Should Hospitals Treat Patients as Customers, Partners or Both?

In an increasingly competitive healthcare environment, hospitals are seeking new ways to attract and retain patients. In addition, now that patient satisfaction is tied to reimbursement under value-based purchasing, hospitals are beginning to think of and treat patients as customers. Some hospitals, for example, have developed hotel-like amenities to create a comfortable environment.

At the same time, hospitals are becoming more patient- and family-centered, focusing on involving patients in making decisions about their care. In a partnership, the partners are assumed to have equal standing, while in a customer-focused relationship, the customer is typically at a slightly higher level and is "always right." Are these two concepts — patient as customer and patient as partner — contradictory? Or are they different sides of the same coin?

Stephen C. Schimpff, MD, professor of medicine and public policy at the University of Maryland School of Medicine and former CEO of the University of Maryland Medical Center, both in Baltimore, explains how hospitals should be both patient-centered and customer-focused to succeed in today's healthcare environment.

Patient as customer: "Rising tide of consumerism"
Hospitals are shifting to a more customer-focused culture not only because of healthcare reform provisions, but also because patients themselves are changing and forcing hospitals to respond. There is a "rising tide of consumerism" in which patients are becoming more demanding of hospitals, Dr. Schimpff says. "The patient doesn't want to be patient any longer. Hospitals and doctors need to recognize this," he says.

The number one demand of patients, Dr. Schimpff says, is respect. "More than anything else, they want to be respected. Unlike in the past, if a patient doesn't get this sense of respect and the sense that you're doing things around their needs rather than your needs, [he or she is] going to go somewhere else."

One way hospitals can demonstrate respect for patients is to be responsive to their needs. For example, hospitals should ensure all physicians, nurses and staff are easily accessible for appointments and are able to communicate with patients at their level — using email and text messaging if necessary, Dr. Schimpff says. This attention and respect can help hospitals avoid losing patients, and their payment, to other healthcare organizations.  

"We as providers need to consider the patient as our customer," Dr. Schimpff states. "Another way of saying that is 'who's paying the bill?' I know the patient's paying the bill, paying my salary." A mistake that some people make is overlooking the patient as a customer in favor of the insurance company, according to Dr. Schimpff; a hospital employee may see the patient "as a person who paid insurance and it is the insurer that is going to pay the bill." Ultimately, however, the opportunity to receive payment depends on attracting patients to the hospital, and that means treating them with respect and as a customer.

Patient as partner: Understanding patients' needs

As hospitals recognize patients as customers who have a choice of where to seek care, they also need to treat patients as necessary partners in their care. One of the triple aims of healthcare reform is improving population health, which requires the engagement of patients in making healthy decisions. Furthermore, patients want to be partners with their healthcare providers, Dr. Schimpff says.

Hospitals can create a partnership between their providers and patients by offering multidisciplinary team-based care that takes patients' individual needs into account when developing treatment plans. For example, Dr. Schimpff says for a single working mother who developed breast cancer and needs chemotherapy, the treatment team can offer appointments late in the afternoon Fridays or on the weekend so the patient does not have to miss work. "Understand what [patients'] needs, frustrations and anxieties are, and then discuss how you're going to deal with it," he says.

As in a customer-focused approach, a patient-centered approach can bring in more patients and more revenue. Partnering with patients in managing chronic diseases, for instance, is particularly important because these patients have more of a choice in where they receive care compared with patients in emergency situations. "If you're hit by a car and a helicopter picks you up and [brings] you to a trauma center, you don't have a lot of choice, and that's okay," Dr. Schimpff says. "With a chronic illness, there's more time and I do have a choice and I will make it."

Patient as customer and partner: Transforming care

Hospitals, and their affiliated physicians, should think of patients as both customers and partners to deliver a positive experience and high-quality care. By treating patients as customers, hospitals and physicians can earn their business and respect; by treating patients as partners, hospitals can provide more individualized care. "You have to think about the patient as both a customer and as a partner. And in doing so, I think these are really transformational changes in healthcare," Dr. Schimpff says.

More Articles on Hospital Strategy:

4 Marketing Tactics to Engage Healthcare Consumers
IHI Suggests Measures for Tracking Progress in Healthcare Reform Goals

6 Considerations Unique to Children's Hospitals in the Drive to Greater Healthcare Value

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