How to teach doctors patient service

Most weeks, Walmart flies a group of 50 from across the country — about 1,800 last year in all, with 2,200 expected this year — to what it calls its Manager Academy.

Throughout the sessions, trainers reinforce the message that Walmart’s success is possible only if the store managers take care of their workers and the customers and community where they operate.

Welcome to the Experience Economy, where businesses must form unique connections in order to secure their customers’ affections–and ensure their own economic vitality.

When it comes to customer experience at the nation’s largest retail pharmacy chains, there is plenty of room for improvement, according to Tilak Mandadi, the chief digital, data, analytics and technology officer at CVS Health CVS

Among other things, customers can be caught off guard by the price of their prescriptions when they go to pay, they might face never-ending menu options when calling customer service, and if they want to quickly pick up toiletries, they often find them locked up in cases. A shortage of pharmacists isn’t helping matters, either.

A concept first introduced by Joseph Pine and James Gilmore – the idea of the Experience Economy ushered in a completely new way of thinking about customer experiences. And although the world has changed since the idea was put forth, the way to a customer’s heart has not.

The idea of staging experiences to leave a memorable—and lucrative—impression is now more relevant than ever.

The main difference between customer experience and service is that experience is delighting customers at every touchpoint with your brand, and customer service is one single touchpoint. Customer experience doesn’t require interaction with a representative, but customer service usually does.

Experience is also proactive, while service is reactive.

The problem is that patients are not customers and here's why.

Tony Hsieh, the former chief executive of Zappos.com Inc., helped build the online shoe retailer with a model of customer service that rested on a simple premise: Make every customer as happy as possible, even at the expense of sales—in the short term. You see, happy healthcare workers make happy patients. Here are five tips from Tony:

Put the Service First

Don’t Hide the Phone Number

Recognize a Bigger Role for Customer Service

Pay Workers to Quit

Create Community

More and more, doctors and other medical staff are being measured, held accountable for and compensated, in part, on their customer service skills, and, for good reason.

A?study?of nearly 35,000 online reviews of physicians nationwide has?found?that customer service is patients' chief frustration, not physicians' medical expertise and clinical skill.

The study, published in the current issue of the?Journal of Medical Practice Management, reveals that 96 percent of patient complaints are related to customer service, while only 4 percent are about the quality of clinical care or misdiagnoses.

In summary, the study found that fewer than 1 in 20 online complaints cite diagnosis, treatments and outcomes in healthcare as unsatisfactory, whereas more than 19 of 20 unhappy patients said inadequate communications and disorganized operations drove them to post harsh reviews.

Despite assertions to the contrary, digital health interventions aren't helping.

The problem, like so many other other demands placed on the clinical staff, like being expected to innovate, is that they are not taught how to do it. The result is frustration, push back and burnout. Here's how to piss off your patients.

If you are like most, you probably hate customer service and companies seem to be doing little or nothing to make it better.

A?recent article?explains why and stresses that the experience should derive from your brand identity, the defining values and attributes that distinguish a brand.

Like building a house, the author suggests that you need to build a blueprint and a customer experience architecture in 7 steps:

To develop a customer experience architecture, follow these steps:

1. The brand platform?— First, define or reaffirm the overarching ideas that represent the brand. REI’s brand platform is the excitement and adventure of the outdoors; Chick-fil-A’s is exceeding customers’ expectations with a servant’s spirit.

2. Customer experience strategy?— Then describe the desired customer feelings and perceptions of the brand across all interactions with the organization. An electronics website might want to create a “place” for customers to discover and be delighted by innovations. A hotelier might want customers to feel pampered by legendary service. Most patients simply want to feel like caregivers care and that they are safe.

3. Business segmentation?— The next step is to break down the business into discrete units. For a new brand, segmenting the business by traffic vs. trial vs. transition might be an illuminating approach; a restaurant company might segment by service mode, e.g., eat-in vs. drive-thru vs. carry-out; and a product-line segmentation might be appropriate for a manufacturer. The objective is to identify the different experiences the organization delivers and to articulate the requirements and objectives of each.

4. Customer segmentation?— Different target segments have different needs — some customers may value convenience over price, others may be looking for an entertaining experience — so their desired experiences vary. Describe each segment with a profile and a needs inventory, including key drivers of purchase decisions and brand perceptions.

5. Prioritization?— Create a grid with the business segments as columns and customer segments as rows. Each business/customer intersection represents a discrete experience to design and deliver. They should be prioritized in order to focus design and management. Prioritization criteria include profit potential, fit with long-term strategy, competitive advantage and differentiation, resource requirements, and how the experience affects and/or reinforces brand values and brand position.

6. Experience design?— Determine how to meet the segment-specific needs in each business segment, either by improving existing approaches based on new insights from the architecture or by developing entirely new ones. All the levers of customer experience — product, service, content, channels, touchpoints, pricing, facilities, sensory engagement, etc. — should be considered and described in the design.

7. Assessment and integration?— Now the architecture is ready to be inspected for integrity and coherence. Is the brand platform expressed throughout every experience? Do the discrete experiences contribute to the overall customer experience strategy? Do experiences complement and enhance each other, or do they conflict or detract from each other?

Some argue that the hospitality industry is?not the appropriate model for the sick care systems business?and that we need to fix how we do care coordination and communication and teach pathetic doctors how to be more empathic.

Why is it so hard for Sick Care, USA to create a good, if not great, patient and HCP experience?

1. Regulations

2. Not adapting to changed patient expectations

3. Workforce shortages

4. Trying to do too many things at once to make money

5. Too much reliance on technology to solve people problems

6. Lack of employee customer service competencies

7. Innovation theater

8. Failures of leadership

9. Mindless policies and procedures that create friction and anger patients.

10. Not giving front line people the authority to solve a patient's problem.

11. Not enough incentives to do it

12. Lack of accountability

Here's a test on patient experience at your place:

1. Was it easy to find a place to park?

2. How many times were you handed a clipboard?

3. How long did you have to wait to get an appointment?

4. How long did you sit in the reception area/waiting room?

5. Was there free WIFI in the reception area ?

6. How long did it take for you to get your test results? Did someone send them to you or was it your responsibility to get them?

7. Was the coffee in the lobby overpriced or free?

8. Were you charged to get a copy of your records and was it more than what it would cost at Staples?

9. Were you able to find your doctor's office easily or did you have to ask someone for directions?

10. Do you remember the names of the people who took care of you?

11. Does everybody really care or, are they too burned out to do so?

So, if doctors are expected to improve their customer service skills, how should we do it?

Here are some guidelines that should inform how we teach and measure doctor customer service:

1. Changing behavior is hard and involves identifying the undesired behavior, targeting triggers, measuring the response, and creating carrots or sticks to eliminate or reinforce the behavior
2. Unless the changed behavior becomes a habit through repetition, education and training, there is a high rate of recidivism
3. Many doctors are simply unwilling or unable to change and they need to be "rehabilitated" or fired accordingly. Instead, many just get promoted to the C suite.
4. Delegating the responsibility to managers or department heads to create customer service improvement does not work without following a delegation process
5. The process of gathering feedback and using it to guide improvement likewise must be done correctly to make a difference.
6. There is little or no correlation with patient experience and the quality of medical inputs and outcomes
7. Improving experience is but one step towards engagement and enabling changes into value added modifications of patient and medical team behavior
8. The cost, time and effort of using sophisticated customer experience vendor solutions can be prohibitive and, instead, require some bootstrapped solutions to solve targeted problems emanating from targeted people in certain departments, who, most likely, are the 20% creating 80% of the problems
9. Often times, because managers themselves are not trained or proficient in customer service, the blind are leading the blind
10. It is an unrealistic expectation for a doctor to have the diagnostic skills of Osler, the technical genius of Leonardo, the compassion and empathy of Mother Theresa and the customer service skills of the bartender at the Ritz Carlton. We need to be realistic about setting acceptable standards that recognize individual strengths and weaknesses and how we recruit for them.
11. Establish guidelines and pathways for dealing with difficult patients and chronic complainers. When and how should you inform a patient that they should get care somewhere else if they are so dissatisfied with the service or experience?
12. Manage online complaints and create a reputation management protocol and platform.

Achieve and maintain 5-star ratings on the Forbes Travel Guide for your establishment with the help of downloadable Forbes 5-star standards checklists.

By following a structured approach, establishments can systematically enhance service quality and exceed guest expectations through these steps:

1. Thoroughly review the checklist to understand the criteria and expectations for each section.
2. Evaluate existing operations against the checklist to identify areas of strength and opportunities for improvement.
3. Create tailored action plans to address deficiencies and enhance performance in alignment with Forbes standards.
4. Implement comprehensive training programs to equip staff with the skills and knowledge needed to meet or exceed standards based on the needs identified while using the checklist.
5. Continuously monitor performance and conduct periodic evaluations to track progress and ensure ongoing compliance with the checklist.
6. Actively seek feedback from guests to gauge satisfaction levels and identify areas for further refinement.
7. Recognize and celebrate achievements and milestones reached in meeting or exceeding Forbes 5-star standards, motivating staff, and reinforcing a culture of excellence.

The emphasis on the "customer experience" already has the unintended consequence of inflating patient/customer expectations, that, quite simply, cannot be fulfilled by doctors who do not have the skills to do it, work in dysfunctional systems or systems and are burned out and disengaged. Much like EMRs have turned doctors into high priced data entry clerks, the customer service movement has turned doctors into unwilling customer service reps. Some are so frustrated they leave not just their job, but clinical medicine to pursue non-clinical careers.

Customer experience expert David Avrin puts it simply-make doing business with you ridiculously easy.

We used to tell substance abusers to just say no and that didn't work out so well.. Unfortunately, just telling sickcare workers to follow the golden rule has not worked either.

Arlen Meyers,MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack and Editor of Digital Health Entrepreneurship