This study aims to suggest managerial strategies for strengthening their competitiveness via analyzing and determining factors to help improve customer orientation and internal customer satisfaction. Furthermore, this study aims to find out the factors of internal service quality affects job satisfaction and customer orientation. The data was collected in 5 small and medium hospitals on 215 workers who had direct interactions with customers. Through regression analysis, all factors of internal service quality affects job satisfaction, however only two factors, credibility and sympathy appeared to affect customer orientation.