Culture Fills in the Gaps

Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. His website alanayersurgentcare.com contains over 500 original articles, presentations and citations on the subject of urgent care.

What differentiates Southwest from American Airlines, Chick-fil-a from McDonald’s, Nordstrom from Sears, Apple from Dell, or Whole Foods from Safeway? Financial metrics such as growth and profitability aside, generally the differences can be summed up in two words—“corporate culture.” Search for these terms online and you’ll be sure to find thousands of references describing what corporate culture is, why it’s important, and plenty of award winning examples.

Although “corporate culture” is conventionally defined as the “philosophies, values, attitudes, beliefs, dress codes, etc. that define and differentiate a company from competitors,” perhaps a more actionable definition for urgent care operators is that culture gives meaning to employee jobs.

One of the characteristics of companies with a strong culture is that they believe treating employees well is a requisite to treating customers well. That’s why most of the “100 Best Companies to Work For” are also the “Most Popular Consumer Brands.” It’s also why companies with the strongest cultures tend to invest heavily in hiring, onboarding, and training their people as well as in the policies, processes and technologies that enable their roles.

All employees want to feel important and to believe that their work contributes to something greater than themselves. A corporate culture can help accomplish this goal. For example, the Walt Disney Company employees learn that their “purpose” is not to sell popcorn, load rides, or sweep streets, but rather is the noble pursuit of “creating happiness.” Disney’s advertising, its community volunteer programs, and its training and reward programs all teach and reinforce its “magical” brand. The “guest experience” at Disney resorts is thus noticeably different from, say, Six Flags or your local municipal zoo and people will travel hundreds of miles, and spend thousands of dollars, to take their families to Disney.

What differentiates health care from hospitality, retail and other “service” industries is that those who pursue careers in health care often do so because they’re naturally inclined to comfort, to assist, and to show compassion. They’re attracted to a career that “makes a difference in people’s lives.” This is a sharp contrast to the jobs making coffee, selling chinos or serving fajitas that people “default to” because they’re readily available to young, unskilled workers. But…if the companies in those businesses can inspire their front line staff to deliver high service levels and create “fans” of loyal customers, then certainly urgent care operators can leverage the inherent “caring” of those who pursue health care careers.

For the urgent care operator, culture fills in the gaps between what you train your employees to deal with and what actually takes place in the center. The stronger the culture, the better prepared are employees to manage the day-to-day uncertainties of a walk-in medical business. When a situation arises for which employees haven’t been specifically trained, they can fall back on the center’s “values” of delivering welcoming, respectful and skillful care.

When employees are “enabled” and “set free” to do what’s best for the patient…amazing things can happen. For example, one urgent care center reported that a passer-by approached its front desk confused over his insurance company’s explanation of benefits from a different provider. A disengaged employee could have just said this was not the center’s issue…and the employee could have referred the patient to his insurance carrier’s toll-free number. Instead, the center manager took the patient into her office, got the insurance company’s provider rep on the speakerphone, and assured that all of the patient’s questions were answered before he left. He vowed to use the center whenever his next urgent medical need arises, and to tell his friends and family to do likewise.

In another instance, a patient was about to be administered IV medication but he was concerned that his car would be ticketed due to the parking meter expiring. He could not, in his condition, safely move his car so the medical assistant asked what kind of car he was driving and where it was parked, and with change out of her own pocket, went and fed the meter for him. Later, when that same patient was trying to contact his wife but his cell phone battery ran out of power, she took his phone to her own car and charged it. Nobody trained the medical assistant to do these things…and she very well could have sat in the medical station claiming “it’s not my problem.” Instead, she took care of the patient and the patient reciprocated by posting a five-star review on Google.

The way employees learn culture is by hearing and repeating similar stories of great customer experiences. While nearly every company says that customers are its top priority, stories show us how employees go the extra mile for each and every one of their customers. Stories are a teaching tool that also celebrates and recognizes those who exhibit the “right” behaviors. Stories that are submitted directly from patients—in the form of feedback on public websites, letters to senior leadership, or written comments on patient satisfaction surveys—are more credible than those devised by management. And the most effective “great patient experience stories” can turn into “lore.”

In addition to spreading word about the “right” behaviors, behaviors damaging to the culture should be strongly discouraged. For example, if one employee gets away with giving poor customer service, the message sent is that high-quality customer service doesn’t matter. If word gets around that employees have been fired for disrespecting a patient—regardless of whether such actually occurred—such can be just as valuable in shaping culture as a positive patient experience story.

It’s not uncommon to hear employees of companies with “strong” cultures describe doing things “the organization’s way”—for example, the Southwest Airlines Way, the Chick-fil-a Way, or the Apple Way. Employees of these companies believe you just come to “know” a corporate culture over time; that culture is something you “do.”

So…what is your center’s culture and how does it differentiate your brand from other health care options in the community?