemed to be satisfied with the service

provided at this place, even though dental care is not cheap, this dentistry promises to do

everything to help customers afford the treatment they need and want. This product

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positioning is advantageous knowing the fact that customers can get a more affordable service

in Nuevo Progreso. A town in Mexico known for its dental care and pharmaceutical affordability

towards people in the United States. Figure 1 presents the type of marketing material is being

used on Facebook and Twitter, besides current advertising, for more engaging customer

response and views are therefore recommended to utilize emotional imagery to emphasize the

need of dental medical care.

Pablo Tagle, Jr. Cosmetic & Family Dentistry: Customer orientation assessment

Beyond an assessment of marketing orientation and according to Berry et al. (1991), a services

marketing audit includes an assessment of customer orientation. Assessment of customer

orientation includes identification of the primary customer in terms of demographic,

geographic, and psychographic segmentation variables, as well as a clear delineation of

customer needs and how such needs are accommodated and communicated. According to

Nielsen MyBestSegments, 40% of households are in the income range of $25K per year, the age

range is larger within the 21-34 segment, and more than 85% are white Hispanics living in the

78501 zip code area, the local market. Total household expenditures in McAllen are below the

national average. Then, Dr. Tagle dentistry is located geographically to engage with the Hispanic

community. Understanding the values, culture, and traditions of such community will take this

dentistry forward to generate more customer relationship marketing and customer acquisition.

Hispanics 35 and older have a higher reach for broadcast and cable TV than younger Hispanics.

On the other hand, Millennials, not surprisingly, spend more time on the internet and social

networking. In total, Millennials spend just over 41 hours per week on TV,

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radio and online, while those 35 and older spend an average of 55 hours each week on the

same platforms. Evidently, this dentistry responds to the Hispanic demand via online platforms

(Social networks and website), however for the 35 and older Hispanic consumer there is no TV

marketing channel in the market. The McAllen local market heavily responds to family-oriented

services due to its Hispanic background. Therefore, implementing a family-centered marketing

strategy is an alternative that fits the dentistry mission and recognizes the need of this target

market.

Figure 1: Facebook Cover image.

Dental service quality
According to Parasuraman et al. (1988), service quality comprises multiple dimensions:

reliability, assurance, tangibles, empathy, and responsiveness. In terms of reliability and

according to Parasuraman et al. (1988), this service quality dimension is about the ability of an

organization to perform the promised service dependably and accurately. This dentistry

promises to operate Monday through Friday varying in hours from 8am to 5pm and 2pm on

Fridays. Dentists at this dentistry are experienced in various dental areas supplying the local

Hispanic demand in the Hidalgo county market. During the covert investigation, the front

employees answered multiple questions regarding the dentistry, pricing, and insurance. They

acted professionally and accurately without hesitation and inspiring trust for the upcoming

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dental cleaning procedure. At the time, there were around three female front employees, three

dentist’s assistants, and two dentists. All of them wore professional dental attire which created

credibility in the service. Service quality in terms of assurance according to Parasuraman et al.

(1988) is about knowledge and courtesy of employees and their ability to inspire trust and

confidence. Email marketing is prominent evidence for this dimension given the fact that Dr.

Tagle’s email strategy has a high marketing organization. Figure 2 is the evidence that this

business emails every new customer with an informational welcome to their community. From

a direct marketing standpoint, this email strategy makes a more personalized contact which

new acquisitions. This email was sent couple hours after the procedure was executed.

Figure 2: Welcome email.

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Dr. Tagle office created trust and inspired confidence by responding the covert investigator

email in a timely fashion as seen in Figure 3. Evidently, customer relationship management is

practiced in this dental office.

Figure 3: First contact made by the customer and reply by the dentistry.

Figure 4 shows another email sent a day later the procedure was executed, this email requests

feedback in a review format of the service delivered at the dentistry. This shows initiative by

the office to collect as much information to improve current activities. Furthermore, it helps

develop confidence that Dr. Pablo cares about customer’s satisfaction.

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Figure 4: Thank you and review emailed sent a day after the dental cleaning.

According to Parasuraman et al. (1988), the tangibles dimension of service quality is about the

physical facilities, equipment, and appearance of personnel. Dental and x-ray machinery

couldn’t be photographed without being noticed, therefore not included. This small dental

office seemed running adequately, medical equipment was clean, organized, and employees

dressed appropriately matching the décor of the backstage. Dr. Tagle promised to deliver

dental practice with the appropriate technology expertise which indeed was captured during

the cleaning procedure. Figure 14 shows a glimpse of the backstage of the office and Figure 15

lays out the blueprint format to better understand the internal operations and interactions.

According to Parasuraman et al. (1988), empathy within the context of service quality is about

caring, individualized attention the firm provides to customers. For this business, Figure 5

serves to remind customers that they are subscribed to Dr. Tagle’s email list. Also generates a

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particular reaction which can be positive towards customer retention. This is recommended to

continue because is direct and personal in order to build a relationship with patients.

Figure 5: Thanksgiving seasonal email.

Figure 6 shows discounts emailed to customers. This current strategy hopes to generate current

customers coming back to Dr. Tagle’s office, therefore increasing sales and establishing a

sustainable relationship with people. As explained in the introduction, it is recommended that

Dr. Tagle continues offering special promotions and discounts due to the competitive rivalry in

the McAllen area and Nuevo Progreso, Mexico. Workshops, contests, and the usage of video

marketing can speed up the creation of a community. Communities serve well to exchange

information and not only Consumer to Consumer, but also Business to Consumer as well. As of

today, a community strategy plan is not in place, therefore is recommended.

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Figure 6: Discounts were emailed on the month of September.

Besides seasonal emails such as Thanksgiving, this office celebrates customers Birthdays by

emailing a simple, but meaningful piece of advertising. This piece promotes the business,

reminds customers that this dental office cares about them, but most importantly creates a

feeling of belongingness between business and customer as seen in Figure 7.

Figure 7: Pablo Tagle dentistry happy birthday email.

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Besides email marketing, this dental office utilizes text messages to inform customers about

upcoming appointments at the office as seen in Figure 8. This communication tactic is very

convenient and accurate marketing channel to reach out millennials in order to effectively

convey information.

Figure 8: Pablo Tagle dentistry text message reminder.

According to Parasuraman et al. (1988), the responsiveness dimension in service quality is

about the willingness to help customers and provide prompt service. Employees and dentists

were kind and patient to respond every question with detail and recommendations. Although

pricing was a little higher than the expected investigator’s budget, the service provided before,

during, and after the dental cleaning was worth the monetary investment.

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Figure 9 shows a visible road signage lies next to the street where the dental office locates. For

new patients, this saves their time to find the office and arrive quicker to their appointment.

This road signage will not be useful for a night environment, however, is not a problem for this

business.

Figure 9: Road signage.

Figure 10 shows mail sent to the covert investigator regarding payment dues within few weeks

of anticipation. This mail helped the covert investigator it was time to pay before the due date.

This type of direct marketing certainly makes a positive difference in the marketing organization

of this dentistry. Days later emails were received from this business regarding the same

message that the investigator needed to pay some dues. If it were not for these two types of

communication, delay fees would have been paid. However, that was not the case and

payment was made with weeks of anticipation. During this second visit at Dr. Tagle office,

employees were kind and friendly as the first time and everything was running normally.
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Figure 10: Pablo Tagle dentistry dues mail

During the dental visit, the doctors found some dental activities needed to be taking care of,

however the covert investigator postponed such activities for later. A few days later, the

dentistry emailed the exact dental activities needed to be taking care of with educational

videos, explanations, and pricing quotes as seen in Figure 11. Not only is this service meaningful

to the patient, but also creates trust and inspires positive word-of-mouth and ratings.

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Figure 11: Suggested medical procedure emailed.

Physical dimension

Ambient conditions within the physical environment include elements such as temperature, air

quality, noise, music, and odor (Bitner 1992; Rosenbaum and Massiah 2011). Physical elements

were found adequate and appropriate to the dental/clinic setting of a dentistry. A clean

fragrance was noticed in the waiting room as well as a silent environment with a muted TV

showing cartoons clearly tailored for patients with kids. Definitely, the waiting room gives a

clear message of the overall service of this dentistry which can be categorized as organized and

clean.

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Figure 12 showcases a clean small waiting room furnished with many chairs, lamps, natural

greenery, and distinctively windows showing the parking lot. During the day of the visit, the

waiting room happened to be close to empty.

Figure 12: Front side of the dentistry.

Figure 13 is the continuation and opposite side of Figure 12, here a mounted TV is seen with

more living greenery, a small table in the middle of the room, and the front of the waiting

room.

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Figure 13: Small, short almost empty waiting room.

Figure 14 shows the front and a little bit of the backstage. An employee is busy on the phone

and the signing sheet is placed on top of the counter.

Figure 14: Signing sheet at the front desk.

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Social dimension

Building on the Bitner (1992) servicescapes framework and beyond the physical environment,

Rosenbaum and Massiah (2011) consider the social environment to include employees,

customers, social density, and the displayed emotion of others. As stated previously in this

report, front employees, assistants, and dentist acted professionally and kindly during the visit.

Accurate and organized work was noticed from the third stage of the blueprint figure until the

sixth stage. A friendly female assistant showed the way to a small clinic type room for an initial

medical evaluation, this employee asked questions regarding school and dental needs which

were appropriate at the time. Right after, a male dentist proceeded with a complete

examination of the covert investigator’s mouth. Dental procedures were done carefully and

with the customer’s permission.

Socially symbolic dimension

According to Rosenbaum and Massiah (2011), the socially symbolic dimension of servicescapes

comprises ethnic signs and symbols as well as ethnic objects and artifacts. Figures 12, 13, and

14 show various symbols and artifacts related to this dentistry. Ranging from of Dr. Tagle

pictures, inspiring quotes, dental information, and health magazines. Such items create this

dental care dimension that helps create a dentistry environment in the waiting room. In the

backstage, more pictures of Dr. Tagle were found as well as doctoral degrees and certifications

from the medical professionals working at this business. Such items give patients trust and

inspire the confidence of the work done at this location. Further, according to U.S. Census data,

minorities now comprise roughly one-third of the U.S. population, and it is anticipated that

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these groups will be in the majority by 2042. It is projected that more than half of all children in

the United States will be from minority groups by 2023. Last year, the American Dental

Association published two articles on the results of a study, the Hispanic Community Health

Study/Study (HCH/SOL), which focused on the oral health status of Hispanic and Latino

populations. The study measured and recorded the prevalence and number of decayed and

filled surfaces, missing teeth, dentate status, and periodontal health. Findings included

The prevalence of decayed surfaces ranged from 20.2% to 35.5%, depending on Hispanic or

Latino background Point2 Homes. (2016). This and more studies emphasize the importance that

Hispanics bring to the oral marketplace in the United States. According to the Association of

Health Care Journalists, the lack of dental care is a big problem for children living below the

poverty level and untreated tooth decay hits Hispanic children particularly hard. Data from one

large national survey found a full 26 percent of Hispanic 6- to 9-year olds suffered from

untreated tooth decay, compared with 14 percent of non-Hispanic white children of the same

age. Based on what previously stated, the current state of Hispanic health in South Texas can

get improved, this dental office can better address the local culture by offering health related

informational material specific to those conditions known to be prevalent within the Hispanic

community as well as offering such materials in Spanish (Otto 2013).

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Natural dimension

According to Rosenbaum and Massiah (2011), the natural dimension of servicescapes includes

the elements of being away, fascination, and compatibility. This dimension is particularly

relevant in the medical context given that those choosing to attend the clinic may not be well.

The waiting room at Dr. Tagle dentistry consists of two living greenery located at the corner of

the office, not shown, but there were also living greenery in the backstage compartment. The

waiting room’s window wall allows patients to appreciate the outside living greenery as well.

Adding living greenery is a way to move towards the goal of offering a healthy servicescape.

Having such natural elements helps patients aligns well within this natural dimension, especially

for a medical business. Figure 12 and Figure 13 showcase the actual scenario at the dentistry.

Note that the mounted TV also helps create elements of fascination and being away, especially

for kids.

Service blueprinting

Another way to analyze and consider the patient experience is to consider the service process.

According to Bitner et al. (2008), service blueprinting is a customer-focused approach that is

used to identify the challenges in services design and innovation. More than that, service

blueprinting allows organizations to visualize the service process, where instances of customer-

employee interaction and the physical evidence associated with the service encounter are

illustrated from the customer perspective. Table 1 shows the service blueprint components of

Dr. Pablo Tagle dental office. These are physical evidence, what the patient observes during the

service process as well as the patient actions needed to be executed during this service. Also,

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there are activities performed by the employees divided into three categories: frontage,

backstage, and support process contact. Figure 15 shows the actual service blueprint panorama

where actions are interconnected with its corresponding stages and authors. Note that

employees at this dental office can possibly interact with patients for at least six stages (from

the second to the seventh). Dr. Tagle’s backstage operations are seemed to be one of the most

demanding division since these employees get prepared and performed multiple procedures

daily. However, frontstage receptionist greets and goodbye the customer which is crucially

important to compact what is being done by the dentist in the backstage. Customer actions

were not clocked by the investigator, but the service was delivered in a timely fashion, no

extended time was added from the one expected by the investigator, the entire service took

around one hour and thirty minutes. More than half of the time was spent at the dental office

with the dentists and assistants, the rest of the time was used to complete paperwork, process

payment, and address questions.

Table 1: Dr. Pablo Tagle service blueprint components

Dr. Pablo Tagle service blueprint components
Physical • 1 Location across the Rio Grande Valley
Evidence • Professional employees in style and presentation
• Dental machinery
• One mounted TV (muted)
• Road signage
• Various artificial greenery
• Dental care information displayed
• Silence and cold ambiance
Customer • Making appointments prior first visit.
Actions • Customers checking if insurance applies.
• Follow instructions during dental service
• Provide information when needed
Frontstage • Customers are greeted and attended at the moment of arrival.
Contact • Customers are offered the bill at the end of the service and the payment
is agreed.
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 • Customers information is taken to continue the customer relationship.
Invisible • Dental procedures
backstage • Administrative/filing activities.
Support • Financial underwriting.
Process • X-ray machine and dental utensils preparation.

Figure 15: Dr. Pablo Tagle service blueprint

Recommendations

Four main recommendations are being described throughout this medical mystery shopping

report which are emotional marketing material implementation, email marketing continuation,

special promotions advancement, and the creation of a member community. A detailed digital

marketing strategy should begin with the understanding of the Hispanic consumer. Using

emotional promotions for online marketing tactics in form of videos will make Dr. Tagle’s

business achieve a sustainable competitive advantage. This strategy should adopt an

undifferentiated marketing strategy to fully communicate an entire campaign in print, online,

TV, and email marketing. Regarding the current state of the email marketing strategy, based on

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previous figures in this report, this dental office mainly uses email to reach out the patient

community, however this in most of the cases is a one-way communication which does not

allow the patient to interact with the business. However, email marketing content is relevant

and should continue to operate, but an implementation of social networks is recommended for

an immediate two-way communication. Starting by redesigning the website which looks ancient

and underperforming to attract potential patients. A clean state of the art website is

recommended to convey Dr. Tagle’s mission of a technological dental experience. Furthermore,

special promotions need to continue at this dentistry, competition is fierce and a big portion of

the current market share goes to Nuevo Progreso, Mexico. Seasonal discount promotions, free

dental cleaning specials, and family dental combos can be implemented as pricing strategies to

first break-even and aspire to achieve profit due to higher customer acquisitions. Lastly, the

results of the previously stated recommendations can be combined into a community

membership outcome where patients identify themselves as part of the business and want to

advocate for what Dr. Tagle professionally practices for the betterment of the local Hispanic

market. Such brand community can first propose new ideas to improve current operations,

attract new patients to this dentistry, retain current patients, and develop long-lasting

relationships with this business. It starts by investing on patients who identify closely to the

business vision and want to support what Dr. Tagle stands for. It is probable that a community

is already non-officially established by current patients through word-of-mouth, therefore is the

responsibility of the business to reach out to those consumers and make them part of the

strategic plan to holistically enhance the service quality at PABLO TAGLE JR. D.D.S & Associates

Cosmetic & Family Dentistry.

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 References

Berry, L. L., Conant, J. S., and Parasuraman, A. (1991), “A framework for conducting a services
marketing audit,” Journal of the Academy of Marketing Science, 19, 3: 255-268.

Bitner, M. J., Ostrom, A. L., and Morgan, F. N. (2008), “Service blueprinting: a practical
technique for service innovation,” California Management Review, 50, 3: 66-94.

Bitner, M. J. (1992), “Servicescapes: The impact of physical surroundings on customers and
employees,” Journal of Marketing, 57-71.

From the ballot box to the grocery store a 2016 perspective on growing Hispanic influence in
America
http://www.nielsen.com/content/dam/corporate/us/en/reports-downloads/2016-
reports/nielsen-hispanic-consumer-report-2016.pdf

Macri, D. (2015, March 9). Hispanics and oral health: What dental hygienists must know.
Retrieved December 06, 2016, from http://www.dentistryiq.com/articles/2015/03/hispanics-
and-oral-health-what-dental-hygienists-must-know.html

Parasuraman, A., Zeithaml, V. A., and Berry, L. L. (1988), “SERVQUAL,” Journal of Retailing, 64,
1: 12-40.t

Point2 Homes. (2016). Retrieved December 06, 2016, from
http://www.point2homes.com/US/Neighborhood/TX/McAllen-Demographics.html

Otto, M. (2013) Hispanic children bear brunt of poor access to dental care. Retrieved December
06, 2016, from http://healthjournalism.org/blog/2013/02/hispanic-children-bear-brunt-of-
poor-access-to-dental-care/

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