Knowledge-Intensive Business Services and Business Models: a Qualitative Comparative Analysis of Small Private Healthcare Providers

 In recent years, companies operating in activities such as dentistry, optometry, physiotherapy, or veterinary have seen the demand for their services grow. Their customers do not require their services only for health reasons but also for aesthetics and welfare issues. As a result, these companies compete in expanding and profitable markets. However, this business context has been detected by many professional entrepreneurs who decided to run their activity in healthcare and set up a firm without the necessary assets and knowledge. To overcome these liabilities, some seek partners who provide them with the resources they do not have by entering into different alliances. In contrast, others choose to compete under an independent business model. This paper sheds light on the factors influencing the decisions about the implemented business model in small knowledge-intensive firms by examining the association between the perception of the institutional environment variables and the dotation of intangible resources. For that purpose, a qualitative comparative analysis (QCA) was performed. Due to government regulations in force in these sectors, and methodological reasons, the study sample consisted of 88 small Spanish firms (less than 15 employees). The data were collected by a questionnaire distributed in 2017. We find that the choice to remain self-governing or to enter into a partnership (e.g franchising) is heterogeneously motivated by the evaluations that entrepreneurs have about the role of institutions concerning their activities and how high they consider their intellectual capital compared to their main competitors. In terms of institutional capital, these entrepreneurs refuse to implement patient loyalty policies and strive to have high-quality human capital in terms of the training & experience of their professionals. Moreover, the results also showed that independent business models pay little attention to market influences and view a certain level of regulation favorably, suggesting vocational and conservative behavior