Who's the primary customer for healthcare services?

Over the past few months I’ve been doing my fair share of online shopping. Unfortunately, I’ve had a few hiccups too like parcels going missing and incorrect sizing. Thankfully though in each occurrence I’ve been greeted with amazing customer service. The kind of service where they tell you “you don’t have to worry about that, you’re the customer”. The kind of service that makes you want to go back to them again regardless of things going amiss this time.

With the exception of my dentist, my last few encounters with healthcare services have felt far from this. They’ve left me feeling like the care providers couldn’t really care less about my overall experience. Don’t get me wrong, the clinical care was adequate and they seemed to perform their professional duties competently, but the customer service totally sucked. But I’ll go back to each of these services again for two reasons (and I’m sure they know it): they’re convenient, and their competition isn’t much better.

I find this interesting, because the word customer is often looked down upon by healthcare professionals. I’ve come across many who get quite indignant at the suggestion that they have customers or read a report referencing healthcare consumers because they feel patient invokes a higher level of relationship.

While I firmly believe that a therapeutic relationship transcends the relationship that exists within a typical commercial transaction, I also wonder if patient is a word that is is a bit too easy for healthcare professionals to hide behind.

If you were working in another small business, would it be ok to treat your customers with a paternalistic attitude? Would you expect people to be loyal to you even though you treated treat them with disregard when communicating with you? Would you think it OK to just gloss over things when they go awry or would you fear the reviews? Of course not. Because you know that your customers are your livelihood.

It might be uncomfortable to think about, but I think there are many cases in healthcare where even though we treat/consult with patients, they service model isn’t designed to treat them as the primary customer. Rather, its the funding body, the referrer, or institution.

This article from Harvard Business Review captures some of the issues underpinning this really well. The gist of it is that with any business there are many different people/funders/other businesses that can be considered customers. But the business can’t be designed to optimise the experience for all of these different customers at the same time.

It presents what it describes as “a truly customer-driven framework” to help inform the development of effective business models. It outlines four steps: identifying the best primary customer, creating processes to learn what that customer values, allocating resources accordingly, and building an interactive control process to monitor the assumptions that underlie your choice. I’m not going to go into it in depth, but it’s an interesting read regardless of whether you’re in private care or not.

Because when it comes down to it, terms like “person-centred care” and “patient-centric” can be thrown around all you like, but they mean very little unless the service models actually treat the patient/healthcare consumer as the primary customer.

People know they get better customer service from Amazon than most of their healthcare providers. That should make us very uncomfortable and want to do something about it.