Negative moments of truth

Regardless of what industry you’re in, customer service matters. But if a recent new study is any indication, it especially matters in health care.

The findings by the PwC Health Research Institute are pretty interesting:

- 42 percent of the 6,000 survey participants said personal experience, rather than price, was their most important consideration when choosing a health care provider.

- Personal experience was 2.6 times more important in choosing a doctor or hospital than for other industries, and peer recommendations were twice as important. (Banking, airlines and the retail and hospitality industries were among the industries used for comparison.)

- Six out of 10 health care experiences were defined by the attitude of the staff, making this twice as important in health care than in any other industry.

There are two conclusions to be drawn: Patients value having a good health care experience above all else, and they value it more than a good customer experience at, say, a movie theater or retail store. The report calls it “moments of truth” – the experiences that can cause customers to either love the organization or loathe it.

If I worked in health care, I would sit up and take notice of this survey. For organizations that already place a priority on patient-centered care and the patient experience, it validates that they’re on the right track. And for organizations that aren’t quite there yet, it’s a warning that they’d better start giving more consideration to what matters to their customers.

For what it’s worth, many health care organizations do get it right when it comes to the patient experience. It shows in details such as the receptionist who brings a form to the patient in the waiting room rather than summoning him or her back to the desk. It shows in the hospital housekeeping staff who ask, “Is there anything else I can do for you?” before exiting the room. It shows in the attention being paid nowadays to privacy and dignity, to explaining things to patients before sticking needles into them or subjecting them to a procedure. It shows in more courtesy, more respect and even more interest in what patients think via surveys and feedback.

Although plenty of health care organizations already did this to some extent, it was often hit-or-miss, and it tended to be seen as an added-on nicety rather than essential. This approach doesn’t seem to cut it anymore. The PwC survey found that people were not very forgiving of bad health care experiences – so-called negative moments of truth -  and one-third said they would switch providers if they thought they would have a better experience elsewhere. For those in health care who wonder why public sentiment is sometimes so angry and hostile toward them, this finding helps partially explain why. And as reimbursement increasingly becomes tied to patient satisfaction, the patient’s experience is going to matter whether providers are ready for it or not.

There’s in fact a fair amount of ambivalence in health care about how far the patient satisfaction thing can be carried. Does it mean that the patient’s every whim should be catered to, regardless of whether it’s medically appropriate?

Give health care workers a break, grumbled a registered nurse on the Hospital Impact blog: “It is difficult enough to deal with the increased acuity of illness of the patients but the demands the families are putting on the staff, wanting extra blankets for family, water, food, etc. are taking time away from their loved one. Where does it end?”

Yet is this really what’s meant by “the patient experience”? Or does the patient experience encompass something more?

An article appearing earlier this month in American Medical News tackles this issue by talking to Dr. Mark Friedberg, an internist and researcher at RAND Corp., who says clinicians can deliver good care while also providing a good patient experience. “I don’t think it’s unreasonable to ask clinicians to meet multiple goals,” Dr. Friedberg told American Medical News. “It is possible for highly trained professionals to be excellent in all respects.”

Of many nuggets of information contained in the PwC report, one stands out: Individual attitude is everything. Providing a good patient experience is partly about organizational culture but it also comes down to individual interactions between patient and staff. A handful of people who are caring and competent in their dealings with the patient can help redeem an organization that’s mediocre when it comes to the patient experience. Likewise, one staff person’s abruptness or missteps can undo everything else the organization is doing to improve the patient experience.

It’s not clear how well this lesson has sunk in. Recent new research by HealthLeaders Media suggests that although most hospital executives see the patient experience as a priority, more than half have yet to make a specific investment in bettering the patient experience in their hospital or health care system.

That health care is even talking about the patient experience, let alone making it a priority, is a measure of the progress being made. As recently as 10 years ago, it was only beginning to register on the radar screen in a meaningful way. But expect many more negative moments of truth along the way as health care struggles to change longstanding attitudes and practices in the business of providing patient care.

2 thoughts on “Negative moments of truth

  1. So true! As a consumer, I for one will let my feet do the talking, in all the transactions I make, and this is no exception. Waitpersons who aren’t attentive cause me to not patronize that restaurant again; sales people who give “attitude” will cause me to leave without buying; and were this to happen at my healthcare provider, I’d change providers too. As it is, I choose to drive 25 miles for health care when I have a clinic right in the town where I live because I like the people in the place where I go. It helps I’ve been going there for 20-some years, plus I am now seeing some changes in this clinic’s approach to care and patient interaction as they’re adding new providers. And if I didn’t like it, I’d walk, but for now they get to keep me as a customer.

    • I think in rural communities it can be especially difficult, because if you aren’t happy with the experience, the next closest clinic or hospital might be half an hour away – not always convenient for those who don’t have reliable transportation. It’s easy for providers to assume they have a captive audience, but as your comment indicates, people can and do travel for a better health care experience somewhere else. And with payment becoming more dependent on patient satisfaction, it’s going to matter for all providers, not just those in a competitive market.

      This is probably a topic for another blog, but it would be interesting to know if it makes a difference when patients register their concern about a negative experience (I don’t like to use the word “complain” because oftentimes people are motivated by wanting to see something change, not just to complain about it). Sometimes providers genuinely aren’t aware there’s a problem, so why not give them an opportunity to fix it? On the other hand, if you’ve registered your concern and nothing happens, I guess it would say something about their commitment to patient-centered care.

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