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Gosh, a whole lot of huffing over a little word!
Customer.
OK, now grab a paper bag and breathe slowly and steadily into it. I know it\’s hard to hear that word. I am sorry to have caused such trouble.
Some folks misunderstood my last post, thinking that I thought patients should only be considered customers, or that they should be referred to as customers. I never said that, nor did I imply it. I simply said that patients are customers. They are. Medical care is not free, and it is being paid for by the patient (directly or indirectly). Medicine is a business that has been so mismanaged that we are now in a crisis over its financial side. The trouble is the cost of care. Cost implies money is used, and trading money for services or goods is what business is about.
We\’ve been spending our dollars on healthcare like a person irresponsibly running up a credit card bill they can\’t pay back. The pain doesn\’t happen now, it happens down the road when the collectors knock. We can\’t order whatever tests we want or prescribe gazillion dollar drugs without remembering somebody will have to pay the bill. Ignoring the business of medicine has gotten us into deep doo-doo.
This fecal vortex is not limited to the financial side of the business; we have also neglected customer service. Doctors have \”waiting rooms.\” What other business admits up front that it won\’t serve you in a timely manner? I suppose we could call airports \”delay zones,\” but I doubt the airline industry would accept that like we have in medicine. Whenever I post on doctor/patient interaction, I am flooded with stories from patients who are treated poorly by doctors and their offices. People are there for good medical advice, right? No, they are there to be cared for, and a huge part of that care is determined by how they are treated in the office.
Early in our practice, we decided we wanted our practice to be like the department store, Nordstrom\’s. Perhaps in the present day I\’d more compare it to the grocery store, Trader Joe\’s. These stores do not focus on having the lowest price, the biggest sales, or the best advertising. Instead, they focus on the customer experience. They want people to have a different experience when they come to their store. The staff is helpful and courteous; they make their store to meet the needs of their customers, not expecting their customers to adapt to their store. When people leave these stores, they feel good about their experience. They feel like they were the center of attention and got their needs met. They are extremely loyal to these stores.
I want my patients to feel the same way when they leave my office. I want patients to brag about our office and how well they are treated. To meet our patients\’ needs, we have a walk-in clinic every morning from 7:30-8:30, every evening from 5:00-7:00, and Saturday morning from 8:00-11:00. Our patients love this. It fits their needs. They don\’t have to call to make an appointment; they just show up. We do have tight rules around this to prevent abuse; we don\’t see chronic problems, nor do we see things that are at all complex. The visits are limited to \”quick sick\” problems.
Oh yes, it also is hugely profitable. We make over 25% of our revenue from this. That is good business: making a profit off of making people happy. We identified a need of our patients and met it. Because of its popularity, the wait times for our walk-in clinics are sometimes longer, but because we are meeting their overall needs of availability, people rarely complain and usually enthusiastically thank us for doing this.
Does this customer-oriented approach mean that we say the \”customer is always right\” and so give antibiotics when not appropriate, or give in to demanding patients? No. It\’s actually the opposite. Since we are meeting our patients\’ needs, they seem all the more willing to listen to us when we tell them they don\’t need an antibiotic, or that they do need to come back for another visit because the problem is too complex. They believe us when we say we care about them because we run our business in a way that sends that message.
One doctor who took offense to my last post objected to my classification of medicine as a business, saying: \”No, sir, it is not business, it is care, and I am truly disappointed you want to defend it as business.\” That\’s like saying a restaurant is not a business, it is the provision of food. Healthcare is care. I don\’t disagree with that (read the rest of my blog if you don\’t believe me!). It is also a business.
I won\’t call my patients \”customers,\” but I will treat them that way. I will treat them like I owe them something because they have paid me. I will treat them like they deserve a good experience when they come to my office. I will listen to their needs and do my best to meet them.
Doing so is good care.
Great post and right on. Should patients be considered consumers like in other markets? Do they know how to “shop” around for the best deal?
Davis Liu, MD
Great post.
I think both of your posts, this one and yesterday’s nailed it with some of the issues we have in health care. It IS a business, and the reality is that business is about building relationships. For a customer of any business, it’s about the experience, about the quality of the relationship. Patients can and do shop around, at least I do. Having worked in the healthcare industry for a number of years, I’m particular for myself and my family. In the end, the best care we have received has been from those doctors who realize that it’s about building relationships.
Of course it’s a business, and I for one am pleased to see that as a physician, you see your patients as valued customers, in addition to all the other ways you described us. Your previous blog post was spot-on, and I suspect anyone who thinks otherwise did not read very carefully what you had to say. Guilty of skimming it too quickly, perhaps?
I’m with you all the way, Dr. Rob. I agreed with yesterday’s post and I agree with today’s as well. Keep up the good work.Adam Nally, DO
Both of these posts were great. I have left two doctors because of poor customer service…from staff and the physician. Gotta do what you gotta do.
I like the customer-oriented mindset. We provide a refusable service. People can not come in, or they can go elsewhere. They have choices, even if it’s just a different provider. Treat them like they are valued customers and everybody wins. If you view patients like they are a burden or a hassle (easier to do in the ER), and that translates into how you treat them, then you will lose business no matter how good a doctor you might be.
Just read both articles, and I must say I’m confused why anyone would label you one way or the other. You very clearly, at least to me, presented the idea that patients mean several things to their doctors. I thought you did an admirable job of detailing the different aspects each of us patients represent: customer, one of a group, someone who needs medical care, some one who needs to be cared *for*. I appreciate this multi-pronged approach, probably because I’ve run into doctors who only see me as a cash cow. I don’t mind being any and all of those things to my docs, as long as they have a balanced approach. Hang in there, Dr. Rob, don’t let the ones who just skim your articles for reasons to troll get you down!
I LOVE the concept of the ‘Patient As Customer’!
I have long lobbied for this in education, too. When my daughter was in university, she came home with tales of incompetent professors ranging from those unable to speak English (seriously) to those showing up falling-down drunk for class. I kept reminding her that she should consider herself to be a consumer, and the product she’s consuming at great expense is called EDUCATION.
Same with being patients. We are consumers of a product and that product is called MEDICAL CARE. I don’t have to go camping with my doctor, but I do think a “customer-focused” approach (which includes ALL medical office staff as well) would be a smart development in the profession.
I lost a molar(!) after biting into something in a Trader Joe’s Chicen Sausage I had bought the same day. I cracked the tooth and had to have it removed as I didn’t have 3500 for an implant.Both Trader Joes and the Villa Roma Sausage company denied my claim as I couldn’t produce what broke the tooth. The whole process was painful and humiliating.
I now am employed and am going through the lengthy, painful and expensive process of having an implant installed.
I haven’t shopped at a Trader Joe’s since (Dec 2009) and encourage everyone and anyone I know not to patronize them.