Improving Patient Satisfaction: Lessons from 18,000 Feet

First Customer Service Representative?

Your call is important to us.  Please listen carefully because our options have changed.

Reader query: During your current or any prior lifetime, has any phone menu option ever changed?

I have more than once experienced an option not offered on the robotic phone menu option choices - a dead phone line after a 30 minute wait.

Have you tried this customer plea as I have?  Could you pretty-please jot down my cell phone number in the event that we are disconnected?  Here are some of the responses one might expect from such in insolent request.

• Are you joking?
• I would but I think it's illegal.
• Sorry, our phone bank only receives incoming calls.
• No, but if you prefer, I can transfer your call to our grievance hotline. Just click on option #17.
• Uproarious laughter from the entire phone bank who heard my request on speaker.

As I write this, I am at 18,000 feet in a propeller plane that I trust will land safely in Cleveland.  Hopefully, the air traffic controllers are all awake and alert. I'm flying in from Canada where my mom and I observed how indifferent the airline and customs personnel were to the plights of the passengers.  Regrettably, this level of  'customer service' isn't restricted to our neighbor to the north.  Air travel isn't much fun these days for anyone anywhere.

I'm sure the airline folks are as hassled as we travelers are.  Would you want to face angry and frustrated passengers each day when you are powerless to remediate their complaints?  At times, the lines of happy travelers at the customer service desk in the airport for lucky folks who have missed flights or lost luggage reminds me of the lines I endured at Disney World.  This analogy is apt since both sets of lines lead to adventure!

Here are my observations as an airline customer.

• I do not feel that my business is appreciated.
• Reaching a living, breathing human being on the phone should only be attempted if a physician has cleared you for this activity. Cardiac patients need not apply.
• Flexibility to adapt to customers' needs or to changes in circumstances have been left out of the playbook.
• Fees charged to make even the most trivial change in ticket reservations are unconscionable.
• No obvious regard for the value of customers' time with regard to flight delays.
• Service on board?  Now we passengers can ask, 'are you joking?'
• Dissatisfied customers have no recourse.  In other spheres of the marketplace, if we are not treated well, we dump them and walk down the street to a competitor.

There are lessons here for the medical profession and for our patients.  Fortunately, patients and physicians enjoy much better partnerships than do airline industry have with its customers.  But, our relationships with patients have been challenged from many internal and external forces. How are we doing in with regard to patient satisfaction?   What do our patients say?  While there are many legitimate reasons why high levels of patient satisfaction are more diffiicult to achieve today, patients still deserve our best effort and outcome.  I am skeptical that pay-for-performance and similar efforts are the right tools to get this job done.  When your only tool is a hammer, than physicians start to look a lot like nails.  Haven't we been hammered enough?

While it is a generalization, I believe that private practice medicine - like any private business - has stronger incentives to provide high levels of patient satisfaction.  Employed physicians, the emerging dominant model for doctors, may not be as vested in catering to their customers, although I know there will be disagreement here.  For employed physicians, their sense of patient satisfaction may be feedback survey results from patients, which will be reviewed by their supervisors and placed in their personnel files.  Private practitioners, in contrast, may be more concerned with pleasing the patient directly than in pleasing the survey. This difference may appear subtle, but I believe it is substantive.  In the same way that teachers are criticized for teaching to the test, physicians who must answer to bean counters may be practicing medicine with an eye toward the survey.  This can lead to gaming the system. 

As I noted on a prior post, the airline industry has taught the medical profession important lessons on medical check lists.  I don't think, however, they have much to teach us about customer service.  If you disagree, give them a call for some pointers on how to soothe seething passengers.  Remember, your call is important to them.