Shorten has pointed orts that productivity and quality are the 2 major elements influencing enterprice performance. Statically, site highest-quality care of a particular problem was usually provided by practioners with a lot of experience in treating patients with that problem. The relationship between the volume of a service and its quality was complex, however. A high initial threshold level was necessary to achieve excellence, alter whirls a lower volume maintained expertise; that is professional quality roar with increasing volume only to a point, beyond which there appeared to be a decline in professional quality with further increases in volume. On rite other-hand, a grind healthcare service quality may result in a higher volume of service. Therefore, service quality and professional quality are both important for healthcare.