CONCLUSIONS
This study shows that both adaptation and standardization are practiced by the Elekta companies in the studied countries.
Adaptation relates mainly to marketing, pricing and building informal relationships. Cultural adaptation has been particularly
important in China which is manifested in the development of Guanxi. Standardization is associated with the service concept
and training, and is practiced in all the Elekta companies. Maintenance of standardization in the core area has served two
purposes: offered uniformity in the delivery of services and evoked trust on quality to the customers and the local employees.
This finding suggests that some standardization is not an option but a necessity to communicate with the markets. The message
should be clear that the company does not compromise with the concept but responds positively to adaptation when it is
important for the country. Hiring on personal relationship in Philippines is an example of how trust is developed and ensured
in the company. But it also shows that how the management is influenced by the culture and no fruitful attempt is made to
develop competence based working force. Professionalism is evident in Elekta Brazil and adaptation and standardization have
been successfully combined to offer betters services to the customers and be highly competitive in the market.
This research work suggests that internationalization of health care service needs a manager’s sensitiveness to cultural
differences and competence to properly combine standardization with adaptation. To make the service tangible, it is also
important that the service is appropriately demonstrated to the customers which Elekta Brazil has done by organizing visits to
reference centers where Elekta equipments are in use. Another important issue is the type of offering made to the customer. As
the technology is complicated and central in health care service, managers need to come up with a package of total solution.
Certainly it is expensive for customers, but it is again the task of the manager to find a reasonable solution for the customer. In
one case Elekta Brazil came in contact with a prospective buyer who had difficulty to arrange financing. The company took
the matter seriously and consulted with the Stockholm office to find out a solution. The matter was solved by the help empathy
and broader perspective of the Brazilian management. Only emphasizing the local culture cannot work in the long run, is
demonstrated by Elekta Philippines. The company has not undergone any upgrading and further lacked the vision of recruiting
efficient employees and relied on the relatives of the doctors and owners of the company.
One limitation of the study is the small number of cases. By including few more cases, the result can be further generalized.
We have looked on the culture from a broad perspective, a detail study on culture relating to different aspect of
internationalization could therefore provide important insight of services marketing. Further, impact of service characteristics
on health care can also be compared within the same country to keep away the role of culture.