Does the dog (organization) wag the tail (marketing) or is it the other way around?

1. What are some potential risks or drawbacks from changing or expanding the scope of Banner University of Arizonas (Tucson Arizona) service line in order to reach new markets?
2. Are there any benefits for doing so?
3. Does the dog (organization) wag the tail (marketing) or is it the other way around?
Francer J. Izquierdo J. Z. Music T. Narsai K. Nikidis C. Simmonds H. & Woods P. (2014). Ethical pharmaceutical promotion and communications worldwide: codes and regulations. Philosophy ethics and humanities in medicine 9(1) p. 7. Available in the Trident Online Library.
Geangu I. P. Dumitru I. & Grdan D. (2013). Ethical and legal aspects of marketing activiity in the field of dental healthcare services. Contemporary Readings in Law and Social Justice 5(2) 904-918.
Gitterman A. (2013). Ethical issues and practical challenges raised by internal investigations in the life sciences industry. Defense Counsel Journal 80(4) 372-394
Glied S. & Oellerich D. (2014). Two-generation programs and health. The Future of Children 24(1).
Hancher-Rauch H. Hicks L. Mayol M. H. & Casselman K. (2013). SAVING YOUR WELLNESS PROGRAM. Journal of Physical Education Recreation & Dance 84(6) 29-34.
Hanna L. Barry J. B.Sc Donnelly R. Hughes F. M.Pharm Jones D. D.Sc Laverty G. Ryan C.. (2014). Using debate to teach pharmacy students about ethical issues. American Journal of Pharmaceutical Education 78(3) 57.
Horwitz J. R. Kelly B. D. & DiNardo J. E. (2013). Wellness incentives in the workplace: Cost savings through cost shifting to unhealthy workers. Health Affairs 32(3) 468-76.
Stichler Jaynelle F. (2013). Ethical considerations in healthcare design and construction. HERD: Health Environments Research & Design Journal 6(4) 5-9.
Womack C. A. (2013). Ethical and epistemic issues in direct-to-consumer drug advertising: Where is patient agency? Medicine Health Care and Philosophy 16(2) 275-80.