A Gap Analysis of Professional Service Quality

Author(s): Stephen W. Brown and Teresa A. Swartz

Source: Journal of Marketing, Vol. 53, No. 2 (Apr., 1989), pp. 92-98
Published by: American Marketing Association
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 Stephen W. Brown & Teresa A. Swartz

A Gap Analysis of Professional

Service Quality
Providers of professional services recently have awakened to consumer challenges, competition, and the
realities of marketing. With these changes, a related and equally important issue has emerged-service
quality and evaluating the service encounter. Using medical services as the primary study setting, the
authors explore the concept of professional services quality and its evaluation from both the provider
and client perspectives. They use gap analysis as an appropriate approach for examining the evaluation
of a professional service. The findings provide special empirical insights on the gaps that can arise from
inconsistent perceptions of expectations and experiences between patients and physicians. Finally, both
managerial and research implications are presented.

AS client sensitivity increases, competition ex-
pands and intensifies, and professional malprac-
tice suits become more commonplace, the issue of
evaluating professional service quality has emerged as
a topic in need of investigation. Regardless of the dif-
ficulty, clients do evaluate the "quality" of profes-
sional services. Though an evaluation is known to oc-
cur, what is lacking is a clear understanding of how
the evaluation occurs and the importance of various
components of the service encounter to the evaluation
outcome.
Despite the importance and distinctiveness of the
professional service encounter, little scholarly work
has focused on its special features. Even with our
StephenW.Brownis Professor of Marketing
andExecutive Director
of
the FirstInterstate
Center forServicesMarketingandTeresaA.Swartz
is AssociateProfessorof Marketing,Arizona
StateUniversity.Theor-
deringof the authors'namesis randomto reflecttheirequalcontri-
bution.Theprojectwas supported by grantsfromthe FirstInterstate
CenterforServicesMarketing andthe ResearchIncentiveFundof the
Collegeof Business,
Arizona StateUniversity.
Theauthors acknowledge
the specialcontributions
of SusanGimborys, MichaelHutt,andBruce
Walker of Arizona
StateUniversityto theproject.
TheyalsothankMary
Jo Bitner,LawrenceCrosby, NancyStephens,allof ASU,andtheanon-
ymousJMreviewers fortheirinsightful
commentsonprevious versions
of the manuscript.
growing understanding of services marketing, most of
the work that has been done in professional services
is general and descriptive (e.g., Bloom 1984; Kotler
and Bloom 1984; Brown and Morley 1986; Gummesson
1978; Quelch and Ash 1981) and none has taken a
dyadic view of the evaluation of service quality and
satisfaction-that is, from the perspectives of both the
client and the provider.
The major purpose of our article is to explore the
concept of professional services quality and its eval-
uation from both the provider and client perspectives.
Our study is one of the first empirical examinations
of any service encounter to consider the perceptions
of both parties in the dyadic exchange. Such an ap-
proach makes possible the identification and analysis
of perceptual gaps between the two parties. Given the
typically high level of personal interaction in profes-
sional service encounters, the examination of both
parties participating in the exchange is necessary for
gaining understanding of the evaluation process.
Background
An evaluation of a service encounter results in degrees
of one of two outcomes: satisfaction or dissatisfac-
tion. Satisfaction and dissatisfaction often are viewed
as opposite ends of a continuum, with disposition being

Journal of Marketing
92 / Journalof Marketing,April1989 Vol. 53 (April 1989), 92-98.

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determinedas a result of a comparison between ex-
pectations and outcome (Oliver 1979). Satisfaction
occurs when outcome meets or exceeds the client's
expectations. Dissatisfaction occurs when a negative
discrepancyis presentbetween the client's anticipated
outcome and the actual outcome.
An alternativeperspective on satisfaction/dissat-
isfaction has been proposed by Woodruff, Cadotte,
and Jenkins (1983; Cadotte, Woodruff, and Jenkins
1987). They suggest that experience-basednorms are
more appropriate than expectations to serve as a
benchmark against which product experiences are
compared. In addition, they hypothesize that there is
a zone of indifference between satisfaction and dis-
satisfactionlevels; thoughthere may be some absolute
performancestandardwith which all experiences for
a given brand(or service) are compared,in reality any
given productexperience must be outside an accept-
able range of performancebefore it is viewed as either
a positive or negative disconfirmation.
In summary,applying a disconfirmationparadigm
to the evaluation of a service encountersuggests that
the individualwill comparehis or her experience with
some set of expectations. These expectations may be
based, in partor in total, on past relevantexperiences,
includingthose gatheredvicariously.For example, one
may form expectationsabouta visit to an attorneyfrom
one's own experience or by observing or being in-
formed about someone else's experience. Encom-
passed in the latter condition would be information
gatheredfrom indirectsources such as readinga novel
or viewing a television series. Hence, our understand-
ing of the evaluation of encounterscan be expressed
analytically as:
Oi = Xi - E
and
Xi = f(E<i)
where:
Oi = evaluation outcome for encounter i,
Xi = expectations for encounter i,
Ei =
experiences for encounter i, and
E<i = experiences prior to encounteri.
Depending on the results of the comparison, the ex-
perienceis assessedto be equalto, betterthan,or worse
than expectations.
Looking beyond a single transactionthat directly
relates to an evaluation of satisfaction, Parasuraman,
Zeithaml, and Berry (1985) developed a model of ser-
vice qualityrepresentingmore globaljudgmentsacross
multiple encounters. This model of service quality is
derived from the magnitude and direction of five
"gaps," which include consumer expectations-expe-
riences discrepanciesin additionto differences in ser-
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vice design, communications, management, and de-
livery. We contend that a simpler model is more
appropriatefor evaluating professional services, es-
peciallyin the initialstages of empiricalresearch,given
the professional-client relationship and the unique
characteristicsof professionals. For example, profes-
sionals typically have advanced degrees, meet cre-
dentialing requirements,and often hold equity posi-
tions in their organizations.
The interactivenatureof professionalservices and
their often simultaneousproductionand consumption
indicate a need to examine the perceptions of both
partiesinvolved in the service encounter(professional
and client). Overall, professionals' perceptions most
directly affect the design and delivery of the services
offered, whereas consumerperceptionsmore directly
determineevaluationof the servicesconsumed.Hence,
from a marketingperspective, both parties are very
importantand must be consideredif a more thorough
understandingof service quality is to be gained.
Potential gaps that relate to expected and experi-
enced service and representboth sides of the service
exchange should have a significant impact on the ser-
vice evaluation. In general, these gaps include:
* an intraclient gap between client expectations
and client experiences and
* client-professionalgaps between client expec-
tationsand professionalperceptionsof those ex-
pectations, as well as between client experi-
ences and professional perceptions of those
experiences.
More specifically, threegaps relevantto our study can
be identified.
Gap 1 = client expectations- client experiences
Gap 2 = client expectations - professional percep-
tions of client expectations
Gap 3 = client experiences - professional percep-
tions of client experiences
Implicit in these gaps are the following hypotheses to
be tested.
H,: The level of positive client evaluationof the
professionalserviceis relatedinverselyto gap 1.
H2: The level of positive client evaluationof the
professionalserviceis relatedinverselyto gap 2.
H3: The level of positive client evaluationof the
professionalservice is relatedpositivelyto gap
3.
Gap 1 is hypothesizedto be relatedto positiveclient
evaluationbecause it measuresthe differencebetween
client expectations and experiences, a standardap-
proach to determining satisfaction and assessing an
encounter. Gaps 2 and 3 are hypothesized to be re-
lated to positive client evaluationbecause they reflect
differences between the client's expectations/experi-
ences and the provider's perceptions of them. From a
A GapAnalysisof Professional
ServiceQuality
/ 93
marketingperspective, the providerwould design, de-
velop, and deliver the service offering on the basis of
his or her perceptions of client expectations. Like-
wise, modifications to the service offering would be
affected by the provider's perceptions of client ex-
periences. Whetherthese experiences exceed, match,
or are below expectations can have a profoundeffect
on future client-professional relationships. For ex-
ample, if a professional exceeds the client's expec-
tations, a true person-to-personbonding relationship
often is initiatedor furthered,which in turnbuildsclient
loyalty and may also encourage referrals. Therefore,
one can argue that gaps in either of these areas can
directly influence positive client evaluation.
Method
Several distinct disciplines fit within the definition of
professional services. Given that our study is the first
of its kind, we decided to focus the initial investiga-
tion on a single profession. The medical services area,
and specifically the physician-patientrelationship,was
selected.
Thirteen physicians in private practice were the
context for the analysis. All of the doctors are in-
volved in primarycare, specializing in family practice
or internalmedicine. Each physician's office provided
names and addresses of adult patients seen in a pre-
vious month, which constitutedthe client sample.
Procedure
Each sample patient received in the mail a question-
naire and a cover letter signed by his or her doctor
endorsing the study and requesting the patient's co-
operationin the survey. The letter assuredpatientsof
their anonymity. Completed questionnaireswere re-
turned directly to the researchersin the postage-paid
envelope provided.Of the 2414 patientssampled, 1128
responded, with individual practice response rates
ranging from 30 to 62%.
Each physician received a questionnaireidentical
to the one the patientsreceived, with the exception of
changes in the introductoryinstructionsand in the de-
mographicand classificationquestions.Physicianswere
instructedto respond to the items the way they be-
lieved their patients would respond. This procedure
allowed for a direct comparisonbetween clients' per-
ceptions and professionals' generalizedperceptionsof
their clients' views.
Measures
Statementspresentedon the questionnairepertainedto
the relationshipof the patientwith his or her physician
and correspondingsupport staff, as well as observa-
tions on various services provided. Past research in
the medical area and observationsof medical profes-
94 / Journalof Marketing,April1989
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sionals assisted in item generation. In addition, care
was taken to include statementsthat correspondedto
the 10 determinantsof service quality proposed by
Parasuraman,Zeithaml, and Berry (1985).
Following this approach, we developed 65 state-
ments relatingto the medical servicesencounter.Items
included both patient expectation statementsand pa-
tient experiencestatements.One additionalitem, "I'm
very satisfied with the medical care I receive from my
doctor," was used as an overall evaluationof past ser-
vice encounters.Subjectsrespondedto these items on
a 5-point Likert-type scale, with 1 representing
"stronglydisagree"and 5 "stronglyagree." Last, var-
ious demographic and classification questions were
presented.
Results
Factor Analysis
Before hypothesis testing, the underlyingdimensions
for the set of expectation statements and the set of
experience statements were identified through prin-
cipal components analyses of the patients' responses.
Each group of variableswas analyzedby using a var-
imax rotation, with a factor loading of .5 or better.
The numberof factors to be extractedwas determined
by evaluatingthe screenplot and the eigenvaluescores.
Three factors were extractedfrom the expectation
statements, accounting for 39% of the variance. Six
factors were extracted from the experience state-
ments, accountingfor 51% of the total variance.These
factors and the items loading on them are reportedin
Table 1. The expectation factors are under the "Gap
2" heading and the experience factors are under the
"Gap 3" heading.
Reliability analysis was performed to refine the
factors further. Using coefficient alpha, we obtained
scores of .55 to .48 for the expectation factors and
.93 to .64 for the experience factors. Individual-item
analysis indicated that all statements in each of the
factors should remain. The internalconsistency of the
experiencefactorsis much strongerthanthatobserved
for the expectation factors.
Hypothesis Testing
For hypothesis testing, gaps 2 and 3 were computed
by taking the difference between each individualpa-
tient's score on each item identifiedthroughthe factor
analyses and his or her physician's score on the same
item. Gap 2 relatesto expectationswhereasgap 3 cor-
respondsto experiences. For areas where both expec-
tationand experiencequestionswere asked, gap 1 was
computed by taking the difference between the pa-
tient's responses to each item. Gap 1 could be com-
puted for only six items.
 TABLE 1
Summary Data on Gaps 1, 2, and 3
Gap 2: Patient Expectatioins-Physician Perception Gap 3: Patient Experiences-Physician Perceptions
Gap 1: Client Expectations-Client Experiences of Patient Exxpectations of Patient Experiences
Mean Mean Mean
Gap Correlation Gap Correlation Gap Correlation
Score with Satis- Factor Score with Satis- Factor Score with Satis-
(S.D.) faction (sig) Loading (S.D.) faction (sig) Loading (S.D.) faction (sig)
Gaps Factor1: Professionalism Factor1: PhysicianInteractions
Doctorkeeps up on latest .53 -.26 Appointmentsshould be made .6283 2.95 .03 My doctor hears what I have to .7531 2.78 .59
medical technologies (1.13) (.00) easily and quickly (.89) (.14) say (.77) (.00)
In an emergency, doctor is -.001 -.32 I expect the doctor's fees to be .6254 3.64 .08 My doctor usually gives me .7383 2.57 .58
available (1.18) (.00) reasonablefor the professional (.59) (.00) enough informationabout my (1.01) (.00)
Convenientoffice hours -1.08 -.22 service rendered health
(1.52) (.00) I expect my doctor to talk clearly, .6247 3.28 .07 My doctor is carefulto explain .7341 2.85 .48
Doctor interested in me .06 -.50 using words that I understand (.94) (.01) what I am expected to do (.80) (.00)
(.95) (.00) I expect my doctor to be sincerely .5365 3.62 .09 My doctor is very thorough .7296 2.66 .61
Brochureavailablefrom doctor .54 -.38 interested in me as a person (.72) (.00) (.84) (.00)
(1.58) (.00) I would preferthat my doctor .5291 2.51 .02 My doctor spends enough time .7218 2.41 .61
Reasonabledoctor's fees .83 -.33 explain tests and proceduresto (1.14) (.26) with me (.89) (.00)
(1.11) (.00) me instead of the nurse or the My doctor examines me carefully .7035 3.09 .57
receptionist before deciding what is wrong (.88) (.00)
I have complete trust in my doctor .6955 2.96 .57
Factor2: AuxiliaryCommunications (.87) (.00)
I would like to have more health- .7095 1.09 -.05 My doctor takes real interest in me .6925 2.98 .56
related informationavailable in (1.08) (.07) (.97) (.00)
the receptionarea I have my doctor's full attention .6646 2.79 .44
I would like to have brochures .6560 1.74 -.06 when I see him/her (.90) (.00)
availablefrom my doctor (1.31) (.04) My doctor always treats me with .6602 3.47 .34
explainingmy medical problem respect (.67) (.00)
and treatment My doctor thoroughlyexplains to .6174 2.74 .53
I would like to receive in the mail .5698 1.30 .02 me the reasons for the tests and (.87) (.00)
a reminderfor my regular (1.41) (.27) proceduresthat are done on me
physical
I expect the doctor's office to be .5307 1.24 -.08 Factor2: Staff Interactions
open at times which are (1.37) (.01) My doctor's office staff takes a .7832 2.10 .29
convenientto my schedule warm and personal interest in (1.32) (.00)
me
Factor3: ProfessionalResponsibility My doctor's office staff knows me .7775 2.51 .26
Where my medical care is .7692 .33 .16 as an individual (1.26) (.00)
concerned, my doctor should (1.63) (.00) My doctor's office staff is friendly .7376 2.76 .25
make all the decisions and courteous (1.05) (.00)
The staff at my doctor's office is .6678 2.08 .31
very flexible in dealing with my (.99) (.00)
individualneeds and desires
My doctor's office staff always .5829 2.89 .26
acts in a professionalmanner (1.04) (.00)
My doctor's office staff is more .5343 -.63 -.23
interestedin serving the doctor (1.57) (.00)
than meeting my needs

Factor3: Diagnostic
My doctor prescribesdrugs and .6660 -1.59 -.22
pills too often (1.18) (.00)
My doctor orders too many X-rays .6592 -1.80 -.25
and lab tests (1.14) (.00)
Sometimes my doctor takes .6030 -2.95 -.22
unnecessary risks in treating me (1.10) (.00)
My doctor's main interest is in .5824 -1.92 -.31
makingas much money as s/he (1.65) (.00)
can
Sometimes my doctor and the .5670 -2.21 -.27
nurse talk like I'm not even there (1.50) (.00)
My doctor will not admit when .5541 -2.16 -.29
s/he does not know what is (1.35) (.00)
wrong with me
There are some things about the .5279 .57 -.37
medical care I receive from my (1.49) (.00)
doctor that could be better
My doctor rarelyever explains my .5124 -3.03 -.36
medical problemsto me 1120) (.00)

Factor4: ProfessionalCompetence
My doctor is bettertrainedthan .7065 1.82 .25
the average doctor (1.06) (.00)
Comparedto other doctors, my .6240 2.00 .23
doctor makes fewer mistakes (1.26) (.00)
My doctor keeps up on the latest .5810 2.33 .29
medical discoveries (1.09) (.00)
My doctor gives me choices when .5158 1.37 .34
deciding my medicalcare (1.25) (.00)

Factor5: Time Convenience

My doctor rarelymakes me wait; .5943 1.32 .26
s/he is usually on time (1.85) (.00)
I am usually kept waiting a long -.5446 -1.12 -.21
time when I am at my doctor's (1.92) (.00)
office

Factor6: LocationConvenience
My doctor's office is conveniently .7672 2.09 .07
located for me (1.46) (.01)
My doctor is on staff at a hospital .7461 2.95 .13
which is convenientfor me (1.23) (.00)

Any patient for whom data were missing on the H1. Table 1 reports the mean gap score for each
statement being tested was eliminated from that anal- item on which a comparison between a patient's ex-
ysis. In addition, one physician failed to respond to pectations and experiences was possible. Each gap 1
several items; both he and his patients were dropped score was compared with the overall evaluation score
from further analysis. The result was a final overall by using Pearson's correlation; a significant negative
patient sample size of 1096 across the 12 physicians. correlation indicated support for HI. Correlation scores

A GapAnalysisof ProfessionalServiceQuality/ 95

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in Table 1 provide support for Hi-the greater the TABLE 2
negative gap, the lower the level of satisfaction. Stepwise Regression Results
H2. Table 1 gives the mean scores for gap 2 and Regression 1 Regression 2
the correspondingcorrelations. Though the correla- Signifi- Signifi-
Gap Beta cance Beta cance
tion scores are weak, ranging from .16 to -.08, only
Physician interactions .6155 .000 .6259 .000
two are in the hypothesizeddirectionand significantly Doctor interested -.1616 .000
different from zero. As a result, H2 is not supported. Doctor available/emergency -.1096 .000 -.1273 .000
This lack of supportmay be a function of the weak- Professionalism .1104 .000 .0682 .009
Reasonable fees -.1122 .000 -.0995 .000
ness of the measures. As noted before, the reliability Professional competence -.2044 .000
of the expectation statements is suspect. Therefore, Latest technologies -.1443 .000 -.0677 .012
Diagnostics -.0866 .007
the relationshiphypothesizedmay not have been truly Staff interactions -.0757 .011 -.0700 .017
tested. Brochures available -.0688 .017 -.1065 .000
H3. Gap 3 mean scores and relating correlations Regression 1
F = 94.55, significance = .000
are also provided in Table 1. Strong positive corre- Adjusted R2 = .60
lations are present for all items but those in factor 3.
Regression 2
Closer examination of this factor reveals that all the F = 125.97, significance = .000
items are negative in orientation(i.e., "My doctor or- Adjusted R2 = .55
ders too many X-rays and lab tests"). Hence, for items
in factor 3 a positive mean score representsa negative physician-client interactions)of the significant gaps.
gap and a negativecorrelationscore supportsH3. Given First, all threegap types are demonstratedto influence
these results, H3 is overwhelmingly supported. the evaluation outcome. This finding suggests that
service marketerscan gain informationby looking be-
Regression Analysis yond the traditionalsatisfaction/dissatisfactionpara-
To explore how the individual gaps measured relate digm when assessing their service offerings. Though
in determiningthe overall evaluation, we performed client assessments are important, the professional's
a stepwise regression analysis using the expectation view, when combined with the client's perspective,
and experience factors' summed gap scores (gaps 2 can provideadditionalinsight into areaswhere change
and 3), as well as the individualdifference scores rep- is needed.
resenting gap 1. Also of interest is the content or topics measured
A significantregressionequationwas achievedwith
by the gap variablesin the regressionmodel. As might
an adjustedR2 of .60. After adjustingfor multicollin- be expected, several of these areas relate directly to
earity, we recomputedthe regression model using the the professional and his or her behavior (e.g., phy-
remainingfactors. The second regression model was sician interactions,doctoravailable, professionalism).
very similar to the first (adjustedR2 = .55), with the However,otherdimensionsalso arerelevant(e.g., staff
exception of the absence of the highly correlatedvari- interactionsand brochuresavailable), indicating that
ables. The beta weights and other summarystatistics the entire service encounteris evaluated, not just the
from both regressionanalyses are reportedin Table 2. interactionwith the professionalserviceprovider.These
The most significant independentregression vari-
findingssuggestthatprofessionalsshouldadopta broad
able is physician interactions.Examinationof the beta
perspective when defining and examining their ser-
weights reveals that gaps found in the experience vice offerings and assessing their clients' evaluations.
statementsrelated to the physician interactionfactor Because past research demonstratesthe consum-
(gap 3) had the greatest single impact on the overall er's reluctance to complain when a negative service
service evaluation. This finding suggests that inter- encounteroccurs (Gr0nhaugand Ardt 1980; Quelch
actions with the primaryservice providerare the most and Ash 1981), especially if it involves a professional
importantin assessing service quality. However, the service, managersmust take a proactive approachin
inclusion of other variables in the regression model,
such as staff interactionsand brochures, supportsthe monitoringservice quality. Our researchsuggests that
one such approachcould involve gap analysis.
multidimensionalityof service evaluation. As illustrated in the regression analysis, incon-
sistencies in expectations and experiences affect the
Discussion
service evaluation. Clearly, the magnitudeand direc-
The results suggest a significant relationshipbetween tion of the inconsistencies will determinewhetherthe
perceptualgaps (between professional and client) and client is pleasantly surprised(resultingin greatersat-
the evaluation of professional services. isfaction), bitterly disappointed (leading to dissatis-
Insight into this relationshipcan be gained by ex- faction and possibly even litigation),or mildly pleased
amining both the type (e.g., gap 1) and content (e.g., or displeased.

96 / Journalof Marketing,April1989

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 Implications
Managerial
Our study shows that gap analysis is a straightforward
and appropriateway to identify inconsistencies be-
tween provider and client perceptionsof service per-
formance. Addressingthese gaps seems to be a logical
basis for formulatingstrategies and tactics to ensure
consistent expectations and experiences, thus increas-
ing the likelihood of satisfactionand a positive quality
evaluation. More consistent expectations and experi-
ence perceptions can be achieved in one or both of
the following ways.
1. Alter serviceproviderbehaviorsandexpectations
(adjustthe professional'sown behaviorand ex-
pectationsto be consistentwith the client's ex-
pectations).
2. Alterclientexpectationsandexperiences(educate
theclientso new expectations,consistentwithwhat
the service provideris offering, are developed).
Altering professional behaviors and expectations.
The professional obviously has more control over the
first method of adjustingexpectations, but even these
self-initiatedactions representa significantchallenge.
For example, assuming a genuine client orientationis
fundamentalto alteringproviderbehaviors (Congram
and Dumesic 1986). However, because of their ex-
tensive specialized and technical producttrainingand
their past immunity to overt competition, many
professionalsappearto be much more task- and self-
oriented than client-oriented.
Altering providers' behaviors and expectations is
possible if professionals become more aware of the
wide array of factors their clients consider in evalu-
ating them and the quality of the services provided.
Providersmust realize that the intangibilityand tech-
nical complexity of a professional service lead many
clients to seek and evaluate surrogate indicators of
quality, includingsuch factorsas paraprofessional staff
behaviors, office ambience, and even signage (Brown
and Swartz 1984). This client propensitysuggests that
professionals should broaden their perception of the
scope of the service encounterand its attendantqual-
ity determinants.
Altering clients' expectations and experiences. The
just-mentioned strategies for changing the profes-
sional provider's behaviors would have the dual ben-
efit of altering the client's expectations and experi-
ences. This observation suggests that the two
approaches for developing more consistent expecta-
tions and performance perceptions actually are inter-
related, not separate and distinct. Before initiating any
new programs to alter client perceptions, the profes-
sional should learn more about his or her clients' ex-
pectations and experiences. Insights from client sur-
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veys, focus groups, or even more informal means of
research are likely to provide a valuable information
base for programsto alter client perceptions.
One majormeans of alteringclient expectationsis
through educational and/or promotional communi-
cations. Today's competitive environmentis encour-
aging professionals to take subtle and in some cases
aggressive steps to promote their services. In this sit-
uation, an increasing number of providers are faced
with the dilemmaof overpromisingversus creatingre-
alistic client expectations and experiences.
Another strategy for altering clients' perceptions
is to involve the client more in the decision-making
process pertinentto his or her case. This participative
or relationshipmarketingapproachto client relations
seems to encourage a more positive client experience
(Crosby and Stephens 1987) and a reductionof mal-
practice suits.
Research
Additional research is needed on evaluating profes-
sional service quality. The dyadic datafrom one study
of one profession should not be construed as repre-
senting the entire medical services encounter or all
professional services. However, the study does pro-
vide a test of the usefulness of gap analysis and its
applicationto the evaluation of service encountersin
general and professional services in particular.
The focus of our researchis the dyadic interaction
between a single professional and a single client, yet
often the client's time is spent interactingwith support
staff and/or multiple professionals. Furthermore,the
professionalpracticemay interactwith several people
within the client firm or household. After an under-
standing of the core professional-clientinteractionis
gained, researchshould explore the impactof the mul-
tiplicity of interpersonalcontacts on the service eval-
uation process.
A limitationof our study is the lack of one-to-one
correspondencebetween expectation and experience
measures. Measurementscales for each must be de-
veloped and refined. The recentwork of Parasuraman,
Zeithaml, and Berry (1986) on the development of
SERVQUALprovides an excellent illustrationof how
to begin measuring both expectations and experi-
ences.
In addition, much of the previous service quality
research has focused on identifying its various di-
mensions (e.g., Berry, Zeithaml, and Parasuraman
1985; Gronroos 1983; Lehtinen and Lehtinen 1982),
yet empirical work assessing the impact of each di-
mension is lacking. Questions particularlywarranting
investigation include: Does process quality have a
greaterrole thanoutcome quality in the overall profes-
sional service evaluation?How importantis the image
A GapAnalysisof ProfessionalServiceQuality/ 97
of the service provider in the client's quality evalua-
tion?
Conclusions
In examining patients' expectations of and experi-
ences with physician services, we uncovered various
gaps. Inconsistencies in expectations and experiences
can and do have an adverse effect on the evaluation
of service performance. More important, inconsist-
encies between patient and physician perceptions of
service experiences also are reflected in the medical
service evaluation. Incongruencies could lead to the
patient offering negative word-of-mouth comments
about the physician and his or her practice. In con-
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