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Ideas, tips and techniques for new generation selling and customer support.
2009
Customer Service in Healthcare (not): An All-Too-True Story
Update: A few weeks later the hospital described here contacted me, telling me of their terrific response! Follow-up post: Customer Service in Healthcare: It’s Alive!
Original post:
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What is wrong with these people???
I’ve been having a pain lately, in an arm that shouldn’t be having pain due to a past condition. The orthopedist who took care of my bones said to get an x-ray at some local shop and send her the CD. (She’s happy to save me the time of driving into Boston, and she knows local clinics can make a good x-ray.)
So I called the radiology department of a well-known, highly rated clinic in nearby Burlington – let’s call it Elsie – to make an appointment.
(You know about appointments. They help customers get served quickly and conveniently, and help managers plan their resource utilization. The win-win thing.)
Me: “Hi. My doctor says I should get an x-ray and send her the CD. Can I do that? — Good, I’d like to make an appointment.”
Elsie staff: “Oh, you don’t need an appointment. Just come right in. I mean, you can have one if you want, but you don’t need one.”
Me: “Cool!”
Me to my manager: “I’m going over to Elsie to get an x-ray. They said I can walk right in – should be quick.”
I get there, find my way through their campus (the directions were perfect), and find radiology.
The line to check in goes out into the hall. And at the front of the line, the sign on the desk says the current wait time is 30 minutes.
I look at my watch, conclude I don’t want to wait 45 minutes (or even 30) for a “no appointment needed” x-ray, and leave.
The parking machine wants money for my ticket. I talk to the cashier and the information counter; saying I wasn’t able to get my appointment so I don’t want to pay. (I’ve been there less than 10 minutes.) Both people look at me like I’m crazy and say there’s nothing they can do. A third person says maybe security will validate it. They gladly do.
On the way out I call again.
Me: “I want to make an appointment for tonight.”
Elsie staff: “Oh, you don’t need an appointment. If you want to make one for sometime tomorrow you can.”
Me: “I can’t make one for this evening so I don’t have to wait?”
Elsie: “No…” (sounding rather uncertain about why I’d be asking)
It’s clear to me that my time is not of the least concern to this clinic. I’ve been hearing this about healthcare in general, but I know of places where they do care. (My own hospital is one of them, and I know there are others.)
I just wonder, what on earth is so complicated? I happen to know first-hand that an appointment system for a few workstations is not at all expensive. Instead, they have a line of people out into the hall – sick and injured people, typically – and they cheerfully (genuinely cheerful) say “Oh, you don’t need an appointment.”
Methinks the world of healthcare is (mostly) so wrapped up in its own importance that it doesn’t even occur to them to respect their customers’ time. And that’s gotta change.
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6 Comments
Dave deBronkart
Posted July 29, 2009 at 4:44 am | Permalink
I cross-posted this on my personal blog, and Jean-Luc Neptune, MD left a great comment
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Hi Dave –
Customer service in the health care services industry is a disaster.
I’m a doctor by training and a business guy by profession and I can tell you that in no other industry would customers (read patients) be forced to endure what you have to deal with as a patient.
I think what you (and many other people) have observed is explainable by at least three factors. First, most “administrative” people at hospitals are unfortunately not trained in basic management principles, and if they have been trained they have not usually been trained to manage in a customer-centric (i.e. patient-centric) fashion. There are some great examples of well-run health institutions (Mayo in Rochester, MN is a good example) that treat patients well and have well-managed processes, but they are the exception. I think getting more professionally trained people into administrative positions might help, as would ongoing customer service training.
Another thing you see is a lack of coordination at most hospitals and other health facilities. For the most part these health organizations tend to be very siloed and I can say that was definitely the case where I trained to be a physician. The nurses do their thing, the doctors do their thing, support staff is doing something else…you get the picture. What’s missing is a unified plan for delivering the product (say in your case the x-ray) to the customer (the patient) by having all the actors (doctors, nurses, staff) work together in the most efficient way possible. Perhaps organizing a hospital according to product lines (as some hospitals have done) might help with this problem.
Finally, a last problem that you see a lot is what I call “butt-covering and box-checking”. All too often as a healthcare provider you are forced to document A, B, and C to make sure you have complied with X, Y, and Z regulations. When this occurs and you’re plowing through paper it can be really easy as a health provider to take your eye off the ball (the patient) and focus on something that’s really tangential to the care you are providing. Regulatory streamlining might help here but there are lots of regulations that would need to be addressed to make a big change.
At the end of the day improving customer service in health care services is a huge challenge, but there’s a great opportunity out there for anyone willing to tackle the problem.
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Thanks, Jean-Luc. That sheds light on the situation, where my post itself mostly generated heat.
Steve Early
Posted July 29, 2009 at 6:38 am | Permalink
Dave:
I understand your frustration. I think there is a lot wrong with the customer service aspects of healthcare, but it is not as bad as it could be. If you hate it now, just wait’ the the government is in charge!
Steve
Dave deBronkart
Posted July 29, 2009 at 8:44 am | Permalink
So, today I went in at 8 a.m. to get my x-ray. What’s the first thing out of Elsie’s mouth?
“Do you have an appointment?”
You can’t make this stuff up…
Dave deBronkart
Posted July 29, 2009 at 12:16 pm | Permalink
his is a repeat of the previous comment due to coding errors. Apologies for any duplication.
Frank Bauer, an MD in Rochster, left a relevant comment on my personal blog:
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Businesses are always in competition. For example, I have heard that even in planned economies with fixed prices, gas stations will begin to compete on the cleanliness of their bathrooms and high-quality service.
Elsie clearly does not make a high level of customer service part of their value curve. What makes them competitive? From your post, location seemed like the biggest deal to you. Is that it or do they have other competitive advantages keeping them in business? Cost? Deals with insurance companies? Location? Or is it just the case that you had no other options?
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Here’s an interesting thing, Frank: there are LOTS of signs throughout that clinic that they do think about the customer experience. Plenty of volunteers around, clear navigation signs on how to get places, etc. It’s apparent that a lot of people put a lot of thought into helping their customer/patients.
So it’s not that they’re being doofuses – far from it. And as for what drew me to them – it was a combination of convenience and reputation for excellence. I’m not interested in schlock just because it’s nearby.
My point in all this is just that with all their good work, it still apparently hasn’t dawned on them that letting me do self-service appointment picking would be a truly valuable convenience for the customer’s time.
Oddly, when I went back this morning, it was apparent that they do have some sort of appointment system, or maybe it’s just simple queueing (first come first served). In that case, they could do what many restaurants do: let you call ahead. (Some emergency rooms are letting you do that now.)
I think I’ll try to contact management there. Now that this has gotten thoughtful, I’ve got something more useful to say than just yesterday’s rant.
Dave deBronkart
Posted July 29, 2009 at 1:16 pm | Permalink
When you’re hot, you’re hot: management gurus Clay Christensen and Jason Hwang just wrote an op-ed in today’s Wall Street Journal, How CEOs Can Help Fix Health Care. As always their thinking goes straight to the structural issues that keep costs high or drive costs down.
In this case they point out the economic damage of long waits for healthcare. They recommend that CEOs encourage the use of retail clinics like Minute Clinic, pointing out that “Retail clinics have made convenience a key part of their sales pitch by offering walk-in, no-wait visits” and “Retail clinics would help reduce the absenteeism related to the time it normally takes to schedule an appointment, see a doctor and fill a prescription.”
My point here is that there are real consequences – to employers as well as employees – from avoidable waiting. I mean, look: yesterday I would have wasted 45 minutes (of my time if unpaid, my employer’s if paid) waiting in line, when I actually tried to pick an available time.
When it gets to the point where a big-time management guru is writing about the issue in the WSJ, with solid reasoning that matches our common-sense experience, I humbly suggest it’s time to wake up and get smarter.
Dave deBronkart
Posted July 29, 2009 at 2:04 pm | Permalink
Next chapter: my bone doc had said “Send me the CD” (with the new images). I said “Heck with that!” and zipped it up and delivered it via http://www.YouSendIt.com, which delivers 100MB files for free.
Modern. Efficient. Cheap. Fast.
(I could have done it immediately if the Elsie Clinic offered free wifi in the lobby, as my regular hospital does. (It’s Beth Israel Deaconess.) But still, I got it to the doc 24 hours faster, without a post office trip and without spending.)