The degree of customer contact affects system efficiency. The Medical profession's case about health service reforms argues that a doctor cannot plan her work as effectively as she would like as the consulting needs of patients vary. Productivity is more difficult to measure and quality involves more subjective assessment. Many organisations do all four. BMW make cars, sell and transport them direct to dealers, offer finance deals and provide after-sales support.
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Conflicts and Objectives. Staff productivity without extra pay may be souyght but workers may resist increased work tempo. Management wants long production runs to use materials, machines and staff efficiently but customers want quick response to an order. A doctor with a long queue may limit consulting time but may overlook a serious illness and have no time for people as people. Options involve conflicts.