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machado: how can we serve patients properly if we never ask them what they need?
google and amazon make it their business to know and understand the needs of their customers, yet health care — arguably the most important business on earth — has no idea what its customers need or want.
jul 10 2023
7 minute read
how can you possibly teach people how to navigate the health-care system without including someone who has actually done it? getty
“but we’ve also spent years building a business that is focused on its customers,” said the sweaty bald man in a whiny voice as he walked briskly past my house, white airpods pushed deeply into his ears. he lived a few streets over in a detached house with an impeccable garden. according to the neighbourhood grapevine, he was a successful business consultant who advised canadian technology companies.
he appeared to be attempting some version of speed-walking as he spoke, though it was clear that all his hand-gesturing and shoulder-shrugging, as he gasped out words into the air, was getting in the way of what could have otherwise been somewhat graceful form.
i was in his way, pruning a yellow rose bush that had stretched across the sidewalk.
“it’s gonna take an eye out,” joked a spicy neighbour as he stood on his porch, gesturing to my blind dog lying at my feet.
amazon and google are ranked top in customer service
as the sweaty speed-walker stepped off the curb to get around me, he sputtered a list of big-name companies into the air, among them, google and amazon. he put one hand to his ear, tilting his head and squinting as if he was having trouble hearing the person at the other end of his airpods.
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i wondered if he was talking about a recent story in forbes that put together a top 10 list of companies that provided the best customer experience (cx for the gurus). amazon was in the top spot, while google was in tenth place. and if you’ve spent any time communing with either of these giants, you may already understand why they are considered cx geniuses.
first of all, each company aims to blow the roof off in terms of service satisfaction of anyone who chooses to interact with them. amazon strives to handle customer complaints in less than an hour, offers free shipping and same-day delivery, while google offers video-calling to handle customer complaints face-to-face, it tracks and responds to customers’ social media comments as well as builds help centres that use ai to ensure the expectations of customers are both met and exceeded.
more importantly, though, is that while these strategies (there are more) may appear on the outside to be not much more than pure customer service plays (albeit successful ones), they are, in fact, valuable tools that allow these companies to not only keep up with the needs of customers, but to also be agile in their ability to shape and reshape processes and products to meet these needs, without even flinching. these companies are in the business of knowing their customers: what they buy, what they like and don’t like, what keeps them coming back.
imagine a restaurant owner sending thank-you notes to customers
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just minutes earlier, a mother i knew from my kids’ elementary school days had stopped to catch up, sharing that her eldest daughter had a job slinging cocktails at a new bar in the west end of the city. that day, she was learning how to make an old fashioned and a pimm’s cup, my friend said, adding that the learning process is a weeklong, paid.
“the owner guy likes everything to be perfect,” she said, adding that he has been known to write thank-you notes to guests, drive intoxicated customers home and draw on menus with small children so their parents could eat in peace. he even put no smoking signs at the entrance of the bar after patrons commented in the monthly survey that he sends out digitally on the smell of cigarettes and weed that wafted past the tables each time the door opened.
wow. so much effort to figure out what customers like, want and need is impressive, and certainly, it makes life easier for us — fun, even — and money for businesses. but let’s get some perspective, people. same-day delivery and a babysitter-dude during dinner are nice-to-haves, they prop up industries, the economy and grad school case studies, but they don’t contribute directly to life or death. and yet, here we are, surrounded by businesses that spend every second doing what it takes to remain relevant, while the most important operation of all, that of health care, is barely standing.
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what are we doing wrong?
you might argue that health care is not a service that most of us pay for, which leaves the brick and mortar susceptible to funding cuts, political will and yes, pandemics. we are getting what we pay for, one might say. but perhaps we need to step back, away from the dollars and cents of what it takes to save a life, and consider canada’s health-care system as a business with clients and customers who have needs, expectations and goals, just like the frazzled parents who desperately need 20 minutes of “us” time to enjoy a excellently-prepared cocktail or the dog owner whose amazon allergy medication order arrives the same day as swollen eyes do.
unlike the google and amazon customer, whose preferences and expectations are investigated, confirmed and confirmed again, what the clients of health care need and expect is virtually unknown to providers. in fact, for many health-care facilities, decisions about how to serve patients are made within private silos, without engaging the thoughts of the very people they exist to care for. other times, clients are summoned for focus groups, online surveys and advisory committees for no other reason than to simply check the “did-you-engage-patients” box.
when health care fails to meet our needs, we pay the price
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of course, it’s not always so bleak. what is, though, is the fact that if google and amazon, even the bar guy, ignored the needs of their customers and failed to meet their expectations, business would falter. but when our health-care system ignores the needs and expectations of its customers, there’s failure, absolutely, but the impact rests on the customers and their families in the form of scary things like missed diagnoses and death. and yet, we go on.
certainly, surveys and advisory boards aren’t the only ways to build valuable patient and caregiver perspectives. we could do introductions at the very beginning — connecting wannabe health-care providers with potential clients when they are still fresh-faced in medical school, psw training programs and health-care administrator courses. the sharing of perspectives and opinions of patients and caregivers at the very beginning of one’s health-care career would not only teach students what it means to offer patient care that is both effective and compassionate, but also perhaps, inspire them to make system changes as they develop their career.
it’s hard, though, not to think of this as just wishful thinking. a few years ago, i was contemplating a career change and considered a role in patient navigation at one of toronto’s hospitals. it was an experiment, the human resources person told me over the phone, explaining that the job aimed to help patients and their families make their way through the health-care system — from walking with them to their doctor’s office to explaining how to pay for medications, the patient navigator symbolized a huge step forward in patient care.
what kind of patient navigator course doesn’t include a patient?
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around the same time, i enrolled in a patient navigator certificate program at york university. in a class of about 50 people, i was the only patient in a sea of hospital administrators, nurses, and doctor’s assistants. when i suggested to the instructor that it would be helpful to have a patient share their perspective of navigating health care in canada, she smiled politely and pretended to make a note of my comment in her instructor’s manual.
earlier this year, after receiving an email from york about another patient-related course, i sent numerous notes expressing the importance of involving a patient — one to the instructor who taught the course i was in and one to the new instructor who had taken over. when she didn’t reply, i sent a note to the marketing manager (a suggestion from the first instructor), and then one to the general mailbox. after all, i wrote, how can you possibly teach people how to navigate a system without including someone who has actually done it?
after a long time, the instructor responded with a one-line email message, saying that there were no plans to change the program. that’s all she wrote. my subsequent emails to the dean went unanswered. in media, choosing not to comment can speak volumes. in this case, the lack of response from the guy who runs the program, not even to acknowledge my concerns, was a stark reminder of how much of a disconnect still exists in terms of how people perceive the role that a patient plays in successful health care. but it also confirmed — once again — how far we have to go in order to get to the customer care models of the googles and amazons. actually, who am i kidding? just considering it is a long shot.
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after all, not incorporating the patient and caregiver experience into old, inflexible systems is one thing. but refusing to acknowledge the patient and caregiver in education both as valuable learning tools, and important levers for future change, is a whole other thing.
what’s clear is that if we keep going the way we’re going, our kids will be living in a bizarre universe where parcel delivery is more efficient than a knee replacement — and that will be no fun.
lisa machado is the executive producer of healthing.
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