t306b final project spring 2010 007819 mona nassrallah...

Mona Nassrallah‐7819‐T306b‐Final Project‐315

ARAB OPEN UNIVERSITY

FACULTY OF BUSINESS STUDIES

Lebanon Branch

T306. Managing Complexity: a systems approach

Demand of Plastic Surgery and its Consequences in "Lebanon".

Final Project Presented by

Mona Nassrallah

Supervisor: Dr. Rima Rouhana

Spring 2010

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FBS‐PT3

F O R M

Faculty of Business Studies

TMA Cover Sheet

Lebanon Branch

Second □ First Semester 2009 – 2010 Academic Year

2 □ 1 TMA No. T306B Course No.

I. Student Information (to be completed by the student) Mona…Nassrallah…..……….……………………………………………………………… Student Name

……315…………... Section No. ….…7819…………………… Student No.

…[email protected]….…….…………………………………………………………….….... E-Mail

I hereby certify that the work presented in this TMA is my own and is not copied from any source.

…5….. / …5…. / 20 Date of Submission M./N Signature

Q3 Q2 Q1 Questions Total

20 10 70 Weight

Allocated Marks

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Total E-Library Word Count Referencing Presentation Criteria Allocated Marks

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Student's Total Mark ١٠٠

I. Tutor's Comments

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sTable of content

I. Acknowledgment

II. Introduction

III. Tutor report

• SSM seven stages

IV. Diagrams

• Rich Picture

• Spray Diagram

• System Map

• Influence Diagram

• Multiple Cause Diagram

• Sign Graph

• Closed Control Loop

V. Client report

• Summary of the Mess

• Recommendations

VI. Project log

• 12 Weekly Summaries

• Final over All Summaries.

VII. References.

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Acknowledgments

Before getting started, I would like to thank some people who helps me achieving this project. First, I want to thank my tutor who helped me choosing my mess, and was teaching me how should I treat it, she was answering all my questions through the whole semester.

Second, I would like to thank my doctor, Dr. Ali Wehbi who guided me for the right references, and was responding for any question or clarification, and provided for me much information about my mess.

Third, I would like to thank the patients that I have interviewed and who helps me in adding more information to the mess by their experience.

Finally I would thank my friends and family members who were responding when I was trying to interview them or ask them anything related to plastic surgery issue.

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Introduction

I am AOU student from four years; I have already got a good experience in learning university courses and especially the level 3 courses. T306 course (Managing complexity) was the best course in my learning cycle because, it touches our daily life it’s a practical course where we can practice every day problem and find the right solution in the right way. T306 helps me to define any system, to be aware of the constraints and possibilities, to differentiate between method, techniques, and methodologies, collecting the right data, define stakeholder perspectives, be open to any discussion, respect others, using the right diagrams in the right place, link problems and know their interconnections, be a system practitioner who juggles the BECM balls that I will juggle later in this project and after all that, I develop the skills and experience needed in order to solve any complex situation in the right way using one of the method that I have learned in the two semesters starting from the Hard System method that can be used where there is a lot of statistics, numbers and calculation and technical solution, Soft System method by the 1st and 2nd mode that helps in many messy situation where the problem is unstructured, qualitative data, and many people are involved and finally the Viable System which is very useful in designing an effective organizational structure for doing it.

After weeks of searching and hard thinking to choose a messy situation that is related to the sustainable development I decide to choose "demand of plastic surgery and its consequences in Lebanon" that is a mess that contacts all people and I am interested to work in this project because it’s a light spot to make people aware about this dangerous issue that is widely expanding over the world and especially in Lebanon, my aim is to find some recommendations to help those people, or to lessen from the consequences of plastic surgery in the suitable way. For that choosing a method was easy issue because I am working in a mess where there is a lot of people involved and no need to make calculations or designs although the two other methods that I have learned are so important but they are not appropriate with my situation. According to my situation all people are stakeholders because plastic surgery case can affect everyone in the society and can be affected by any one. There are many individuals involved, groups and organization that have connection to this situation. There are the important actors or sources of reaction that are the patients and the surgeon, others who influence opinions about this issue: society, government, the world view and syndicate of doctors, some of people have a clear role with respect to situation like the psychologists and banks, the groups that are affected by the situation are all the society and finally those with relevant positional responsibilities like accountant in plastic surgery center, nurses, machines and medical organizations.

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Tutor Report:

After deciding who are the stakeholders that I should involve in my situation it’s the time to start juggling the BECM balls that I should use in order to follow the seven stages of the soft system method (2) that is very useful for determining what's going on and what actions can be taken to improve and by taking a multiple perspectives of the stakeholders into account we can reach some assumptions that lead to the right solutions in the best way. According to the BECM balls that I will juggle as a system practitioner I will begin my analysis by the B ball that makes the practitioner aware of the constraints and possibilities of the situation, then, I'll passes to the E-ball, and that means engaging with the complexity, Next, I'll starts to juggle the C-ball, which means contextualizing systems approaches, where I starts to differentiate between systemic and systematic thinking and action. The last ball juggles is the M-ball.

Where I manage the complexity, or acting what I decided to do in order to solve.

Starting with the b ball I will discuss the first three stages of the SSM mode 2 in order to have a clear view of the situation and be aware of the constraints and possibilities.

S0: Warming up: Distinguishing between the three different roles of members and organizations of the situation I am dealing with.

The client: are the one who having the major role and without him there is no situation and thus no problem. Clients of plastic surgery are those patients who have defects from accidents, by birth or those who likes to follow every new and they are psychologically patients.

The problem solver: are those people or organizations that influence this issue and can solve part of the problem. Problem solvers in this situation are the governments, syndicate of doctors and society at all.

The problem owner: are those people that lead to the situation or affected by the situation. Problem owners are: Surgeons, nurses, hospitals, patients, psychologists, accountants, medical machines organizations, pharmacies and syndicate of doctors approximately all the society.

Stage 1: Problem situation unstructured: Plastic surgery is one branch of medicine that is chosen by doctor who has an interest in this field, ethics, capabilities and ability to cope with defect patient. Plastic surgery is a special type of surgery that can involve both a person's appearance and ability to function. Plastic surgery issue looks to some people as a vague and they think that Just because the name includes the word "plastic" it means that patients who have this surgery end up with a face full of fake stuff but this is not the case because the name isn't taken from the synthetic substance but from the Greek word plastikos, which means to form or mold (and which gives the material plastic its name as well). Demand of plastic surgeries and its consequences in Lebanon is a mess issue and its techniques were being carried out in" India by 2000 B.C"! But it starts to develop 10 years ago especially in Lebanon that record the 3rd country in the world in the demand on plastic surgeries, and according

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to statistics it shows that there is a strong demand in this field and it has been increased from 10 to 20 % from 2006 till 2007 and this is a harm indicator. We can call this strong demand in this period as a revolution in the surgery field but before this revolution when we were asked about what do we hear or know about plastic surgery? Our answers would be focused on a Hollywood stars who are trying to delay the effects of aging who want to change their stomach size, lift their face, or even enlarge their breast this was the case in the past where it was hard for a woman or girl to change from being a normal girl to Cinderella in one night!! But nowadays the dream become true and all what any woman need is to make some plastic surgeries by the hand of good surgeon to be in short time the 'beauty of the beauties'! Plastic surgery becomes a gift to many women that find it a good way to turn back their self confidence. And concerning Lebanon's plastic surgery market it has been steadily expanding over the past decade, with demand for procedures like Rhinoplasty, liposuction, lipofilling or filling of lips and cheeks and injections of Botox that is a toxin that paralyzes facial muscles to remove wrinkles. To know more about plastic surgery there are common surgeries:

Rhinoplasty ("nose job"): reshaping of the nose. Mammoplasty including: Breast augmentations ("breast implant" or "boob job"): augmentation of the breasts by means of fat grafting, saline, or silicone gel prosthetics. Reduction mammoplasty ("breast reduction"): removal of skin and glandular tissue, which is done to reduce back and shoulder pain in women with gigantomastia. Mastopexy ("breast lift"): Lifting or reshaping of breasts to make them less saggy, often after weight loss (after a pregnancy, for example). It involves removal of breast skin as opposed to glandular tissue

Suction-assisted lipectomy ("liposuction"): removal of fat from the body Abdominoplasty ("tummy tuck"): reshaping and firming of the abdomen. Blepharoplasty ("eyelid surgery"): reshaping of the eyelids or the application of permanent eyeliner. Browplasty ("brow lift" or "forehead lift"): elevates eyebrows, smoothes forehead skin. Otoplasty ("ear surgery"): reshaping of the ear, most often done by pinning the ear closer to the head. Rhytidectomy ("face lift"): removal of wrinkles and signs of aging from the face. Buttock augmentation ("butt implant"): enhancement of the buttocks using silicone implants or fat grafting ("Brazilian butt lift") and transfer from other areas of the body. Buttock lift: lifting, and tightening of the buttocks by excision of redundant skin.

Demand on plastic surgery in Lebanon, increased about 25% in the last five years and this is due to the increase in individual net income, the increase in the used techniques in the surgeries, its easiness and the way in which it develop the appearance of the individual. We can find that society as a whole is affected and can affects the plastic surgery field. And by applying the SWOT analysis we can touch the internal strength and weakness, the external opportunities and threats of the plastic surgery where we can find that its strength is presented by the success of the surgery and the satisfaction of the patient moreover the satisfaction of the society, where its weakness is focused on the internal process in the surgery where it’s the place of mistakes and any mistakes lead to patient defect or death. On the other hand, opportunities could be found by being updated to the technology in which there are a new techniques and machines that facilitates the surgeons work and make it more efficient. And the professional surgeon will have a good reputation and thus will have an opportunity to

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http://en.wikipedia.org/wiki/Rhinoplasty

http://en.wikipedia.org/wiki/Nose

http://en.wikipedia.org/wiki/Mammoplasty

http://en.wikipedia.org/wiki/Breast_augmentation

http://en.wikipedia.org/wiki/Breast_augmentation

http://en.wikipedia.org/wiki/Breast

http://en.wikipedia.org/wiki/Reduction_mammoplasty

http://en.wikipedia.org/wiki/Gigantomastia

http://en.wikipedia.org/wiki/Mastopexy

http://en.wikipedia.org/wiki/Liposuction

http://en.wikipedia.org/wiki/Abdominoplasty

http://en.wikipedia.org/wiki/Abdomen

http://en.wikipedia.org/wiki/Blepharoplasty

http://en.wikipedia.org/wiki/Browplasty

http://en.wikipedia.org/wiki/Otoplasty

http://en.wikipedia.org/wiki/Ear

http://en.wikipedia.org/wiki/Rhytidectomy

http://en.wikipedia.org/wiki/Buttock_augmentation

http://en.wikipedia.org/wiki/Buttock

http://en.wikipedia.org/wiki/Buttock_lift

http://en.wikipedia.org/wiki/Buttock


expand, and be known internationally. While threats for plastic surgery are those surgeon who wants to make profits only, regardless of the patient thus affecting the other surgeon and create a ground for competition and the surgeon who makes mistakes in the surgery suffer from the threat that may affect their reputation. We know that plastic surgeries are created to improve the looks of an individual, there are a certain percentage of risks because, some may cause the skin to lose its color, others to get life defects, and if the percentage of risk is high then death is the result!! Many of known singer, actors has dead due to small mistake in plastic surgery (Soad Youness that is Egyptian actor have been dead in liposuction surgery) and many have a successful and good result (Lebanese singer Nawal Al-Zoghbi "Rhinoplasty"). We should all have knowledge that result of plastic surgery can never be predicted. For that choosing a good doctor can helps the problem. Consequences of plastic surgery can never be known and we cannot count it because, for example in Blepharoplasty any mistake will lead to the defection of the eye: open eye, nerves cut, lifted more and other consequences may appear only in one surgery! How about the other plastic surgery and how many patients have been try and suffer from the surgery

Here there is a need to apply STEP analysis in order to find the aspects that could influence negatively or positively the development of plastic surgery. According to the social aspects (patient's living standard level, ethics, the values and behaviors of the society for example some people agrees others reject…) technological aspects (surgeons should be up to date to the technology and watch conference that encourage the use of technology and information system), economic aspects (shows that as plastic surgery increase there will be increase in the net profit of Lebanon and the reputation of good surgeons can attract patients from other countries and thus increase the financial situation) political aspects (if the political situation in Lebanon is fluctuating the demand level of foreign patient will decrease and also Lebanese patient will be not encouraged to make surgeries in such periods!) moreover adding to those the government policies in which government apply rules and regulations on surgeons and punish them by paying or prison if they defect any patient and in special cases there is a punishment or patients who in some cases stole in order to make plastic surgeries!. These patients may suffer from psychological problems and need to be treated by a good psychologist!!

From the B ball to the E ball:

Stage 2: Rich Pictures, issues & primary tasks In order to know more about this issue I will explain the rich picture that will analyze the situation and gives a snapshot in order to clarify the idea, it’s a holistic view. There is a high demand on plastic surgery in Lebanon, some patient are happy in doing surgery others are not. Banks give beauty loans to patients (FNB is best example) thus improve the economic situation and by doing more plastic surgeries the financial situation will developed and as Lebanese the good surgeon reputation is expanding and attracting foreign patients from all over the world. The usage of new techniques and the attending of international conference make the surgeries easier. And to do so, there is a need for hospitals, medical machines, medicines, gains and medical supplies in order to achieve the surgery. Moreover advertising is affecting all the society and thus encourage patient to do plastic surgeries and the syndicate of doctors' helps doctors

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and protect them. Finally the consequences of plastic surgeries cannot be expected thus may lead to defect patients or even to death thus the need of government intervention is important to apply rules and regulations and punish the surgeons.

On the other hand, primary tasks are those tasks that the organization might have to do in order to meet its primary purpose and here in plastic surgery the primary tasks are:

• The ability of changing defect patient to a normal one (improve appearance). • Correct faults if there is anyone. • Recommendation given by the surgeon for patients who don’t need a surgery. • Technological awareness for the easiness and efficiency of the surgery.

And according to the issues, those are the things that might stop the primary tasks to be done some of these are:

• The Ethical issues that some surgeons don’t have! • Surgeons' responsibility of the faults they did. • Best use of techniques for the surgery success purposes. • The individualism issue, because many surgeons do surgeries for financial

aims only.

Primary tasks and issues are very important and we can turn them to systems in order to define the next stage the relevant system.

Stage 3: Relevant Systems & their Root Definitions: After listing the primary tasks and the issues in the plastic surgery situation, it becomes easy for us to discuss the relevant systems:

• Social system awareness for people who don’t have idea about the consequences and the risk of plastic surgeries.

• Information system that links the plastic surgery clinics with the syndicate of doctors in order to monitor all the surgeries and prohibit the unnecessary one.

• Technological systems in order to be updated to all new techniques. • Advertisements control system. • New rules and regulation systems applied on all the surgeons that make

mistakes. • Ethical system that should be applied to all surgeons on a yearly base, in order

to show that ethics helps surgeon to differentiate between right and wrong and to prefer the patient interest on the financial interest.

In order to know more about the relevant system, root of definition is the solution.

The social system of awareness is beneficial in our culture because there are many women who just want to make plastic surgery to be like Haifa singer or other but they don’t need such surgeries and risk of doing these surgeries fluctuating between one woman and other because some bodies cannot hold the pain or the consequences others are normal. And some people prefer to make plastic surgery on their studying or their children, the psychological factor plays a big role in this case. For that we

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should have a social system that develop awareness program about this issue. And according to the information system, it's important especially in Lebanon because there are many surgeries that is done in the clinics with no nurses or anesthetic doctors and lead to patient defects Moreover there are some surgeries that are not necessary but surgeon make it due to his greedy to get more money. Here there is a need to link the surgeons' clinic with the syndicate of doctors in order to monitor the surgeries and all the data should be between its hands. Moreover by making information system the technological system is beneficial because, all the new techniques will be held on the internet and international conference will invite the surgeons by the help of e-business thus the surgeon should be up to date to all technology and attend the conference in order to improve his work and know the latest techniques. Advertising play a good role in attracting people to make surgeries but there is a random advertisement in Lebanon for plastic surgery thus it should be controlled by the help of government and it should make sure of the rightness of these advertisements. Plastic surgery has many consequences and thus there is a need for government intervention to apply strict rules and regulations for those who make mistake and lead to patient defects or death but here in Lebanon and even there is a lot of failure surgeries but there is no time that we hear X surgeo9n have been punished or prohibit from working because we are in Lebanon and because the syndicate of doctors is protecting the surgeons and defence for them. Thus new regulation should be followed. Finally government or syndicate of doctors should develop an ethical system programs in which surgeon will know the importance of ethics that he should be hold and to encourage them to prefer the individualistic side over the financial side. After discussing the root of definition there is one way to show if the roots are correct and will be applied by the use of CATWOE checklist.

C: customers: those who are the key problem and can solve the problem: patients from all levels.

A: actors: those who work in order to achieve the goal: doctors, surgeons, nurses, employees, accountant.

T: transformation process in which the transfer of input to output is done: skills, technology experience and defect patient is transformed into healthy patient.

W: world view of the mess: some people see its advantage other concentrate over the risks, so world view is divided between people who accept plastic surgery and others who reject.

O: owners those who have control over the situation: are the surgeons.

E: environmental constraints those are the external factors that affect the situation: Governments, Competitors and Advertisements

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Moving to the C-ball.

Stage 4: Conceptual model:

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.

2.

Social Awareness System

6.

Information System

3.

Technological Development

4.

Ethical System Programs

7.

Demands Balance

5.

Advertisement Control System

8.

Lessen P.S Consequences

1.

Rules & Regulations System

Stage 5: Comparison of CM with Rich picture:

Here we should compare the conceptual model activities with what actually exist in the real situation.

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Blob in CM Is it in situation? Comment Carry forward?

Rules & Regulation System

They are in the rich picture but are not effective and not applied.

Government intervention is necessary in this situation and control should be applied.

Yes, strict rules & regulation system should be applied over the surgeon who makes mistake.

Social Awareness System

There is a presence for the demand of plastic surgery and all the factors that encourage this issue but no social awareness except those who accept or reject the plastic surgery.

People should have an idea about the risk of plastic surgery but the help of some social programs that makes people aware.

It's important to carry this system to real situation even it will cost time and money for the government and social institutions.

Advertisement Control System

The advertisements appear in the real situation but to attract people to make plastic surgery but there is no control!

Random Plastic Surgery Advertisement should be controlled and punish the one who advertise wrong information.

Yes, because it has an effect over the real situation and can influence the demand of plastic surgery.

Technological Development

Technology is found where there are new techniques, updated surgeons and attendance of international conference.

When the surgeons use technology by the help of new techniques, machines and method It will be easier to him and for the patient.

Surgeon should be updated to technology because it has many benefits so, technology should be included in all surgeries.

Ethical System Ethics is one of the important issues that Surgeon should holds but in real situation it's not found where there is a greed and

Government should develop an ethical system that learns surgeon about the importance of ethics and how they should prefer it

Yes, Surgeon should have ethics in order to help people and not to be financial focus and recommend for patients surgeries

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financial focus. over the financial issues.

that are not necessary.

Information System

There is no presence for any information system in real situation.

Information system can help the syndicate of doctors to have control over the surgeons' clinic and all the data of patients and surgeries.

Its preferred to have information system to know more about the surgeries and collect data about the patient and thus control over the clinics.

Demands Balance There is a strong demand of plastic surgery in the real situation by the help of technology, ads and loans.

Balance the demand is one aim of the project and thus there is a need to achieve all what we mentioned in order to get the balance.

Yes, balancing the demand should be the result of the previous actions and thus shows the awareness of the people is developed.

Lessen P.S. Consequences

Consequences are found in the real situation by defect patient and dead ones.

Consequences of plastic surgery should be lower by the help of government, social institution and technology.

Yes, because we should not have defect patient any more.

Moving to the M ball

S6- Debate with Stakeholders:

After discussing the conceptual model and find the gaps between the CM and rich picture there is a need to debate with stakeholders in order to develop the ideas and choose the best solutions.

I have made many interviews with surgeon, patients and plastic surgery center where we can discuss the issue of plastic surgery and get their opinion in this issue.

Starting with the Dr. Ibrahim Al-Ashkar who is a Lebanese surgeon he said that "there is a special transaction in plastic surgery world that we can find in every home, with approximately every woman or man and moreover the international and local

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conference that presents the new techniques in this field. Plastic surgery becomes a necessity in our society especially that the Lebanese women are the most beautiful women in the world. But surgeon should knows that in beauty world he should follow the medical development and search for new things and try to create this revolution because west are not better than us in our creativity and here we should be aware that not all new and developed things are the best. For that surgeon should be completely aware of this and he wants to change the patient appearance he should change him to the better and his job should be focused to clear the defects or correct the mistakes in order to protect the patients identity after the plastic surgery.

On the other hand I have visited the laser & plastic surgery center "Anaconda" that is owned by Dr. Ali Wehbi (Surgeon) to get some information about the demand of plastic surgery. They told that the demand of plastic surgery is increasing from the development of the center and especially the Liposuction, Breast Augmentation and Rhinoplasty. Moreover, Dr. Ali Wehbi makes surgery outside his clinic at hospitals for those big surgeries like Tummy tuck and Breast enlargement because; there is a necessary for patient to stay in hospital for 1 day. They don’t mention any fail in their surgeries and assure that all their patients are satisfied and got a good appearance.

But the 1st and last stakeholder is the patient who underwent the surgery and benefit or suffers from it. Suzan Nasser is one of the patients that underwent a breast enlargement surgery she was very proud and happy by the surgery and recommend all women to undergo this surgery in which it improve their self confidence and change their appearance but to choose a good doctor that have ethics and good skills. But Hilda Sahyoun has a different perspective. She's a 50's old woman that underwent a face lifting surgery in a clinic and the appearance of her face change for worst not for better. She is suffering from this problem and don’t encourage anyone to do it even there were many wrinkles on her face but the mysterious thing is that she doesn't want to tell the lawyers or the syndicate of doctors about the faults in her face that are done by the surgeon!! She tells that doesn't have confidence that the surgeon will apply the rules or the punishment moreover he didn't take responsibility of his work.

And by discussing the agenda above on the stakeholders I found that the issues mentioned are very useful and feasible especially with the patients that encourage having social awareness about the plastic surgery issue and give the surgeons idea about the importance of the ethics in their job and they wish to make a strict rules and regulation to punish those surgeons that made make mistakes in the surgery.. Moreover and according to Dr. Al-Ashkar and Wehbi they welcome the idea of making information system to link the entire departments with the syndicate of doctors and this shows that they are qualified surgeon and don’t fear from such an issue and when they were asked about the technology the answers of them were they are updated to technology and use the latest techniques and to improve their work they attend an international plastic surgery conferences. On the other hand, and according to Dr. Ali Wehbi he encourage not to have a random advertisement about plastic surgery because this may lead patient to think and demand plastic surgery

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more thinking that is very easy and with no risks. Control over advertisement should be applied.

Doing so, will balance the demand of plastic surgery and lessen its consequences, thus, the items on the agenda are systemically desirable and culturally feasible.

S7- Implementing: Debating with stakeholders was beneficial in order to take the action of implementation. For that, and after they agree on the agenda terms it’s the time to implement the changes. Those changes are concerned with strict rules and regulation system by the control of government, social awareness system applied with social institutions, ethical system that can be related with the social awareness system, information system and updated technology and advertisement controlling system. Thus by applying these changes the consequences of plastic surgery will be lower and the demand will be balanced.

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Diagrams:

• Rich picture

• Spray Diagram

• System Map

• Influence Diagram

• Multiple Cause Diagram

• Sign Graph

• Control Model

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This is a rich picture showing the situation of plastic surgery in which there are the plastic surgery centers, hospitals, advertisements, psychologists, surgeons who are always up to date, medical and supplies companies. Moreover it shows the government intervention and the banks that give the beauty loans for patients and it shows the plastic surgeries as a way to bring healthy patient or to make them defect.

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Spray Diagram showing the Demand of Plastic Surgery and its Consequences in Lebanon.

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Demand of Plastic Surgery and its consequences in Lebanon

Information Technology

Economic Situation

Government Intervention

Surgery Failure

Surgery Success

Rules & Regulations

Updated surgeon Information

System

New Techniques

Higher Net Income

Good Financial Situation

Bank Beauty Loans

Liquidity

Satisfied Patient

Healthy patient

Good Reputation

Social Problem

Reject the issue

Death

Defect Patients

Affect Reputation

Punishment

Standard Political Situation

Foreign patient

Prohibit Job


This is a spray diagram showing the different issues that may lead to the demand of plastic surgery and its consequences such as the information technology that lead to the information system and updated surgeon and thus new techniques. The economic situation that may improved with the demand on plastic surgery and can increase the net income and liquidity and helps in giving bank loans. On the other hand when the surgery success it will gives healthy and satisfied patients and good reputation while if it fails it can makes social problems, affect reputation and bring defect patient and here the government intervene by giving punishment, apply rules and regulations and prohibit from job.

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System Map showing the Different Stakeholders of Plastic Surgery.

Government

Judges

Regulation

Rules

Lawyers

Demand of P.S and its Consequences in Lebanon

Hospitals

Surgeons, Nurses

Patients

O.R.

Psychologists Information Technology

Techniques

Conference

Information System

Economic

Higher income

Financial Situation

Bank Loans

Companies

Medicine

Supplies

MachinesCompetitors

Lower prices

Good Service

High Techniques

Advertisements

TV's

Radios

Website

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This system map shows the different stakeholders that are involve in the plastic surgery domain where there are internal stakeholders like hospitals, economic, information technology and companies. And the environment is limited by competitors, government and advertisement.

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Influence Diagram showing the influence of different stakeholder on plastic surgery.

Government

Judges

Regulation

Rules

Lawyers

Competitors

Lower prices

Good Service

High Techniques

Demand of P.S and its Consequences in Lebanon

Hospitals

Surgeons, Nurses

Patients

O.R.

Psychologists

Accounting

Companies

Medicine

Supplies

Machines

Information Technology

Techniques

Conference

Information System

Economic

Higher income

Financial Situation

Bank Loans

Advertisements

TV's

Radios

Website

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This is an influence diagram showing the influence of the environment on stakeholders and influence between stakeholders in which competitors and government have high influence on the hospitals and their parties while advertisement have less impact. Moreover all the internal stakeholders affect one another.

This is a multiple cause diagram showing the different causes that lead to the demand on plastic surgery like the information technology, political situation, economic situation, surgeon good reputation, bank loans, advertisement and the need to improve the appearance. On the other hand, the consequences are analyzed by three categories: healthy patients, defect patient and thus government intervention.

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This is a sign graph that shows the positive and negative factors that affect and shape the demand of plastic surgery in Lebanon. Starting from the technology, banks, economic situation, and advertisement that all affect the demand of plastic surgery positively. On the other hand, there are some factors that affect negatively on the demand and that are the negative consequences like the defect patient, social problems, the old techniques and the mistakes.

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This is a closed control loop that shows the transformation process of the plastic surgery and the inputs that are the patients, surgeon and machines, the process that is presented by making change to defect person and improve the appearance and the result can be defect patient or healthy one. On the other hand there is a need for feedback loop to check the output if it's correct or not and this can be done by comparing the result of the loop after applying the changes in order to reach the goal that is : balance the demand of plastic surgery and reduce its consequences.

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Client Report:

Dear, Medical Minister.

I am a Business administration student who asked to develop a sustainable development issue for the final project of the university and after negotiation, thinking and hard working I choose to talk about the demand of plastic surgery and its consequences in Lebanon due to its importance and my interest to know every tiny issue in this field. For that I found you Sir, as the well informed person who are generally contacting with all this issue and can help me in choosing the best solution.

Plastic surgery is a mess issue that affect all of us because we are all stakeholders in this field since all the institution that works with plastic surgery is a social institution that deal with people starting from government, doctors, surgeons, patients, nurses, hospitals, pharmacies, banks, medical companies, machines and supplies companies, going to TV's advertising that attract the people from all countries and encourage them to do surgeries. Demand of plastic surgery and its consequences in Lebanon is an issue that has been increased in the last 10 years with the development of technology, the increase in the individual income and the qualified surgeons. But although it has advantages concerned with improving the appearance and economic situation there are many disadvantages that we should stop on them and discuss them in order to fine some solutions... There are a certain percentage of risks because, some may cause the skin to lose its color, others to get life defects, and if the percentage of risk is high then death is the result!! After analyzing this issue using method and techniques I reach some recommendation that I feel it good and lead to lessen from this issue as much as possible. Those recommendations are as follows:

• We should have a social awareness by the help of government that should develop social awareness programs to aware people about the issue of the plastic surgery and its consequences

• Governmental control over the random advertising about plastic surgery. • Monitoring surgeons' clinic for the unofficial surgeries where some of them make

surgeries at clinics with no nurses or anesthetic doctors. • Strict rules and regulation should be applied on the surgeons who make mistakes in

any surgery. • Monitoring from syndicate doctors for the surgeries that are unnecessary and it

should protect patients not to be in the surgeons' side even if they were wrong! • The increase in plastic surgery consequences will lead to create fear in patient thus

may decrease the demand in this field although we don’t hope so!. • Surgeons should have a high level of ethics in order to help people not to have only a

financial aim… Wish that my recommendations touch your perspective about the problem and can be taken into consideration in order to feel that I made a little change and help those patients to have some recommendation and awareness about this mess. With respect Sincerely Yours Beirut: 5/5/2010

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Project log

T306 managing complexity course by its two parts was full of knowledge, open views, methods, new techniques, different ideas, beneficial subjects and some cultural issues that touch our daily life. According to the second part of this course that is include block 4 (managing sustainable development) and block 5 (The systemic practitioner) they were different in their outcomes but interrelated with their way of teaching to reach the aim of the course that is to be a system practitioner whose managing any complexity using different tools, techniques, methods and by using our awareness to know our stakeholders and to reflect upon any complex issue. Passing through this semester I can summarize 10-12 weekly summaries about

the development of this course.

Week 1It was introduction about block 4 and brief definition about the meaning of

sustainable development and reminding about the final project

Explaining sustainable development and why its related to our t306 and especially nal project.

Week 3 Defining values beliefs and circumstances and related them to our project in which we should not insert our values or beliefs in the project. We should be

subjective. Week 4 Starting to think about the project that is related to sustainable development and develop many subjects to choose between them. Week 5 Tutor explains more the final project and tells it’s the time to develop our subject and starting to collect data about it. Week 6 Choosing the demand of plastic surgery & its consequences in Lebanon as my mess that I will analyze in the final project. Week 7 Showing my tutor the subject to comment, the result was that my subject is good and accepted by the course members Week 8 Reading the project guide to get the structure of the project. Week 9Developing an introduction, the causes and the stakeholders about the mess and drawing a rich picture. My tutor gives me a push: Good job and go ahead! Week 10 Improvement is done and the B ball is complete but tutor said try to draw diagrams as much as possible to improve your work. Week 11Completing the tutor report and drawing the 7 diagrams.

Week 12Client report and project log are done and at the end I used to: Review the tutor and client report.

Improving some of the diagrams Adding some information to the project log.

Check the referencing and submit the TMA04.

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:Overall Summary

T306 managing complexity course by its two parts was full of knowledge, experience, method, techniques, tools, new subjects concerning sustainable development and some cultural issues those who can influence us like beliefs and values. Moreover by attending these two semesters I conclude why this course is important and assigned to be a level three course due to its subjects diversity that are interrelated and completing each other in order to get the aim of this course that is to be a system practitioner who can solve any complexity using the suitable method with the best techniques and tools, trying to develop his methodology and be well aware of the different stakeholders perspectives that are necessary in any situation and thus being reflective upon any issue.

During two semesters taking T306 course managing complexity that is a major course and holds a lot of information related to my major business administration and can helps me in taking the best decision and solution in the best time with the best method and the useful techniques and during lectures I have learned many concepts that are similar and I thought there is no difference between but I was wrong.

According to the 1st semester I have developed and learned a lot of concepts and theories about:

• Be a system practitioner who can juggle the four balls (BECM) Being‐ Engaging‐ Contextualizing and Managing in order to solve any situation.

• Information system and information technology and how to differentiate between them.

• The difference between data (huge amount of information), Capta (our interested data), information (data about many subjects) and knowledge.

• Moreover I have learned how draw many diagrams that I have been taken in the T205 course like rich picture, spray diagram, multiple cause diagram, sign graph, system map and influence diagram and I have develop the idea where to use these diagrams and what are their usefulness and I took concepts like the Kolb's cycle and SUDA approach (Sensing‐ Understanding‐ Doing and Acting).

• The purposeful behavior (that is willed and its like a holistic view directly to the aim) and purposive behavior (systematic view of reaching the purpose‐ step by step) that are found in our daily life.

• Further more in T306 I learned how to apply different methods (SSM, HSM and Viable system), in different messy or difficulties situation with different tools and

best techniques and try to develop our methodology that can adapted by a particular user in participatory situation.

• Differences between Variety (number of distinguishable states that it can take up), Autonomy (capacity of a system to select and decide within limits

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its own behavior) and power (the ability and capability to control).

• IALC -interpersonal action-learning cycle concept that is very useful using “I” statement, active listening, and Autonomy supporting conversations.

While in the 2nd semester the learning outcome was wide though not depending so much on theories and concepts.

• Defining sustainable development and why it's related to T306 course.

• Viewing different perspective on sustainable development.

• Get idea about the differences between values (something that individuals or

groups regard as something good or that gives meaning to life) beliefs

(intellectual starting points for a sequence of reasoning) and circumstances

(personal factors as role & experience that affect how a situation is

perceived).

• Respect others perspectives, values and beliefs and appreciate them.

• Contextualizing our experience in the domain of sustainable development.

• Developing some system models for structuring purposeful reflection on system practice as a system practitioner.

• As a system practitioner I should be aware to my system practice through reflection on the practice and my role in it.

For these outcomes and more I can see that T306 course is important and help us in the future for our work to be professional, for daily life to respect and appreciate the behavior of others and be open to hear other views using IALC concept. Moreover T306 makes me aware of all the constraints that may found in any situation and helps me to solve any complexity as I am a system practitioner who can juggle the different 4 balls using different method with best technique and tools. Now and after one year of studying T306, I will be able to go for any company to take a job and I know that I will be different manager that has many

skills and experience and solve any problem in a different way.

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References:

Anaconda Center for Laser and Plastic Surgery, 2010, Interviews, Mocharafieh, Leb.

Christine Blackmore, Ray Ison and Jake Chapman, 2000, 'managing sustainable development: learning with other stakeholders' The Open University.

Dr. Ali Wehbi, April 2010, 'Anaconda Center' Leb.

Dr. Ibrahim Al-Ashkar, 2010, ''Al-Morooj Magazine", issue Feb. 20,

p: 56-58.

Graham Paton, Bob Saunders, Eddie Hurst, Bob Zimmer and Sue Holwell, 2000, 'Project Guide' The Open University.

Journalist Dina Zein-El Dinne, 2010,'What are the plastic surgeries that attracts the Arabian Women?" MBC magazine, 16 Dec. 2010, issue 94, p: 47-48.

Journalist Hanaa Nahle, 2008, "The medical mistakes…under Microscope", 'Ouyoun Saida Mag.', Aug.2008, Issue no. 1 p: 90-91.

Plastic Surgery, Dec 2009, http://wikepedia/plasticsurgery.html

Rosalind Armson, 2000, 'the systemic practitioner: being reflective, becoming aware' The Open University.

Tears of Lebanon, April 20, 2007 < http://www.plasticsurgery/ demand up in Lebanon.html >.

Teen's health, 1995, 'Plastic Surgery' http://plasticsurgery.html.

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http://wikepedia/plasticsurgery.html

http://plasticsurgery.html/

t306b final project spring 2010 007819 mona nassrallah...

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