Dr. Shouldice established a speciality hospital in 1945 near downtown Toronto, Ontario, for the treatment of hernia with a special focus on primary hernia. Starting as a small six room nursing home in 1945 the hospital grew over the years to become an 89 bed facility by 1982. Dr. Shouldice's seminal contribution was to develop a surgical technique for the treatment of hernia which proved to be far superior to the existing practice and had crystallized from his observations over the years that quick and early ambulation following the operation expedited the trouble free recovery process. This surgical technique, popularly known as the 'Shouldice technique' was based upon incorporating operative and post operative processes such as the "use of local anaesthetics, the nature of surgical process itself, the design of a facility to encourage movement without unnecessarily causing discomfort and the post operative regimen designed and communicated by the medical team", which facilitated early ambulation. The entire process significantly reduced the stay in the hospital for the patients and facilitated their early return to their jobs. It was also the cheapest option available to the patients. Besides, the entire experience of staying in the hospital itself was a pleasant experience for the patients. This constituted a major "value proposition" for the patients who themselves provided "word of mouth" publicity of the benefits and experience undergone by them at the hospital and contributed greatly towards the success of the Shouldice Hospital.
Facts of the case reveal that the Shouldice hospital had acquired a huge reputation of a hospital which offered reliable and quality medical facility for the treatment of hernia at a very cheap cost. This had also led to the expansion of the hospital from a modest beginning into a modern facility which carried out 6850 operations in 1982. We...