Chuck Lauer: Leadership for Great Customer Service

It’s a jungle out there, so it’s time to treat patients as if they are your lifeblood. Trust me; they are.

The first edition of "Leadership for Great Customer Service" was published only a decade ago, and yet it seems like an epoch as distant as the Pleistocene. In 2004, the notion that treating patients as human beings was good for business as well as outcomes was still relatively new. In fact, there was fierce resistance to paying much attention to patient satisfaction, which was often dismissed as irrelevant whimpering about dirty rooms and rude, incommunicative nurses. Healthcare meant the important business of clinical quality, end of story.  chucklauer
In 2014 the resistance from some clinicians remains, but the tectonic plates underneath this industry are shifting, creating an entirely new landscape. The regulatory environment is now suffused with terms such as value-based purchasing, HCAHPS and the patient experience of care. Accountable care organizations, medical homes and bundled payment networks – the delivery mechanisms for population health management – require keeping patients loyal and in network in order to have any chance of success.
The economic terrain is also seismically unstable, as new competitors emerge in the form of retail clinics, hospitals at home and mobile health solutions. Employers are pushing workers into high-deductible health plans, and the new marketplace plans under reform also take more from people’s pocketbooks.
Consumers now have a world of choices in accessing the care delivery system and are far more cost-conscious. They are going to be making decisions based in large measure on how they feel about their prior experiences. That means hospitals, health systems, medical practices and ambulatory care providers had better get with the program of good customer service as a core strategy for survival.
It’s a jungle out there, so it’s time to treat patients as if they are your lifeblood. Trust me; they are.
In this concise, penetrating and entertaining update of their earlier work, Drs. Thom Mayer and Robert Cates show how patients have come to expect both clinical quality and service quality, which are inextricably linked. Numerous studies now underscore this connection. Patients who experience a dirty room often are in a hospital with high rates of infections. Outcomes are affected when patients feel mistreated, no matter how appropriate or “successful” the clinical treatment.
Gaining buy-in from hospital employees for any new customer service initiative is critical, the authors show. They ought to know, having conducted hundreds of customer service training sessions in hospitals. They use the analogy of “renters” versus “owners” to describe the mental shift required to incorporate service principles into the daily routine of care. Owners are fully engaged in the organization’s success and view their roles as “responsibilities.” Renters are those who just show up and do the minimum to get paid, viewing their roles as “jobs.” Mayer and Cates make it clear that selecting people with positive attitudes and giving them the right training is essential.
Full disclosure: The good doctors are singing my tunes. I have been writing about the importance of good customer service in healthcare and other industries for decades. Like Mayer and Cates, I am fanatical about the importance of true servant leadership. They demonstrate how the CEO needs to explain why customer service is important to frontline caregivers as well as how to get service right. Without giving away too much, they show how it makes everyone’s job easier, not harder, to treat patients with empathy and caring.
A good friend of mine, Paul Spiegelman, along with his co-author, Britt Berrett, recently published a book entitled "Patients Come Second." In their introduction they acknowledge that their title is controversial, but it reflects the importance of focusing first on healthcare workers, engaging them openly and honestly about the “why” of customer service. Some of them may never “get it,” but most should feel energized when they understand the link to making their jobs more fulfilling and patient outcomes better.
Another way to think about this was provided by Terry Mulligan, who for years led sales for American Hospital Supply Co. when it was the premier supplier of medical products to hospitals all over the world. Mulligan told me he would often ask his salespeople whom they reported to, and they would always come up with the name of their supervisor. He told them in no uncertain terms that the people they really reported to should always be their customers. After all, without customers buying products no company could stay in business very long.
The same concept should apply within health systems, but if you asked people in this industry who their boss is, almost all would say the chief medical officer or the head nurse or the CEO. We hear so much about patient-centered care, and I have no doubt for some people and organizations that is really their mission. But viewing the patient as the boss takes things to a different level.  
I have watched patients and families walk into the lobby of a hospital, looking anxious and uncertain of where to go. When they ask a passing hospital employee where outpatient surgery or radiology is, the employee wordlessly points down a long corridor filled with signs and doorways. When the patient is your boss, you escort her down the hallway, introduce her to the person she needs to see and thank her for the opportunity to serve her needs. Only then do you return to your previous task.
A woman named Sharon Brooks did that for me. I was at Rush University Medical Center in Chicago, having blood drawn for my upcoming hip replacement surgery. It was the first of two trips for the same purpose, and I have to admit I was a little nervous. Prior to giving blood I had to register at the admitting desk. Usually when I go through that bureaucratic process I wind up offended. Often there is little eye contact, and no reassuring smile or other personal touch at a time when you could use it. But at Rush,  Sharon not only smiled, she took care of me. She gave me strips of stickers that say “Smiles are Contagious – Catch One!” She was so full of energy, enthusiasm and goodwill I couldn't help noticing.
But that was only the beginning. After she got all the information she needed, she got out a machine that blew soap bubbles. Everyone in the admitting area was smiling, even those who were clearly there for something far more serious. Whatever the hospital pays Sharon, it isn’t enough. She has probably done more for the image of the hospital than any expensive advertising campaign could do.
The people who study customer service call my interaction with Sharon a “moment of truth.” That's when an individual first comes into contact with an organization, whether it is a pizza parlor, a physician's office or a Fortune 500 company. The way you are treated at that moment is usually the impression you have of that organization until someone takes a great deal of effort to change it. If you are treated rudely, you won’t forget it.
"Leadership for Great Customer Service" is about more than just how to make a good first impression. It is about how to create a culture where everyone from the housekeeper to the CEO views the mission of the organization to be the delivery of the highest quality care – for both body and spirit. Healthcare providers that really understand this message will be the ones left standing when the earth stops shaking.


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