Cover SheetProject Analysis ByMatthew PankeyBBA in Finance2011-20

Cover SheetProject Analysis By:Matthew PankeyBBA in
Finance2011-2021MGT 4810 W1-W2 Fall 2022
Executive SummaryExecutive Summary Johnson & Johnson is
a multinational American company with headquarters in New
Bunswick, New Jersey. Medical devices, pharmaceuticals, and
consumer health are the three main business sectors of Johnson
& Johnson, which was founded in 1886. J&J is a Fortune 500
firm with about 250 subsidiary businesses that operate in more
than 60 countries and sell goods in more than 175 nations. To
stand out from rivals, Johnson & Johnson relies on its products
and innovation. With the help of this company analysis,
students can examine every facet of Johnson & Johnson's
operations as consultants. This pertinent data may be used to
shed light on how J&J might enhance internal and external
operations while enhancing its financial performance and
stockholder value. The Strategic Management textbook and
other trustworthy sources, such as Johnson & Johnson's annual
reports, investor website, and news releases, were used to
compile all of the information for this research. Through this
capstone project, students can examine pertinent corporate
finances and gain knowledge about the potential pitfalls of their
chosen career pathways.I was able to get substantial Microsoft
Excel knowledge with this assignment, which will help me as I
begin to improve my career-related skills. Due to the significant
study and analysis required to create each tool, I also had to
learn good time management techniques. When examining a
company's financials and annual reports to estimate its value, I
also feel as though I learned knowledge.
Table of ContentsTable of ContentsTool 1:Historical
AnalysisPage 4Tool 2:Mission Statement AnalysisPage 5Tool
3:Remote Environment AnalysisPage 7Tool 4:Competitive
Profile MatrixPage 12Tool 5:Internal Factor EvaluationPage
14Tool 6:CohesionPage 17Tool 7:Generic StrategyPage 20Tool
8:Perceptual MappingPage 22Tool 9:GlobalizationPage 23Tool

10:Financial Ratios and BenchmarkingPage 25Tool
11:SWOTPage 30Tool 12:Financing Recommendations for
SWOTPage 35
Tool 1Historical AnalysisPurpose: Identify which strategies
have historically been successful and how they have affected
revenue by relating recent strategic events inside the company
to consumer health, medicines, medical devices, and overall
revenues. Findings from this research will be used in a SWOT
analysis to identify strengths and weaknesses. Data was taken
from yearly reports by Johnson & Johnson.YearsGross
RevenueConsumer HealthPharmaceuticalMedical
Devices2011$82,584$14,053$45,572$22,9592012$82,059$13,89
8$42,198$25,9632013$81,581$13,853$40,734$26,9942014$76,4
50$13,602$36,256$26,5922015$71,890$13,307$33,464$25,1192
016$70,074$13,507$31,430$25,1372017$74,331$14,496$32,313
$27,5222018$71,312$14,697$28,125$28,4902019$67,224$14,44
7$25,351$27,4262020$65,030$14,883$24,368$25,7792021$93,7
75$14,635$52,080$27,060Recent Strategic Events2, 3March
2011: Acquires Crucell, a biopharmaceutical company
specializing in vaccines and antibodies to fight disease.February
2012: Announces Alex Gorsky as the new CEO.June 2012:
Acquired Synthes, Inc., a premier global manufacturer of
orthopedic devices to create the world’s most innovative and
comprehensive orthopedics businessMarch 2013: FDA approved
INVOKANA® for the treatment of adults with type 2 diabetes.
November 2014: Announced the acquistion of Alios BioPharma,
Inc, a privately-held clinical-stage biopharmaceutical
company.November 2016: The FDA approves DARZALEX® for
the treatment of multiple myeloma.April 2016: Acquires
NeoStrata Company Inc., a leader in dermo-cosmetics.February
2017: Acquires Abbott Medical Optics.February 2018: FDA
approves ERLEADA® for treatment of patients with prostate
cancer.April 2019: Announces completion of acquisiton of
Auris Health, Inc to enable and deliver digital surgery.April
2020: FDA approves IMBRUVICA® for treatment of patients
with chronic lymphocytic leukemia (CLL).October 2020:

Acquired Momenta Pharmaceuticals, Inc to broaden leadership
in autoimmune diseases and provide a major catalyst for
sustained growth.February 2021: COVID-19 vaccine authorized
by U.S. FDA for emergency use.November 2021: Announces
split into two publically traded companies.January 2022:
Announces partnership with Microsoft to further enable digital
surgery solutions. Sources:1https://www.jnj.com/about-
jnj/corporate-reports2https://www.jnj.com/media-
center3https://ourstory.jnj.com/timeline
Prepared by Williams, Louis &"System
Font,Regular"&10&K000000&P
Revenue Streams1
Gross Revenue 2011 2012 2013 2014 2015 2016 2017 2018 2019
2020 2021 82584 82059 81581 76450 71890
70074 74331 71312 67224 65030 93775
Consumer Health 2011 2012 2013 2014 2015 2016 2017
2018 2019 2020 2021 14053 13898 13853 13602
13307 13507 14496 14697 14447 14883
14635 Pharmaceutical 2011 2012 2013 2014 2015 2016
2017 2018 2019 2020 2021 45572 42198 40734
36256 33464 31430 32313 28125 25351
24368 52080 Medical Devices 2011 2012 2013
2014 2015 2016 2017 2018 2019 2020 2021 22959 25963
26994 26592 25119 25137 27522 28490
27426 25779 27060
Tool 2Mission Statement AnalysisPurpose: to assess Johnson &
Johnson's mission statement and offer suggestions for
strengthening the parts that it is lacking. will, in general, offer
insight into the organization's worth, caliber, and business plan

to present the mission statement with clarity and
succinctness.Mission Statement1We consider that our primary
duty is to the people who use our goods and services, including
patients, physicians, nurses, parents, and everyone else.
Everything we do in order to meet their demands must be of the
highest caliber. We must continuously work to deliver value,
cut expenses, and keep prices fair. Orders from customers must
be processed accurately and quickly. Our business partners must
be given the chance to profit fairly.
Our worldwide team members who work for us are subject to
our obligations. We need to create a workplace where everyone
is treated with respect and taken as an individual. Their
uniqueness, decency, and merit must all be respected. They
must feel secure, content, and working there serves a purpose.
Workplaces must be tidy, organized, and safe, and pay must be
fair and sufficient. We must promote our employees' health and
wellbeing and assist them in carrying out their familial and
other personal obligations. Employee concerns and
recommendations must be welcome. For those who qualify,
there must be equal opportunities for employment, development,
and advancement. We must produce highly competent leaders,
and they must behave justly and morally.
We have obligations both to the local communities where we
live and work and to the global community. By promoting better
access and care in more locations around the world, we must aid
in people's health. Being decent citizens means paying our fair
amount of taxes, supporting charitable causes, improving health
and education, and supporting good works. The property we
have the luxury of using must be kept in good condition so as to
safeguard the environment and natural resources.
Our ultimate duty is to our stockholders. Businesses need to
earn a healthy profit. We must test out fresh concepts. Research
must be continued, creative initiatives must be created, future
investments must be made, and mistakes must be compensated
for. It is necessary to buy new machinery, build new facilities,
and release new items. In order to prepare for bad times,

reserves must be built up. The stockholders should receive a fair
return when we do business in accordance with these
principles.10 Components of a Mission StatementComponents
will be measured on a scale of 1-5 with 5 being the highest.1.
Customers123452. Products123453. Markets123454.
Technology123455. Survival123456. Philosophy123457. Self-
concept123458. Public Image123459. Consumers1234510.
Quality12345Sources:1https://www.jnj.com/credo/Strengths/We
aknesses of Likert Scale Rating1. Customers were given a rating
of three since they might be generally classified as patients,
physicians, nurses, parents, and caregivers.2. Because they were
not listed, products received a rating of 1.3. Markets received a
2 since there was only a passing mention of their employing
people globally and no information about how many markets,
countries, or industries there were.4. Due to the lack of depth in
the technologies used, technology received a 2 rating.5.Because
it was mentioned that the company needed to make money and
how it would do so, survival was given a rating of 3.6. The
mission statement as a whole describes the company's general
philosophy and principles, hence philosophy is given a rating of
4.7. Since it wasn't addressed in the mission statement, self-
concept received a score of 1.8. Public image was rated a 2 the
company's duty to its communities was mentioned.9. Consumers
were rated a 3 because customers were mentioned as well as the
company's worldwide market.10. Quality scored a 4 because
high-quality products were mentioned as well as providing
reasonable pricing.Proposed Mission Statement ChangesAs the
world’s largest and most broadly-based healthcare company, we
believe our first responsibility is to the patients, doctors and
nurses, to mothers and fathers and all others across 175+
countries who use our medical devices, consumer health, and/or
pharmaceutical products and services. In meeting their needs
everything we do must be of high quality by using innovative
technology and research strategies. We must constantly strive to
provide value, reduce our costs and maintain reasonable prices.
Customers' orders must be serviced promptly and accurately.

Our business partners must have an opportunity to make a fair
profit.
We are responsible to our employees who work with us
throughout 60+ countries. We must provide an inclusive work
environment where each person must be considered as an
individual. We must respect their diversity and dignity and
recognize their merit. They must have a sense of security,
fulfillment and purpose in their jobs. Compensation must be fair
and adequate and working conditions clean, orderly and safe.
We must support the health and well-being of our employees
and help them fulfill their family and other personal
responsibilities. Employees must feel free to make suggestions
and complaints. There must be equal opportunity for
employment, development and advancement for those qualified.
We must provide highly capable leaders and their actions must
be just and ethical.
We are responsible to the communities in which we live and
work and to the world community as well. We must help people
be healthier by supporting better access and care in more places
around the world. We must be good citizens — support good
works and charities, better health and education, and bear our
fair share of taxes. We must maintain in good order the property
we are privileged to use, protecting the environment and natural
resources.
Our final responsibility is to our stockholders. Business must
make a sound profit. We must experiment with new ideas.
Research must be carried on, innovative programs developed,
investments made for the future and mistakes paid for. New
equipment must be purchased, new facilities provided and new
products launched. Reserves must be created to provide for
adverse times. We must utilize our scale, size, and intellectual
property to maintain a competitive advantage. When we operate
according to these principles, the stockholders should realize a

fair return.
Prepared by Williams, Louis &P
Tool 3Remote Environment Analysis1, 2, 3, 4Purpose: To
analyze Johnson & Johnson's external environment to display
the threats and opportunities of economic, social, political,
technological, and ecological factors that may influence the
choice of direction and action the company takes.Economic
FactorsWeightHighly UnattractiveMildly
UnattractiveNeutralMildly AttractiveHighly AttractivePresent
RatingFuture OpportunityThreat or Opportunity12345Economic
Growth Rate0.251.00Opportunity1.25Foreign
Currency0.300.90Threat0.60Inflation0.100.20Threat0.10Voltatil
ity in Economy0.250.75Threat0.50Consumer
Spending0.100.30Opportunity0.40Total13.152.85ThreatExplana
tion of Economic FactorsSince the COVID-19 pandemic, the
healthcare sector's economic growth rate has dramatically
increased and is predicted to keep rising. The healthcare sector
is steady since it is anticipated to expand as population
increases and customer interest in their health and wellbeing
increases. Due to currency fluctuations and the strength and
weakness of the US dollar, the foreign exchange rate has an
impact on the company's revenues and costs. Despite efforts to
mitigate these alterations, the oscillations could still be a
challenge. Maintaining activities' profitability is difficult when
there is inflation. The effect is uncertain as long as inflation
rates continue to rise. The ability of the corporation to maintain
profit margins is also threatened by the economy's volatility.
Significant variations could have a detrimental effect on the
operatingPolitical FactorsWeightHighly UnattractiveMildly
RatingFuture OpportunityThreat or
Opportunity12345Government
Regulation0.250.75Threat0.50Customer
Function0.301.20Opportunity1.50Tax
Policy0.100.30Threat0.20Intellextual Property

Law0.250.75Threat0.50Import and Export
Regulations0.100.30Threat0.20Total13.302.90ThreatExplanatio
n of Political FactorsThe pharmaceutical and medical device
parts of the business may be significantly impacted by
government regulations as a result of healthcare reforms and
mounting price pressure. The client function is given high
marks because the company's services and goods will always be
in demand as a healthcare provider. Because of the potential
susceptibility to extra tax liabilities, changes in tax policy may
have a negative impact on profitability. The corporation cannot
be convinced that it will be able to secure sufficient patent
protection for new products and innovations given that public
policy, both in the U.S. and internationally, is becoming
increasingly negative toward intellectual property rights.
License regulations for import and export could have an impact
on product distribution and profitability.Social
FactorsWeightHighly UnattractiveMildly
RatingFuture OpportunityThreat or Opportunity12345COVID-
19
Pandemic0.250.75Threat0.50Talent/Workforce0.301.20Opportu
nity1.50Consumer Awareness0.100.30Opportunity0.40Public
Perception0.200.60Threat0.40Accessibility0.150.45Opportunity
0.60Total13.303.40OpportunityExplanation of Social
FactorsThe COVID-19 pandemic has badly affected some parts
of the company's business operations, including production and
the supply chain. It has also forced changes to other aspects of
the company's business operations. There is a chance that
businesses will continue to suffer because to COVID-19's
continuous proliferation. A diversified workforce, along with
the capacity to hire and keep talented, highly skilled workers,
are essential components of success in the healthcare industry.
Despite the fierce competition in the market for skilled
individuals, the organization has been named one of the best
places to work in 20223. This offers the chance to draw in
creative workers at the top of their fields. As customers become

more health-conscious, there is a chance to broaden the client
base and sustain industry growth. public opinion Due to recent
allegations of bribe, unethical business practices, and other
allegations that could negatively impact the company's
consumer base, the company received a low score.
Opportunities exist for the organization as telemedicine
continues to rise and accessibility in healthcare becomes more
crucial.Ecological FactorsWeightHighly UnattractiveMildly
RatingFuture OpportunityThreat or Opportunity12345Eco-
Efficiency0.251.00Opportunity1.25Business
Disruptions0.300.90Threat0.60Environment
Regulations0.100.30Threat0.20Sustainability in
Manufacturing0.250.75Threat0.50Sustainable
Materials0.100.30Threat0.20Total13.252.75ThreatExplanation
of Ecological FactorsBy 2030, Johnson & Johnson plans to
increase its eco-efficiency. The organization has endured minor
expenses and interruptions to operations and processes since the
COVID-19 epidemic, but has now recovered. The pandemic
might still have a negative impact on business if it persists,
though. Already committed to enhancing sustainability, any
additional environmental regulation could negatively affect
Johnson & Johnson's capacity to accomplish this objective in a
cost-efficient way. Producing high-quality medical devices with
sustainable materials and achieving a more environmentally
friendly manufacturing method with fewer emissions both pose
risks to profitability.Technological FactorsWeightHighly
UnattractiveMildly UnattractiveNeutralMildly AttractiveHighly
AttractivePresent RatingFuture OpportunityThreat or
Opportunity12345Capacity to
Innovate0.250.75Opportunity1.00Cbersecurity/Data
Privacy0.200.60Threat0.40Telehealth0.200.60Opportunity0.80R
esearch & Development0.250.75Opportunity1.00Cost of
Production0.100.30Threat0.20Total13.003.40OpportunityExpl an
ation of Technological FactorsInnovation is crucial for the
medical sector to stay competitive. With Johnson & Johnson's

dedication to innovation and existing initiatives like their
supply chain technology, this is a chance to foster innovation in
order to stay one step ahead of rivals. Along with technology,
cybersecurity and data privacy continue to develop. Security
and privacy are essential in the healthcare sector. If rules
continue to tighten and grow harder to follow, this could be a
threat. Since the COVID-19 pandemic, telehealth has expanded
tremendously and has continued to do so. Technology
development offers a special chance for research and
development to advance innovations. Profit may be negatively
impacted by rising production
costs.Sources:1https://www.investor.jnj.com/annual-meeting-
materials/2021-annual-report2https://pestleanalysis.com/pest-
analysis-of-healthcare-
industry/3https://www.medicaldesignandoutsourcing.com/emplo
yees-say-intuitive-boston-scientific-jj-medtronic-best-places-to-
work-in-2022/#:~:text=2021%20Winners-
,Employees%20say%20Intuitive%2C%20Boston%20Scientific%
2C%20J%26J%2C%20Medtronic%20are%20among,places%20to
%20work%20in%202022&text=Intuitive%20Surgical%2C%20B
oston%20Scientific%2C%20Johnson,2022%20based%20on%20e
mployee%20reviews.4https://pestleanalysis.com/pest-analysis-
of-healthcare-industry/
Tool 4Competitive Profile MatrixThe Purpose: To compare
Johnson & Johnson to rivals using an analysis of the major
performance indicators in the healthcare sector, with 1 being the
poorest and 4 the best. Key Performance
Indicators1KPI'sWeightJohnson & Johnson3Pfizer4Procter &
Gamble5RankScoreRankScoreRank ScoreEmployees
Worldwide0.140.420.230.3Product
Quality20.240.820.430.6Customer
Satisfaction20.1530.4520.310.15Revenue
0.140.430.320.2Pricing20.140.420.230.3Market
Share60.140.430.320.2Customer

Service20.254120.530.75Total13.852.22.5Explanation of KPI
RatingsEmployees Worldwide: Johnson & Johnson is ranked
number one because they have more than 130,000 employees.
Procter & Gamble is second with approximately 97,000
employees. Pfizer is last with more than 79,000
employees.Product Quality2: Johnson & Johnson, Pfizer, and
Procter & Gamble all scored a 4.2/5 on product quality. Johnson
& Johnson ranked first out of 6 amongst competitors, Procter &
Gamble ranked second out of 6, and Pfizer ranked fourth out of
six.Customer Satisfaction2: Johnson & Johnson is ranked first
because they scored a 33 on customer satisfaction. Procter &
Gamble scored a 30. Pfizer scored a 27.Revenue: Johnson &
Johnson is ranked first because, in 2021, their total revenue was
approximately $93.8 billion. Pfizer is second with $81.3 billion
in revenue in 2021. Procter & Gamble is third with $19.7
billion in revenue for 2021.Pricing2: Both Johnson & Johnson
and Procter & Gamble both scored 4/5 for pricing. However,
Johnson & Johnson was ranked first, so they have come in first
over P&G. Pfizer is third with 3.9/5.Market Share: Johnson &
Johnson came in first with an 8.06% market share. Pfizer is
second with 6.99%. Procter & Gamble is third with
6.92%.Customer Service2: Johnson & Johnson is first with a
4.1/5 for customer satisfaction. Procter & Gamble is second
with a 4/5. Pfizer is third with a 4/5, and a sixth out of six
rankings compared to other
competitors.Sources:1https://diagnostics.roche.com/nl/en/news -
listing/2019/Five-key-performance-indicators-for-healthcare-
organisations.html2https://www.comparably.com/companies/joh
nson-johnson/competitors3https://www.jnj.com/about-
jnj/corporate-
reports4https://investors.pfizer.com/Investors/Financials/Annual
-Reports/default.aspx5https://www.pginvestor.com/financial -
reporting/annual-
reports/6https://csimarket.com/stocks/competitionSEG2.php?co
de=JNJ

Tool 5Internal Factor Evaluation1, 2, 3, 4Purpose: To evaluate
Johnson & Johnson's future oriented goals, SMART objectives,
and policies in order to determine if they align with their
mission statement. Strengths and weaknesses are assigned a
ranking of 1-5 (5 being the highest).
StrengthsWeightHighly UnattractiveMildly
RatingFuture Rating12345Large Product &
Services0.100.400.50Revenue0.301.201.50Research &
Development0.100.300.40Global
Operations0.050.200.25Customer
Satisfaction0.030.090.12Customer Service0.020.060.08Product
Quality0.050.200.2Consumer
Recognition0.050.200.25Innovation0.060.240.30Skilled
Employees0.020.060.08Strategic Partners0.020.060.08Profit
Margin0.100.300.40Market
Performance0.100.300.40Total1.003.614.56WeaknessesWeightH
ighly UnattractiveMildly UnattractiveNeutralMildly
AttractiveHighly AttractivePresent RatingFuture
Rating12345Intellectual Property Laws0.010.020.01Uneven
Revenue Distribution0.300.901.20Pricing
Pressures0.100.300.40Product
Regulations0.100.200.10Kickback
Allegations0.050.100.05Supply Chain Issues0.050.150.10Labor
& Employment
Practices0.030.090.12Competition0.040.120.08Public
Perception0.200.400.60Cyber Security 0.050.100.15Economic
Instability0.020.060.04Kickback
Allegations0.030.060.09Government
Regulations0.020.060.04Total1.002.562.98Johnson & Johnson
Strengths SummaryJohnson & Johnson is one of the largest
healthcare companies worth billions of dollars with a global

consumer base in 150+ countries. The company is easily
recognized by consumers and trusted in the industry. With 2021
revenue of over $90 billion, and a 22.26% profit margin, J&J
has had continued growth and steady market performance as
well as high scores for product quality and customer
satisfaction. They are dedicated to innovation and R&D.
Johnson & Johnson seeks highly sought employees and is
consistently pursuing strategic partnerships, mergers, and
acquisitions to grow the organization. Johnson & Johnson
Weaknesses SummaryDue to kickback (bribery) allegations and
other legal battles over the last few years, further government
restrictions and product regulations pose a threat to the
organizations' ability to do business, and public perception has
been negatively affected. Additionally, allegations of poor
employment practices can impact adversely impact the
organization as well. With competition increasing and pricing
pressures mounting, the organization is challenged to find ways
to decrease costs while still maintaining competitive product
pricing and quality. With the U.S. and global economies in
unpredictable states, business and supply chain interruptions
may occur, including cybersecurity issues. Though J&J has high
revenue and profit margins, the majority of its revenue comes
from the pharmaceutical sector, with consumer health sales
down. The company has announced plans to separate its
consumer health sector into a separate company.
Sources:1https://pestleanalysis.com/johnson-and-johnson-swot-
analysis/2https://swothub.com/johnson-and-johnson-swot-
analysis/#Strengths_of_Johnson_and_Johnson_in_SWOT_Analy
sis3https://www.comparably.com/companies/johnson-
johnson/competitors4https://www.investor.jnj.com/annual -
meeting-materials/2021-annual-report
Tool 6CohesionPurpose: To evaluate Johnson & Johnson's
future oriented goals, SMART objectives, and policies in order
to determine if they align with their mission statement. Mission

Statement1We believe our first responsibility is to the patients,
doctors and nurses, to mothers and fathers and all others who
use our products and services. In meeting their needs everything
we do must be of high quality. We must constantly strive to
provide value, reduce our costs and maintain reasonable prices.
Customers' orders must be serviced promptly and accurately.
Our business partners must have an opportunity to make a fair
profit.
We are responsible to our employees who work with us
throughout the world. We must provide an inclusive work
environment where each person must be considered as an
individual. We must respect their diversity and dignity and
recognize their merit. They must have a sense of security,
fulfillment and purpose in their jobs. Compensation must be fair
and adequate and working conditions clean, orderly and safe.
We must support the health and well-being of our employees
and help them fulfill their family and other personal
responsibilities. Employees must feel free to make suggestions
and complaints. There must be equal opportunity for
employment, development and advancement for those qualified.
We must provide highly capable leaders and their actions must
be just and ethical.
We are responsible to the communities in which we live and
work and to the world community as well. We must help people
be healthier by supporting better access and care in more places
around the world. We must be good citizens — support good
works and charities, better health and education, and bear our
fair share of taxes. We must maintain in good order the property
we are privileged to use, protecting the environment and natural
resources.
Our final responsibility is to our stockholders. Business must
make a sound profit. We must experiment with new ideas.
Research must be carried on, innovative programs developed,

investments made for the future and mistakes paid for. New
equipment must be purchased, new facilities provided and new
products launched. Reserves must be created to provide for
adverse times. When we operate according to these principles,
the stockholders should realize a fair return.Future Oriented
Goals21)A world where the current and future healthcare
workforce has the necessary competencies to deliver high-
quality healthcare.2)A world where all people have healthy
places to live, work and play.3)A world where every woman and
child survives and has the opportunity for a healthy future.4)A
world where safe, essential and timely surgical care can be
accessed by all to save lives, prevent disability, promote
economic growth, and reduce social marginalization.5)A world
where innovations and holistic health solutions prevent, control,
and eliminate global disease challenges and epidemics.Analysis
of Future Oriented GoalsJohnson & Johnson's future goals are
mostly aligned with the mission statement. The first goal
regarding the training and competency of the healthcare
workforce was briefly mentioned in the mission statement as the
development and advancement of employees. The eco-
friendliness goal aligns with the mission statement as protecting
the environment and natural resources were mentioned.
Controlling global disease and women's health were not
included in the mission statement but innovative solutions were.
The goal for safe surgical care aligns with the mission statement
due to the mention of customers deserving prompt and accurate
care.SMART Objectives21)By 2030, 650,000 health workers
will have received training to better deliver quality
healthcare.2)By 2030, 60 million citizens living across 30 cities
will have benefited from climate and air quality acti ons that
have the potential to positively impact public health.3)60
million women and children will have received support and
tools to enable a healthy future by 2030.4)By 2030, 50 million
people will have had access to safe, essential, and timely
surgical care.5)175 million individuals will have benefited from
Johnson & Johnson solutions that prevent, control, and

eliminate global diseases by 2030.Analysis of SMART
ObjectivesJohnson & Johnson's SMART goals are partially
aligned with its mission statement. The first objective regarding
workforce education and quality is aligned with the commitment
in the mission statement to the development and advancement of
those qualified. The third objective is not mentioned in the
mission statement. however, the fourth and fifth objectives are
mentioned in the mission statement as needs to provide
accessible healthcare and to continue innovations.Policies3,
41)There must be equal opportunity for employment,
development, and advancement for those qualified. We must
provide highly capable leaders and their actions must be just
and ethical.2)Employees are required to adhere to Company-
wide programs, and to be familiar with and comply with
environmental laws and regulations that relate to our specific
work responsibilities. This includes complying with regulations
related to the reporting, approval, and registration of chemical
ingredients used in our production and products.3)We strive to
provide an equal opportunity for women and their children to
access quality care, information, and education to ensure the
continued health, happiness, and prosperity throughout the
course of their lives.4)We must help people be healthier by
supporting better access and care in more places around the
world.5) At Johnson & Johnson, we believe strengthening health
systems is essential to achieve a much-needed transformation in
healthcare, particularly in resource-limited settings. We believe
a holistic, strategic, inclusive approach is necessary, involving
all those with the power to influence healthcare access,
delivery, and outcomes from the public and private sectors and
civil society.Analysis of PoliciesThe policies related to the
development and advancement of employees, environmental
preservation, innovative healthcare solutions, and access to
healthcare are all addressed in the mission statement. Women's
health is included on their policies and positions page but is not
addressed in the mission statement. Sustainability is also
included in their Code of Conduct, which provides general

guidelines for internal rules and regulations as well as how J&J
conducts business. Johnson & Johnson's policies and Code of
Conduct address diversity, human rights, and
innovation.Sources:1https://www.jnj.com/credo/2https://www.jn
j.com/sustainable-development-
goals3https://www.jnj.com/about-jnj/policies-and-
positions4https://www.jnj.com/code-of-business-
conduct/english
Tool 7Generic Strategy1Purpose: To discover what generic
strategy is used by Johnson & Johnson and if it is implemented
wellLow Cost Leadership RequirementsYesNoDifferentiation
RequirementsYesNoSustained Capital InvestmentXStrong
Marketing CapabilitiesXReady Access to CapitalXStrong
Product EngineeringXStrong Process Engineering
SkillsXCorporate Creative FlairXInte nse Supervision of
LaborXStrong R&DXProducts designed for ease of
ManufactureXStrong Distribution ChannelsXLow Cost
Distribution SystemXCorporate Reputation in Quality
Technological LeadershipXTight Cost ControlsXLong Industry
Tradition or Unique Skill SetXFrequent, Detailed Control
ReportsXStrong Internal Cohesiveness among
DepartmentsXHighly Structured Organization
StructureXSubjective measurement of personnel for incentive
purposes as opposed to quantitative measuresXIncentives based
on Strict Quantitative TargetsXAbility to attract Talented Labor
and ManagementXOverall AssessmentNoOverall
AssessmentYesFocused (Product Leadership)YesNo1.) Does the
subject company have a core competency or distinctive
advantage in at least one functional area?X2.) Does the subject
company have a strong position in at least one segment of their
defined market?XOverall AssessmentXStrengths: Johnson &
Johnson uses differentation as their primary strength. Low cost
leadership is their second strength.SummaryJohnson & Johnson
uses the generic strategy focusing on differentiation by

providing a wide variety of products, medications, medical
devices, and services. By being a leading global healthcare &
pharmaceutical organization, Johnson & Johnson displays
differentiation. Due to the increase in competition and pricing
pressure within the industry, it is difficult for J&J to focus on
low-cost leadership as a strategy. The company must balance
between being cost-effective, well priced for consumers, and
still providing quality products and services while making a
profit. Johnson & Johnson continues to be innovative and
remains focused on providing quality to its
customers.Sources:1https://www.investor.jnj.com/
Tool 8Perceptual MappingPurpose: To display the product
diversity vs. the profitability of Johnson & Johnson compared to
its biggest competitors in the healthcare industry.Product
QualityProfitabilitySources:https://www.investor.jnj.com/https:/
/www.comparably.com/companies/johnson-
johnson/competitorshttps://www.macrotrends.net/stocks/charts/
UL/unilever/revenue#:~:text=Unilever%20revenue%20for%20th
e%20twelve,a%200.47%25%20decline%20from%202019.https://
www.statista.com/statistics/272350/revenue-of-merck-and-
co/#:~:text=Merck%20%26%20Co%20%2D%20total%20revenu
e%202006%2D2021&text=The%20revenue%20of%20Merck%20
%26%20Co,U.S.%20dollars%20over%20the%20year.
https://www.investor.jnj.com/
Tool 9GlobalizationPurpose: To assess if Johnson & Johnson is
a global company and to map the countries in which J&J
operates. This analysis will display domestic and foreign
revenue the company produces. It will also describe where
Johnson & Johnson should expand their next global
operation.Johnson & Johnson's Operations Map1 Johnson &
Johnson is an international organization that operates in 91
countries and has products sold in over 175 countries. J&J is
headquartered in New Brunswick, New Jersey, U.S.A., but has

66 offices spread across 53 countries including Australia,
Argentina, Brazil, China, India, Japan, Poland, and more. The
red areas in the graphic above represent the countries in which
Johnson & Johnson operates.51% of Johnson & Johnson's 2021
revenue came from international and non-U.S. sales. Therefore,
J&J is an international company.2($ In Millions)Total Non-
U.S.$12,641United
States$12,163Total$24,804PercentageInternational
Revenue51%Domestic Revenue49%Johnson & Johnson should
expand operations into Bogota, Columbia to increase the
company's presence in Latin America.3, 4Johnso n & Johnson
should expand operations into Bogota, Columbia because of the
opportunities for growth and expansion in Latin America. The
pharmaceutical market in Columbia was worth $4.795 billion in
2019 and has a projected value of $2.944 billion. Bogota,
Columbia is one of the main pharmaceutical companies in Latin
America being home to 66% of the medicine manufacturers and
65% of the pharmaceutical wholesalers.
Columbia ranks third for highest public spending on
healthcare in the region and is predicted to continue to grow. In
this market, J&J can expand its reach in Latin America and
grow its worldwide brand. This also presents a unique
opportunity to begin developing generic brands of their popular
medications and expand the J&J customer base while becoming
more competitive in all markets. Johnson & Johnson should
enter the Colombian market through a partnership with leading
pharmaceutical company Tecnoquimicas. Entering into a joint
venture or possibly acquiring Tecnoquimicas would provide a
strategic entrance into the Columbian market, and remove a
major competitor as well.
J&J used a similar strategy when entering the German market
in 1961 with the acquisition of Jassen Pharmaceutica which
eventually led to Johnson & Johnson ranking among the 20
largest research-based pharmaceutical companies in the world.
Based on past success, this strategy could yield similar results
in the Colombian

market.Sources:1https://www.careers.jnj.com/careers/one-
career-global-reach2https://johnsonandjohnson.gcs-
web.com/news-releases/news-release-details/johnson-johnson-
reports-q4-and-full-year-2021-
results3https://investincolombia.com.co/en/sectors/healthcare-
services-and-life-sciences/pharmaceutical-
sector#:~:text=In%202019%2C%20the%20pharmaceutical%20m
arket,for%20this%20market%20by%202022.4https://www.janss
en.com/emea/our-company/our-heritage
Johnson & Johnson's Domestic v. International 2021 Revenues
International Revenue Domestic Revenue
0.50963554265441058 0.49036445734558942
Tool 10Financial Ratios & BenchmarkingPurpose: To show
Johnson & Johnson's financial ratios compared to the 2021
industry average and competitor, Procter & Gamble. Through
this, I will be able to get quick analysis on the health of the
company. Johnson & Johnson's Five Year Ratio Analysis1,
2Ratios and Working Capital20172018201920202021Trend2021
Industry Average3P&G
2021Liquidity RatiosCurrent
Ratio1.411.481.261.211.35Increasing2.860.70Quick
Ratio1.121.201.010.990.99Neutral0.960.50Leverage RatiosDebt
to Total Assets0.190.170.200.19Decreasing0.340.26Debt to
Equity0.570.510.470.560.46Decreasing0.720.69Long-Term Debt
to
Capitalization0.340.320.310.340.29Decreasing0.360.33Activity
RatiosReceiveables
Turnover5.675.795.676.086.14Increasing5.0716.11Total Assets
Turnover0.490.530.520.470.52Increasing0.450.64Inventory

Turnover2.93.153.063.042.87Dereasing3.796.20Profitability
RatiosOperating
Margin23.1222.0621.1219.9824.29Increasing17.5923.63Net
Profit
Margin1.7018.7518.4217.8222.26Increasing17.5718.43R OE2.16
25.625.4223.2528.20Increasing20.931.35ROI1.4317.5017.5915.
3420.07Increasing14.9920.57Pre-Tax Profit
Margin23.1222.0621.1219.9824.29Increasing19.7123.14Johnson
& JohnsonPharmaceutical IndustryP&GLiquidity RatiosCurrent
Ratio1.352.860.70Quick Ratio0.990.960.50Johnson &
JohnsonPharmaceutical IndustryP&GDebt to Total
Assets0.190.340.26Debt to Equity0.460.720.69Long-Term Debt
to Capitalization0.290.360.33Johnson & JohnsonPharmaceutical
IndustryP&GReceiveables Turnover6.145.0716.11Total Assets
Turnover0.520.450.64Inventory Turnover2.873.796.20Johnson
& JohnsonPharmaceutical IndustryP&GOperating
Margin24.2917.5923.63Net Profit
Margin22.2617.5718.43ROE28.2020.931.35ROI20.0714.9920.5
7Pre-Tax Profit
Margin24.2919.7123.14Sources:1https://www.macrotrends.net/s
tocks/charts/JNJ/johnson-johnson/financial-
ratios2https://www.macrotrends.net/stocks/charts/PG/procter -
gamble/financial-
ratios3https://csimarket.com/Industry/industry_Profitability_Rat
ios.php?ind=803
2021 Liquidity Ratios
Johnson & Johnson Current Ratio Quick Ratio
1.3483000000000001 0.99 Pharmaceutical Industry
Current Ratio Quick Ratio 2.86 0.96 P & G
Current Ratio Quick Ratio 0.7 0.5

2021 Leverage Ratios
Johnson & Johnson Debt to Total Assets Debt to Equity
Long-Term Debt to Capitalization 0.19 0.46
0.28999999999999998 Pharmaceutical Industry Debt to
Total Assets Debt to Equity Long-Term Debt to
Capitalization 0.34 0.72 0.36 P & G Debt to Total
Assets Debt to Equity Long-Term Debt to Capitalization
0.26 0.69 0.33
2021 Activity Ratios
Johnson & Johnson Receiveables Turnover Total Assets
Turnover Inventory Turnover 6.14 0.52 2.87 Pharmaceutical
Industry Receiveables Turnover Total Assets Turnover
Inventory Turnover 5.07 0.45 3.79 P & G
Receiveables Turnover Total Assets Turnover
Inventory Turnover 16.11 0.64 6.2
2021 Profitability Ratios
Johnson & Johnson Operating Margin Net Profit Margin
ROE ROI Pre-Tax Profit Margin 24.29 22.26
28.2 20.07 24.29 Pharmaceutical Industry
Operating Margin Net Profit Margin ROE ROI Pre-
Tax Profit Margin 17.59 17.57 20.9 14.99 19.71

P & G Operating Margin Net Profit Margin
ROE ROI Pre-Tax Profit Margin 23.63 18.43
31.35 20.57 23.14
Tool 10bJOHNSON & JOHNSON (JNJ) BALANCE
SHEETFiscal year ends in Dec. 31PfizerProctor &
Gamble2021%2020%2021%2021%AssetsCurrent assetsTotal
cash14,4875%13,9855%31,06920%10,2889%Receivables15,283
6%13,5765%15,74510%4,7254%Inventories10,3874%9,3444%9
,0596%5,9835%Other current
assets20,8228%14,3226%3,8202%2,0952%Total current
assets60,97922%51,22720%59,69339%23,09119%Non-current
assetsGross property, plant and
equipment46,80417%47,67919%29,95619%-0%%Accumulated
Depreciation(28,717)-10%(28,038)-11%(15,074)-10%(2,735)-
2%Net property, plant and
equipment18,9627%18,7667%14,88210%21,68618%Equity and
other investments74,02327%63,27825%16,47211%(2,834)-
2%Goodwill36,24613%35,39314%49,20832%40,92434%Intangi
ble assets46,39217%53,40221%25,14616%23,64220%Deferred
income taxes10,2234%8,5343%3,3412%(258)-0%Other long-
term assets10,2164%6,5623%4,5693%9,9648%Total non-current
assets214,14978%205,57680%119,16277%96,21681%Total
assets$275,128100%$256,803100%$154,229100%$119,307100
%Liabilities and stockholders' equityLiabilitiesCurrent
liabilitiesShort-term
debt3,7662%2,6312%2,2412%8,88912%Accounts
payable11,0556%9,5056%5,5785%13,72019%Taxes
payable1,1120.6%1,3920.8%1,2661%3971%Accrued
liabilities13,6128%13,9688%3,3323%10,52314%Deferred
revenues-0%%0%3,0673%-0%%Other current
liabilities10,6866%11,9447%24,93924%00%Total current

liabilities40,23123%39,44023%42,67141%33,13246%Non-
current liabilitiesLong-term
debt29,98518%32,63519%36,19535%23,09932%Deferred taxes
liabilities7,4874%7,2144%3,3413%-258-0%Pensions and other
benefits8,8985%10,7716%3,7244%6,7619%Minority
interest74,02343.2%63,27837.1%2620.3%-15-0%Other long-
term liabilities10,6866%11,9447%9,7449%10,26914%Total
non-current
liabilities131,07977%83,17274%61,34359%39,52154%Total
liabilities$171,310100%$170,45297%$104,013100%$72,653100
%Stockholders' equityCommon stock3,120-
36%3,1202%2795%4,0099%Additional paid-in-capital-0%%-
0%%(111,361)-1851%(64,848)Retained earnings123,060-
1428%113,89075%21,636360%106,374228%Treasury
stock(39,099)454%(38,490)-25%00%(114,973)-246%Accum.
other comprehensive income(13,058)152%(15,242)-
10%(16,121)-268%(13,744)-29%Total stockholders'
equity(8,617)100%(18,316)-12%6,015100%46,654100%Total
liabilities & stockholders'
equity65,406100%152136100%$50,710100%$119,307100%John
son &Johnson (JNJ) INCOME STATEMENTFiscal year ends in
Dec. 31PfizerProcter &
Gamble2021%2020%2021%2021%Revenue93,775100%82,5841
00%81,288100%76,118100%Cost of
revenue29,85532%28,42734%30,82138%3,7185%Gross
profit63,92068%54,15766%50,46762%39,01051%Operating
expenses0%Research and
development14,71416%12,15915%13,82917%-0%Sales, General
and
admin.24,65926%22,08427%12,70316%21,02428%Other00%00
%00%00%Total operating
expenses39,37342%34,24341%30,23237.2%58,13276%Operatin
g income24,54726%19,91424%20,23525%17,98624%Interest
Expense1830%2010%1,2912%-502-1%Other income
(expense)1,6412%3,3274%5,3317%5901%Income before
taxes22,77624%16,49720%24,31130%17,71523%Provision for

income taxes1,8982%1,7832%1,8522%3,1904%Net income from
continuing
op.20,87822%14,71418%22,45928%14,52519%Other00%00%00
.0%00%Net
income$20,87822%$14,71418%21,97927%$14,5101 9%Producti
vity AnalysisJohnson & Johnson 20211Net
Sales$93,800,000,000$661,961.89Employees141,700Pfizer
20212Net Sales$638,000,000$8,075.95Employees79,000Procter
& Gamble 20213Net
Sales$76,118,000$753.64Employees101,000Productivity
Analysis SummaryBased on this analysis, Johnson & Johnson
has the highest revenue per employee, indicating that they are
more productive than Pfizer and Procter & Gamble, which
results in better profit for the
company.Sources:1https://www.investor.jnj.com/annual-
meeting-materials/2021-annual-
report2https://s28.q4cdn.com/781576035/files/doc_financials/20
21/ar/PFE-2021-Form-10K-
FINAL.pdf3https://assets.ctfassets.net/oggad6svuzkv/3qbxcfyz
N04dDEn0YM7Pzj/6c7ae1393e16a9f182fec90d6478ed15/2021_
form_10k.pdf
Tool 11SWOT AnalysisPurpose: To show the linkages and
connections between various SWOT elements for Johnson &
Johnson. This enables the company to craft exploitive, alliance,
defensive, and covert strategies to improve the company.
StrengthsWeaknessesS1Johnson & Johnson offers a large,
diverse product line and services including medical devices,
pharmaceuticals, and consumer health productsW1J&J has had
several lawsuits against the negative effects of several of its
products. This causes a loss of trust and taints the company's
reputation.S2Due to having one of the highest revenue streams
in the market, J&J is an industry leader.W2Uneven revenue
distribution as the majority of J&J's revenue depends on a few
key products.S3Invested around $14.7 billion USD for research

and development costs to remain competitive.W3 Accusations
of unethical practices in using misleading marketing campaigns
threaten the trust and brand reliability J&J has built over the
years.S4With a presence in over 90 countries, Johnson &
Johnson has a strong global reach.W4Kickback allegations stain
the company's reputation and can result in costly fines and legal
consequences.S5Has consistent, stable market
performance.W5Gender discrimination allegations could
adversely affect the company's ability to recruit top talent as
well as tarnish its public image. S6With over 130 of
existence, J&J is highly experienced and knows what it takes to
fulfill the needs of the market.W6A decline in consumer health
sales results in lower revenue and contributes to the uneven
distribution of revenue.S7Johnson & Johnson has several robust
initiatives to give back to global communities, resulting in
strong community engagement.W7Low current and quick ratios
suggest that J&J is not as efficient with financial
planning.S8Very adept at completing strategic acquisitions and
mergers to enter new markets.W8Lack of diverse
products.S9Being the leading healthcare company on a global
scale, J&J is highly influential and has great brand
recognition.W9 Product quality has been called into question
due to lawsuits and can affect public opinion and profit.
S10Has skilled employees and a strong, global
workforce.W10Public opinion is negatively impacted by
lawsuits and allegations.OpportunitiesThreatsO1J&J's robotic
surgery system provides the opportunity to make innovative
changes in surgery as well as an advantage over the
competition.T1Government regulations place restrictions on
profit, and operations, and can be challenging to remain in
compliance globally. O2The capacity to innovate and the
strong investment in R&D make Johnson & Johnson a leader in
the market.T2With heavy investments in R&D, relaxed laws
around intellectual property put some of J&J's most valuable
assets at risk.O3The growth of bio-implants is an opportunity to
invest in R&D in this area, and get ahead of the

competition.T3Inflation could make it difficult to provide
competitive pricing and impact profits.O4J&J is popular for its
ability to make strategic mergers and acquisitions. Continuing
to use this method is an opportunity to enter new markets and
increase market share.T4Rising pay demands threaten
profitability and resources to acquire top talent.O5Since the
COVID-19 pandemic, the telehealth industry has had
tremendous growth and is predicted to continue to grow. If
adequately invested in, this could lead to increased profits and
an expanded customer base. T5New environment regulations
can make it more difficult for J&J to carry out green initiatives,
and can affect profitability.O6J&J has developed one-dose
COVID-19 immunizations that earn twice the profit as the two-
dose drugs of their competitors.T6The threat of a recession can
make it difficult to keep the company financially profitable.
O7Consumers are becoming increasingly invested in their health
providing an opportunity for the health industry to
grow.T7Cyber security poses a threat as it becomes increasingly
challenging and important to keep patient information
secure.O8Further market development will lead to the dilution
of competitors' advantages and can enable J&J to increase its
competitiveness.T8An increase in the production of generic
versions of medication could affect the company's
profitability.O9Stable profit and free cash flow present the
opportunity for J&J to invest and expand products and the
company.T9The pharmaceutical market is becoming
increasingly competitive, and it's difficult to maintain profit
margins while still offering the best prices on the
market.O10J&J has announced plans to separate into two
companies providing the opportunity to expand and
grow.T10Lawsuits threaten the company's reputation as well as
profit.Sources:https://swothub.com/pharmaceutical-industry-
swot-analysis/https://pestleanalysis.com/johnson-and-johnson-
swot-analysis/https://bstrategyhub.com/johnson-johnson-swot-
analysis/Exploitive StrategiesE1Johnson & Johnson can
continue to provide a more diverse product line by innovating

bio-implant to remain competitive within the healthcare
industry.Match S3 with O3E2Partner with other organizations
through mergers or acquisitions to increase profit margin and
market share.Match S8 with O4E3High revenue streams allow
J&J to further invest in robotic surgery and gain a competitive
advantage over competitors.Match S2 with O1Defensive
StrategiesD1Increased pay requirements could make it
increasingly difficult to hire top talent, but J&J has had strong
revenue which could be utilized to prevent an impact on
profitability.Match S2 with T4D2Utilizing the company's
influence and reach, J&J could lobby and campaign for more
relaxed government regulations and industry restrictions.Match
S9 with T1D3Can differentiate itself in the market from new
companies with their experience and established presence in the
market.Match S6 with T9Alliance Strategies W & OA1J&J's
products lack diversification, however, if the company focuses
on R&D and innovation it can create diverse products and
increase competitiveness.Match with W8 and O2A2An uneven
distribution of revenue between J&J's three segments: consumer
health, pharmaceutical, and medical devices, will be eradicated
with the company's split into two companies.Match with W2 and
O10A3Public opinion has been adversely affected by lawsuits
and allegations against the company, but consumers' increased
interest in their health is an opportunity to gain lost and new
customers by providing for their needs.Match with W10 and
O7Covert StrategiesC1As a major pharmaceutical company, the
many allegations against J&J's unethical proceedings have
contributed to the government being stricter on regulations, but
J&J is lobbying in the hopes of changing these
regulations.Match W3 with T1C2With the production of generic
medications, it will be difficult to compete. However, Johnson
& Johnson is investing a lot in R&D to produce innovative
products. Match W8 with T8C3Several lawsuits caused public
opinion to falter, but J&J is investing in community engagement
initiatives to continue to give back to the global
community.Match W10 with T10General StrategiesG1With

R&D incredibly important to remain competitive, Johnson &
Johnson should continue to invest significantly in
innovation.Match S3 with O2G2Strategic partnerships and
acquisitions can broaden J&J's global reach and increase
revenue.Match S8 with O4G3As J&J separates into two separate
companies, its global reach will provide the new company with
an established customer base.Match with S4 and
O10PredictionsE1Johnson & Johnson will be able to increase
profits by continuously innovating its products in the
competitive healthcare market.E2Market share will increase as
Johnson & Johnson expands their global operations and
increases its global reach.E3Profits will increase as Johnson &
Johnson invests in surgical technologies and becomes a leader
in robotic surgery.D1The hiring market has become increasingly
competitive and pay requirements have increased, however, J&J
has the revenue and brand recognition to attract and hire top
talent that will increase efficiency and contribute to innovation.
D2J&J will be able to unite companies with their reach and
partnership capabilities to ignite change in the government
regulations on the industry.D3The market is becoming
increasingly competitive, however, with J&J's experience and
seniority in the market, they will still remain competitive and
will maintain their customer base.Predictions Cont. A1Profits
and product quality will increase with emphasized focus on
research and development.A2Johnson & Johnson will increase
global reach and overall profitability.A3J&J will continue to
invest in marketing to create more positive brand recognition
and will increase reach.C1Investments in lobbing will increase
and J&J will partner with other companies in the industry to
influence regulation reform.C2R&D investments will increase
as well as product innovation and diversification. This will
differentiate J&J products from generic brands.C3The
settlement of lawsuits continued improvement in company
operations, and investments in the global community will
positively affect public opinion.G1Innovating new and current
products will give J&Ja a competitive edge and result in

increased revenue.G2Broadening global reach will increase
brand recognition and profits.G3Separating into two companies
will result in additional strategic acquisitions as well as a
broadened global reach and increased profits.
&P
Tool 12Financing Recommendations for SWOT1Purpose: To
make financing recommendations for Johnson & Johnson based
off its SWOT analysis and company knowledge to implement
the recommendations and how to get the funding for the
proposals.Exploitive StrategiesE1Johnson & Johnson can
continue to provide a more diverse product line by innovating
bio-implant to remain competitive within the healthcare
industry.This recommendation gathers funds through its $14.7
billion R&D investment. E2Partner with other organizations
through mergers or acquisitions to increase profit margin and
market share.Partner with other organizations through mergers
or acquisitions to increase profit margin and market
share.E3High revenue streams allow J&J to further invest in
robotic surgery and gain a competitive advantage over
competitors.This recommendation can be paid for by cash,
equity, revenue, or a combination of all.Defensive
StrategiesD1Increased pay requirements could make it
increasingly difficult to hire top talent, but J&J has had strong
revenue which could be utilized to prevent an impact on
profitability.The company should ensure that all employees are
compensated according to the standard of their living country,
as well as consider increasing investments in
benefits.D2Utilizing the company's influence and reach, J&J
could lobby and campaign for more relaxed government
regulations and industry restrictions.In 2021, Johnson &
Johnson spent $6.08 million on federal lobbying expenses. This
investment should remain around the same as well as seek
partnerships with other companies in the market. D3Can
differentiate themselves in the market from new companies with
their experience and established presence in the market.Johnson

& Johnson has spent over $100 million on advertising in digital,
print, and TV. This investment should remain the same and
should differentiate J&J from newer companies by emphasizing
their experience and resources.Alliance StrategiesA1J&J's
products lack diversification, however, if the company focuses
on R&D and innovation it can create diverse products and
increase competitiveness.This recommendation gathers funds
through its $14.7 billion R&D investment. A2Uneven
distribution of revenue between J&J's three segments: consumer
health, pharmaceutical, and medical devices, will be eradicated
with the company's split into two companies.J&J should draw
funds from investors, stocks, and shares to fund the splitting
into two publically traded companies. A3Public opinion has
been adversely affected by lawsuits and allegations against the
company, but consumers' increased interest in their health is an
opportunity to gain lost and new customers by providing for
their needs.J&J should invest over $100 million towards their
marketing budget as well as continue to invest in global
community initiatives which will increase brand
recognition.Covert StrategiesC1As a major pharmaceutical
company, the many allegations against J&J's unethical
proceedings have contributed to the government being stricter
on regulations, but J&J is lobbying in the hopes of changing
these regulations.J&J should continue its previous investment of
$6.08 million in lobbying.C2With the production of generic
medications, it will be difficult to compete. However, Johnson
& Johnson is investing a lot in R&D to produce innovative
products.This recommendation gathers funds through its $14.7
billion R&D investment.C3Several lawsuits caused public
opinion to falter, but J&J is investing in community engagement
initiatives to continue to give back to the global community.The
company should utilize its $100 million marketing budget as
well as part of its $800 million commitment to community
initiatives.General StrategiesG1With R&D incredibly important
to remain competitive, Johnson & Johnson should continue to
invest significantly in innovation. This recommendation draws

from the $14.7 billion R&D investment. This investment should
increase as revenue increases and should be about one-quarter
of revenue. G2Strategic partnerships and acquisitions can
broaden J&J's global reach and increase revenue.The company
should allocate an equivalent budget of $86.47 billion like the
previous years to acquire companies.G3As J&J separates into
two separate companies, its global reach will provide the new
company with an established customer base.The company
should allocate shares and investor funds to their split into two
companies.Overall, the financing for the recommended
proposals should not be detrimental to Johnson & Johnson
because it focuses on the betterment of the company through
expansion, growth, and research and development.
Sources:1https://www.jnj.com/about-jnj/corporate-reports
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Copyright © 2018 Wolters Kluwer. All rights reserved. Page 1
BATES’ VISUAL GUIDE TO PHYSICAL EXAMINATION
OSCE 12: Child and Adolescent Asthma
This video is designed to help prepare you for objective
structured clinical examinations, or

OSCEs.
You are seeing a 14-year-old boy and his mother in an urgent
care setting. The boy’s chief
complaint is difficulty breathing. As you watch this encounter,
you will be asked to answer
questions while the image on the screen freezes. These
questions will engage you in practicing
the skills of focused history taking, physical examination, and
clinical reasoning as you develop
your preliminary differential diagnosis, based on the guidelines
designated in the USMLE Step 2
Clinical Skills Examination.
Note also that you will be performing the history and the
physical examination with the mother
in the room. Some of your history will be obtained from the
patient himself, with additional
information obtained from his mother.
You are expected to develop three diagnoses with supporting
history and physical exam
findings and list the diagnostic workup studies you would order.
You will have time to record your findings and receive
feedback.

Health History
Good morning, Devan and Mrs. Williams. Tell me what brings
you in today.
I’m having trouble breathing, and I can’t stop coughing.
You see, Devan has been coughing for 3 to 4 days now. But last
night, he couldn’t stop. And I
noticed he was having difficulty catching his breath. I almost
brought him to the emergency
room, but we were able to get him through the night.
I am sorry to hear that. And I’m glad you brought him in now.
What preliminary diagnoses are you considering at this time?
Press pause and list your answers. Resume when you are ready
to receive feedback.
Asthma.
Downloaded from http://batesvisualguide.com by Nova
Southeastern University user on 26 September 2022
Pneumonia.
Viral upper respiratory infection.

Devan, can you or your mom tell me more about this? Please
start when you first got sick.
I think my mom better tell you.
[patient coughs]. I can’t remember.
He started about 4 days ago. I didn’t think anything of it….you
know, it was just a runny nose
and a mild cough. But last night, he was coughing non-stop.
Does it feel like anything is coming up when you cough? Like
from your chest up into your
throat?
Nope. I don’t cough anything up.
Tell me about your breathing.
It feels like I can’t catch my breath. Kind of like when I run too
much.
Sometimes he makes a sound when he breathes. He isn’t doing
it now, but I heard it last night.
It was loud.
Could you tell whether it was loud when he was breathing in or
when he was breathing out?
I didn’t notice. Maybe both but I’m not sure. I thought he was
wheezing, but I don’t really know
what wheezing sounds like.

That’s okay. Did it seem like the sound was coming from his
nose or his mouth, or was it from
deep in his chest?
Definitely deep in his chest.
You said Devan was also having trouble breathing, although it
is better now. Can you tell me
more about what that was like?
He was taking deep breaths, and he looked anxious. His chest
was moving in and out. I got
scared!
Did he also mention chest tightness or shortness of breath?
Yes, he was short of breath.
That’s right! My chest felt like it was closing in on me.
What did you both do?
I tried to give him some cough medicine that I have, but he
threw up. I turned on the vaporizer,

but I don’t think that that helped either. I just tried to calm him
down. It got better after a
coughing spell. I don’t know if something just loosened up, or
what.
Has he had a fever?
Maybe at first, a few days ago. But not in the past day.
Has this type of coughing ever happened before?
Not like this. He coughs a lot at night though. I don’t know if
there’s something in his room
making him cough.
Okay. Let me go back a bit and ask questions about whether this
type of thing has happened
before. You just said Devan coughs a lot at night. Can you tell
me about how often he coughs or
has breathing problems at night? For example, during a typical
2-week period, how many nights
does he cough or have breathing problems that keep him from
sleeping or that wake him up?
Oh, I don’t think a week goes by without him coughing in his
sleep to the point where he wakes
up. His coughing keeps me up! I think this happens about 2 or 3
nights in a 2-week period.

That is helpful. What about overall? In a typical week, how
much would you say Devan’s cough
or breathing problems restrict his usual activities? Would you
say: Not at all during a typical
week? Slightly? Moderately, or a lot?
I would say slightly during a typical week. It is usually the
cough. But most of the time it isn’t
bad, like it was last night.
Okay, so in a typical week, how often during the day does
Devan cough or have breathing
problems?
It is mostly at night, but I would say 2 times a week, on
average.
Thanks. I know these questions are hard to answer. Other than
his cold, is there anything else
that might have triggered or caused Devan’s breathing
problems? For example, is there
anything new in your house? For example, a new pet or
something new that you’re doing?
No, there’s nothing new. We don’t have any pets. I was
wondering about the rug in his
bedroom, since it is old. But nothing has changed in our home
or in his bedroom.

Now I’m going to ask you some specific questions. These
questions will help me understand
what is happening.
Does Devan take any medicines regularly?
No.
Have you ever brought him to the doctor or emergency
department before for this type of
thing?
No, never. We just “gut it out.”
Has a doctor or nurse ever said that Devan has asthma?
No, we’ve never heard that.
Does Devan tend to have eczema, or dry skin? Or frequent
rashes?
He does have very dry skin! I use lotion on him all the time.
And sometimes he has rashes in
patches.

And they really itch!
Does he have allergies?
I think so. During the late summer and fall, he sneezes a lot. I
sometimes give him
antihistamines—and they tend to help.
Okay. I asked you about nighttime cough. What about snoring?
Does he tend to snore?
Yes he does! Not every night, but sometimes.
What kind of exercise do you get, Devan? Do you play any
sports or exercise regularly?
I play soccer. And I bike around a lot.
Does your coughing or breathing limit what you can do?
Yeah, sometimes I cough when I play soccer and I get that chest
feeling.
Mrs. Williams, do any diseases run in children, either in your
family or in your husband’s family?
Anything like allergies, skin conditions, asthma, or other
childhood diseases?
Well, everyone has dry skin in my family. It’s a family thing.
My nephew had asthma, but he is
older and he grew out of it. They don’t live nearby, so I didn’t
really see it. That’s about all.

Okay, thank you. Tell me about Devan’s birth. Was he full term,
or did he arrive early?
He was full term. A big baby, in fact.
Has Devan had any serious illnesses in the past?
No, he’s been healthy overall.
Does anyone smoke in the house, or does anyone smoke around
Devan?
Yes, my husband smokes—but he is down to half a pack a day.
And we open the house or car
windows when he is smoking, so I think that helps.
You both have been really helpful in telling me about you,
Devan, and what is happening. Let
me summarize. You’ve had a cold for 3 to 4 days, and your
cough has been pretty bad,
especially last night when you had trouble breathing. You’ve
been healthy all your life except
for eczema or dry skin, and you do tend to cough frequently
when you exercise and also at

night. Does that sound right?
Yes!
Is there anything we’ve missed? Anything else important that I
should know about?
No, that’s about it.
Let me do a complete physical examination, and then we can
talk over what might be going on,
and our next steps. Okay?
Physical Examination
With the patient’s health history in mind, and after good hand
hygiene, you are ready for the
physical examination.
What areas of physical examination are important for this
patient?
Vital signs
Skin
Pharynx (tonsils)
Lungs

Heart
Abdomen
Your weight is 69 Kg, or 153 pounds. This is at the 97th
percentile for boys your age. Your
height is 159 cm or exactly 5 feet 3 inches tall—about an
average height for your age. Your
body mass index is 27, which is about the 97th percentile. In
other words, it’s high. Your blood
pressure is 120 over 75, which is a bit on the high side but still
okay. And your heart rate is 90
beats per minute, which is a bit fast. Your respiratory rate, or
your speed of breathing, is about
20 breaths per minute, which is also just a little fast. Your
temperature is normal.
Examine the skin on the arms and torso.
Examine the pharynx.
Open your mouth for me nice and wide, stick out your tongue,

and say “Ahhh.” Very good.
Next I’m going to do a careful examination of your lungs.
Okay.
Lung examination consists of the following steps:
Inspection.
Chest expansion.
Tactile fremitus.
Percussion.
Auscultation.
Begin with inspection.
First, I am going to watch you breathe. Just breathe normally.
Mrs. Williams, I do see some retractions here when he breathes,
just a little bit. Is this normal
for him?
No, it’s not.
The next step in the lung examination is chest expansion.
Now, Devan, take a deep breath [Devan coughs]….
Try instead to take a breath that’s not quite so deep. That’s
good. I know that breathing deeply

is hard, and it makes you cough.
Palpate to assess tactile fremitus.
Devan, I’m going to ask you say the number “99” many times,
as I feel your back. Keep saying
99.
99, 99, 99, 99…
This feels normal.
Perform percussion. In children, sometimes using the flat of the
hand works better than
percussing with one finger, as is done in adults.
Now, Devan, I want you just to breathe quietly with your mouth
open, while I tap on your back
with my hand.
Okay, this all sounds normal.
Perform auscultation in the same manner as for adults.
Devan I’m going to move my stethoscope back and forth across

your back as you breathe. I’ll
listen to your sides and chest. Please keep your mouth open as
you breathe.
I hear some wheezing noises on both sides of your chest when
you breathe out. I also hear a
few rhonchi, or wet noises, when you breathe in---but just a
few. I don’t hear something called
rales, or crackles.
Devan, now please just breathe normally and sit quietly while I
listen to your heart.
I’ll examine your abdomen. I want first to listen to it, and then I
will gently feel it.
Diagnostic Considerations
What are your three diagnostic considerations, in order of
priority?
This 14-year-old boy most likely has underlying childhood
asthma.
A recent viral upper respiratory infection has triggered an
exacerbation or flare-up.
His constellation of symptoms includes cough; shortness of
breath; and intermittent breathing

problems, particularly last night.
These symptoms, together with his history of intermittent but
frequent coughing at night, when
exercising, and with colds all suggest typical childhood asthma.
The patient’s personal and family history of eczema and
allergies also is typical among children
with asthma.
Children who are overweight, especially if obese, have a higher
prevalence of asthma than
normal-weight children. Children exposed to tobacco smoke
have a higher prevalence of
asthma.
Devan’s physical examination confirms childhood asthma as the
most likely diagnosis. He has a
normal respiratory rate but a prolonged inspiration/expiration
ratio with expiration longer than
normal. Lung examination reveals good expansion and no

abnormalities or tactile fremitus or
on n percussion. However, he exhibits both bilateral expiratory
wheezes and slightly increased
work of breathing using accessory muscles.
This patient exhibits several other abnormalities on physical
examination suggestive of typical
comorbid conditions that often accompany childhood asthma.
These include the following:
Elevated body mass index at the 97th percentile, which signifies
obesity.
Upper respiratory signs of congestion consistent with viral
infection, a common trigger of
asthma exacerbations in children.
Large tonsils, which reflect tonsillar hyperplasia that can
accompany obesity.
Devan’s large tonsils are likely a hint for adenoidal hyperplasia,
which may be causing his
snoring. Patches of eczema, which tend to occur in children
with allergies and may predispose
them to asthma via allergy-mediated pathways.
The diagnosis of asthma rests primarily on the history and
physical examination rather than on
laboratory tests. The diagnosis can be further supported by

demonstration of airflow
obstruction using peak flow meters or spirometry,
demonstration that the symptoms are
reversible (e.g., by using bronchodilator treatment during an
acute exacerbation), and exclusion
of other likely diagnoses. There are dozens of causes of
wheezing in childhood, and a judicious,
careful history and physical examination (without laboratory
tests) will generally rule out most
other causes.
The patient’s respiratory symptoms and history of fever suggest
the possibility of bacterial
pneumonia, specifically community-acquired pneumonia.
The combination of fever, cough, and shortness of breath would
increase the likelihood of
pneumonia.
Bacterial pneumonia in children typically presents with a triad
of signs and symptoms:

High fever.
Cough.
Tachypnea.
Physical examination often reveals tachycardia, work of
breathing, and unilateral lung
abnormalities such as abnormal fremitus, dullness, and rales.
Other than a cough, Devan did
not have any of these signs or symptoms.
It is critical to rule out the diagnosis of bacterial pneumonia
because of the potential for
progression and the need for rapid administration of antibiotics.
Atypical pneumonia, generally from Mycoplasma pneumoniae
or a Bordetella pertussis, is more
indolent, with less severe symptoms and signs. Lung findings
are bilateral and generally involve
inspiratory rhonchi or crackles, without expiratory wheezing.
Atypical pneumonia is often missed, and many patients do not
seek medical attention.
Lack of tachypnea excludes a diagnosis of bacterial pneumonia.
On physical examination, lack of
tachypnea and presence of prolonged inspiration/expiration
ratio are very helpful to point

toward the diagnosis of asthma.
Viral pneumonia tends to be less severe than bacterial
pneumonia. Patients present with upper
respiratory symptoms with accompanying cough. Physical
examination may reveal increased
work of breathing, tachypnea, and bilateral lung findings.
The common cold, or viral upper respiratory infection, is the
most common physical illness in
childhood. Viral upper respiratory infections tend to have a
constellation of symptoms. These
include:
Nasal congestion and runny nose.
Cough.
Fever.
Sore throat.
And sometimes headache.
Typically, fever and sore throat occur during the first several
days of an upper respiratory
infection. Nasal congestion lasts several more days, and cough
may persist for many additional
days.

Associated conditions include otitis media and lower tract
infections such as viral pneumonia or
bronchiolitis. Asthma in children is often triggered by a viral
upper respiratory infection, so they
often co-exist. With viral upper respiratory infection, school-
aged children do not have
respiratory distress or increased work of breathing.
Diagnostic Workup
List three next steps in your diagnostic workup.
Pulse oximetry.
Several diagnostic tests should be considered, although the
astute clinician is likely to perform
pulse oximetry as the only diagnostic study.
Bedside pulse oximetry is readily available to test for oxygen

saturation. In most cases of mild
asthma exacerbations, as in this patient, oxygen saturation is
normal
Chest radiograph.
Seasoned clinicians usually will not obtain a chest radiograph in
a patient with mild asthma
exacerbations. High fever, tachypnea, and crackles might
indicate the need for a chest
radiograph to identify consolidation that would be suggestive of
a bacterial pneumonia.
In this case, the relatively mild symptoms, absence of fever and
tachypnea, presence of
bilateral wheezing, and absence of rales all make bacterial
pneumonia highly unlikely.
Although chest radiographs in childhood asthma often reveal
minor abnormalities such as
streaking or increased air trapping, these findings do not
generally assist in management.
Peak flow meter.
Peak expiratory flow rate can be obtained in the office using
hand-held peak flow meters.
Multiple readings usually are necessary to identify a patient’s
baseline measurement and assess

pulmonary function. Patient cooperation is required.
Peak flow meters are generally used to monitor pulmonary
function for chronic asthma. They
are not for acute asthma management. This test is described
here because of its utility in
managing chronic asthma of childhood.
Summary
In summary, this 14-year-old boy presents with respiratory
symptoms triggered by a viral upper
respiratory infection.
His cough; shortness of breath; intermittent breathing problems;
and frequent coughing at
night or with exercise all suggest typical childhood asthma.
His physical examination is positive for prolonged inspiratory
to expiratory ratio as well as
bilateral expiratory wheezes and slightly increased work of
breathing. His history and physical

examination are consistent with chronic mild persistent asthma
and an acute asthma
exacerbation. Physical examination is also remarkable for
obesity and eczematous patches.
These comorbid conditions commonly accompany childhood
asthma.
Diagnoses include asthma, bacterial pneumonia and viral upper
respiratory infection.
Possible diagnostic studies include:
Pulse oximetry.
Chest radiograph.
Peak flow meter or spirometry testing, once the acute
exacerbation has resolved.
However, this condition is best managed by a careful history
and physical examination, with at
most pulse oximetry for laboratory testing.

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