Pocasangre Oliva Dental Case Study

Small businesses are the heart of the United State economy. There are 28 million small businesses in America and count for more than 54% of sales (Small business trends). New start up business pop up daily and so do the closure of many of them. Small businesses are usually the vision and dreams of someone who thought they could do it better. That is the case for Pocasangre Oliva Dental, a small single doctor dental practice open by Victoria Carolina Pocasangre. This paper will be an over view of the office and an assessment of where the office is now and what can happen for the future at the present condition.
The paper will give an overview of the history and background of the office, describe the type of leadership that exist and give an

evaluation on what type of leadership will make the office efficient. I will also be discussing the type of organization culture within the dental practice by evaluating the roles of all the employees including the owner dentist. In utilizing the EFE and IFE Matrix finding to determine the strengths, weaknesses, opportunities and threats that will affect the office presently and hinder its success in the future. As a solution a quantitative strategic planning matrix will be present and discuss the optimal total attractiveness score. Based on the findings of QSPM will give my improvements for making the office better. The conclusion will be a summary of the information presented for final evaluation with organization.

History of the office
Dr. Victoria Carolina Pocasangre is a first generation immigrant from El Salvador and like many immigrants she came to America with the dream of success. Part of her dream of success came true when she opened her own dental practice in 2010. Since the opening of the office, Dr. Pocasangre has faced some of the same challenges many small business owner have when first starting out; trying to make their business profitable, while balancing all the responsibility of the business on their own.
In the past five years she has faced closure to many times to count. The reason the business survived, was due to her strong commitment and tireless dedication to make it work beyond all odds. Dr. Pocasangre, along with two other employees in the past five years, held the business together solely on the quality of her dentistry and the staff’s ability to work with her.
As a single dentist practice over the past five years, Dr. Pocasangre has been the only full time employee. She was able to employ at different times three to six front and back office part-time employees. As the office began to grow she was able to hire a part- time Hygienist and Dentist. The office annual gross revenue fluctuated from $250,000 to $350,000, which is considerably lower than the median annual salary of Dentist in the Central Valley.
The office is located in a prominent section of Clovis, near residential and commercial neighborhoods. The people of the area are predominately white, with more than 50% married and homeowners with an annual median salary of $65,000. At the start of the business all those demographics provide a substantial amount of the patient base to the office and growth of the practice.

The leadership and organizational structure
Effective leadership is more than giving directives.

The leadership of any organization is the foundation that will either grow the business or the lack of leadership will lead to its failure. Pocasangre Olivia Dental biggest problem is its lack of effective leadership. Because of the poor leadership it created a destructive business culture that has negatively affected the business as well as the employee’ and the overall morale.
As with many small business owners they vision of their business usually only extends to their own abilities. They are driven and full of determination and believe their abilities will be able to sustain the business to success. Unfortunately, many small businesses lack the knowledge to be able to effectively be owners’ and leader’ to their organizations.
In the case of Pocasangre Olivia the business was started with everything the owner could provide to start a dental practice, from the building, equipment and supplies everything except the staff. That is where the problem started. At the start of the business Dr. Pogasangre enlisted the help of a colleague from her previous employer. That employee was given the position of Office Manager, however over the course of the years; the position was only a title. The Office Manager was never allowed the take the realm of leader, because of Dr. Pogasangre inability to relinquish control. As a result of her not finding the balance between her and the Office

Manager it created an unstable atmosphere that transferred to the performance and attitudes of the remaining staff.
Organizational culture usually reflects the vision or mission of founders (Robbins S. D., 2015, p. 45). Just as a business requires the structure to house it, leadership will be what catapults it to a healthy and successfully organization. Because of the instability of the leadership and the parochialistic attitude of the doctor, the office is no longer thriving, but instead just surviving day to day. The decisions for the office are based on intuition with the hope that things will turn out in their favor.
EFE & IFE Analysis and Findings
To rebound the negative effects of what has happen in Pocasangre Olivia dental, an analysis of the external and internal forces was done to determine the opportunities and strengths of the practice and then evaluate the results to identify the threats and the weaknesses.
Opportunities
The office has several external opportunities to increase its revenue; however there are three that could be the most tangible and lucrative for the office. The first opportunity is to utilize the expansion of Medical benefits from the Affordable Care Act. The Affordable Care Act opened a revenue stream to the office by introducing new patients to the practice who otherwise did not have any dental coverage. The majority of the patients who qualified for benefits were given the state funded program, medical. The next opportunity for the office is to market young adults in the age range of 18 to 35. They are a demographic of patients who usually do not regularly utilize their dental benefits. The third opportunity is the 6% rise in the global dental diagnostic and surgical market. With a society that has become more health conscience and with consumer leaning towards a more sustainable existence, dental technology and practices are lining up with that trend.
Strengths
Although, the office is in dysfunctional there are still internal strengths that could be instrumental to the changes needed for the office. First and foremost, Dr. Pogasangre has come to a point of willingness for change that can have a positive effect on the entire office. She is ready and willing to do what is necessary for improving. That leads to the next strength which is her extensive specialty training outside of general dentistry scope. Her ability to treat patient on a wider range of services will definitely be beneficial to the practice. The final strength is the office ability to actually accommodate additional patients. The office is equipped to expand as the productivity of the office grows.
Treats
The external treats the office could lead to its closure at the condition the office is in to date. The three main threats to the office are the mandated fees associated with the Affordable Care Act are considerable less than all insurances acceptable fees and therefore as the patient increase so will the cost for supplies and repair. The decrease in fees can inadvertently have a negative effect on the practice as a whole. The second threat is the patient willingness to accept treatment that exceeds their insurance coverage that requires them to pay higher out of pocket fees. The most important factor for the office is longevity and the last threat has the most effects on that. The final threat come from accepting more patients with the medical program can involuntarily change the entire patient demographics to a more unpredictable and unstable patient base.
Weakness
Unlike the other areas the office, their weaknesses all stem from the lack of organizational leadership and culture. The office is poorly managed with unqualified staff that has affected the entire profit margins of the company. Also As a result of the weakness the office has become over dependent on the medical program and isolated their payer type to only one specific group.

The SWOT and QSPM
The best interest for the office is not continuing down the path they have been going, instead it is time to develop a strategy that will get them to the level of success that they are really capable of.

Based on the external and internal forces it is in my opinion that the office concentrate on their strength and weakness opportunities.
The best opportunity for the office is to hire a new full time Manager, to lead the office to the next level. In hiring a new manager, Dr. Posangre can concentrate on the skill attributes of the office while the manager can run the daily operations and maintain the staff. Another opportunity based on the SWOT would be for the office focus on the patient population. Instead of isolating the office as a single insurance type it should be more inclusive to attract the potential clientele within a 20 mile radius of the office.
Based on the two major opportunities the office has two strategic choices for the direction the office should go into. With all the key factors taken into consideration the two strategies are 1.) Hire a new Manager and restructure the entire organization or 2.) Continue existing structure and expand with the medical demographics. The rationale for choosing the two strategies was based on the total attractive score of the opportunities, threats, strengths and weaknesses of the dental practice. In the office current status it is surviving, but unfortunately will never reach its full potential without changes. Therefore the

option to restructure would be optimizing the strengths and opportunities and take the office to success.

Conclusion
The overall analysis of the office is that it could do better. As understated as that may seem it is as simple as putting an experience manager in place to help assist the doctor on the vision she had for the office at the beginning of it inception. The office has faced numerous challenges but still have many opportunities to grow and operate better. Given the two alternatives for the future of the office, they can now make a decision and plan to move forward to prospers future.