Be Big Or Be A Boutique: Economies Of Scale In Health & Human Services "Be big or be a boutique." I've heard those words spoken at meetings of my colleagues here at OPEN MINDS, in reference to the pressures of the current health and human service market – and the need for service delivery organizations to either get bigger to improve their economies of scale, or stay smaller with a focus on a very narrow market niche. The reality of the situation is that with or without . . .