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Research addresses the competitiveness of medical services and evaluates the size of gaps concerning dysfunctions strategic, competitive and operational. Investigate strategic dysfunction and the impact of operational dysfunction in ophthalmology clinics. The sample consists of subjects related to clinics located in Sao Paulo, Brazil. The results showed that the average gap value is 0.61, which is significantly higher (at the significance level of 0.05) than the average 0.43 of functions. We concluded that the strategic alignment (no gaps) rests in the hands of the physician owner who has some closeness with the preferences of their clients. For this physician owner should focus on the relationship with the manager of the clinic, in order to check if the value delivered to clients is the value that they want

Competitive Dysfunctions: The Contribution for Services of Ophthalmology Clinics